D Farhud Dariush, Zokaei Shaghayegh, Keykhaei Mohammad, Zarif Yeganeh Marjan
School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Basic Sciences, Iranian Academy of Medical Sciences, Tehran, Iran.
Iran J Public Health. 2019 Dec;48(12):2124-2132.
In-vitro fertilization (IVF) has been very popular since the birth of the first "test-tube" baby. This method is the last hope and the most serious solution for couples with infertility problems. Although childbearing is a concern of many couples, it must always be noted that any method can also have disadvantages. Thus, many studies have been done on the problems encountered by this method.
We searched for relevant articles in Pub Med, Springer, Elsevier, and Google Scholar databases, and studied more than 70 papers. Keywords used included ovarian cancer, in vitro fertilization, gonadotropin hormone, clomiphene citrate, and infertility.
Due to the large number of studies, high doses of the ovulation-stimulating drugs and their repeated use in this method can increase the risk of the ovarian hyper stimulation syndrome (OHSS), and ovarian cysts, which can lead to ovarian cancer. Also, an increase in the risk of developing ovarian cancer can be due to the increased duration of treatment for up to 12 months and the high doses of medications that are followed by defecation and failure of this treatment.
Due to the increase in the rates of infertility treatments and the incidence of gynecological cancers, especially ovarian cancer, this method need to be used with caution. IVF clients and candidates should be informed about potential future risks. People should be evaluated genetically for their history of ovarian cancer and be more aware of the importance of "Personalized medicine".
自首例“试管婴儿”诞生以来,体外受精(IVF)一直非常流行。这种方法是不孕夫妇的最后希望和最有效的解决方案。尽管生育是许多夫妇关心的问题,但必须始终注意到任何方法都可能有缺点。因此,针对这种方法所遇到的问题已经进行了许多研究。
我们在PubMed、Springer、Elsevier和谷歌学术数据库中搜索了相关文章,并研究了70多篇论文。使用的关键词包括卵巢癌、体外受精、促性腺激素、枸橼酸氯米芬和不孕症。
由于研究数量众多,这种方法中高剂量的促排卵药物及其反复使用会增加卵巢过度刺激综合征(OHSS)和卵巢囊肿的风险,进而可能导致卵巢癌。此外,患卵巢癌风险的增加可能归因于长达12个月的治疗时间延长以及高剂量药物治疗后出现排便和治疗失败的情况。
由于不孕治疗率的上升以及妇科癌症尤其是卵巢癌的发病率增加,这种方法需要谨慎使用。应告知体外受精的客户和潜在对象未来可能存在的风险。人们应该根据其卵巢癌病史进行基因评估,并更加意识到“个性化医疗”的重要性。