Ayhan Ali, Salman Mehmet Coskun, Celik Husnu, Dursun Polat, Ozyuncu Ozgur, Gultekin Murat
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Hacettepe, Ankara, Turkey.
Acta Obstet Gynecol Scand. 2004 Dec;83(12):1104-11. doi: 10.1111/j.0001-6349.2004.00669.x.
Ovulation-inducing drugs have been widely used for various types of infertility since the beginning of 1960s and their use increases day by day parallel to the success achieved in fertility treatment. However, the researches performed in the last two decades have begun to discuss about the safety of these drugs and the risks associated with their use. Especially, the potential neoplastic effects of these drugs are increasingly questioned. The studies have discussed whether there is an association between the exposure to ovulation-inducing drugs and the incidence of various cancers. Moreover, several studies have been performed to reveal whether there is an increased risk of childhood cancers in children conceived after fertility treatment. The point we reached through the available data is that the risk of breast, uterine and invasive ovarian cancers is not increased, but the risk of borderline ovarian tumors might increase after such a therapy. The risk of cancer has been found similar for children conceived after fertility treatment and those conceived naturally. It should also be kept in mind that cancers are overdiagnosed in infertile women population because of the close medical surveillance, which may also contribute to the early detection of cancers. Although it is still early to state the last words on this topic, the possible association should be addressed when obtaining an informed consent before starting treatment.
自20世纪60年代初以来,促排卵药物已被广泛用于各种类型的不孕症治疗,并且随着生育治疗取得的成功,其使用量日益增加。然而,过去二十年进行的研究已开始讨论这些药物的安全性及其使用相关的风险。特别是,这些药物潜在的致癌作用受到越来越多的质疑。研究探讨了接触促排卵药物与各种癌症发病率之间是否存在关联。此外,还进行了多项研究,以揭示接受生育治疗后受孕的儿童患儿童期癌症的风险是否增加。通过现有数据我们得出的结论是,乳腺癌、子宫癌和浸润性卵巢癌的风险并未增加,但这种治疗后交界性卵巢肿瘤的风险可能会增加。接受生育治疗后受孕的儿童与自然受孕的儿童患癌症的风险相似。还应牢记,由于密切的医疗监测,不孕症女性人群中癌症存在过度诊断的情况,这也可能有助于癌症的早期发现。尽管就此话题下定论还为时过早,但在开始治疗前获取知情同意时,应提及可能的关联。