Si Manfei, Wang Xiaoxiao, Song Xueling, Long Xiaoyu, Qiao Jie
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.
National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.
Biomedicines. 2023 Jun 26;11(7):1835. doi: 10.3390/biomedicines11071835.
Whether infertility drug exposure increases the risk of borderline ovarian tumors (BOTs) remains controversial. The present study was conducted with a comprehensive search for studies published from January 1990 to December 2021 in the online databases Cochrane Library, PubMed, Web of Science and EMBASE. We considered the first diagnosis of a BOT as the primary outcome. The odds ratio (OR) was calculated with corresponding 95% confidence intervals (CIs) for the risk of BOTs in patients who were treated with infertility drugs. Ten studies, a total of 2,779,511 women, qualified for inclusion in this meta-analysis. The pooled OR of 1.56 (95% CI: 1.09-2.22) revealed a significant positive association between infertility drugs and an increased risk for BOTs, but for specific drugs, only CC plus Gn had statistical significance. No publication bias was detected using the Egger and Begg tests ( > 0.05). A significant difference in BOT incidence was observed among infertile women and nulliparous women who were treated with or without infertility drugs. In conclusion, the use of infertility drugs may increase the risk of BOTs, but a dose-dependent relationship was not observed between the number of assisted reproduction technology cycles and the risk of BOTs, and infertile women who successfully became pregnant might have a reduced risk. Registration: PROSPERO, CRD42022330775.
不孕不育药物暴露是否会增加卵巢交界性肿瘤（BOTs）的风险仍存在争议。本研究全面检索了1990年1月至2021年12月在在线数据库Cochrane图书馆、PubMed、科学网和EMBASE上发表的研究。我们将BOT的首次诊断视为主要结局。计算了使用不孕不育药物治疗的患者发生BOTs风险的比值比（OR）及相应的95%置信区间（CIs）。十项研究，共2,779,511名女性，符合纳入本荟萃分析的条件。汇总的OR为1.56（95%CI：1.09 - 2.22），表明不孕不育药物与BOTs风险增加之间存在显著正相关，但对于特定药物，只有克罗米芬（CC）加促性腺激素（Gn）具有统计学意义。使用Egger检验和Begg检验未检测到发表偏倚（>0.05）。在接受或未接受不孕不育药物治疗的不孕女性和未生育女性中观察到BOT发病率存在显著差异。总之，使用不孕不育药物可能会增加BOTs的风险，但未观察到辅助生殖技术周期数与BOTs风险之间存在剂量依赖关系，成功怀孕的不孕女性风险可能会降低。注册信息：PROSPERO，CRD42022330775。
