Controlled ovarian hyperstimulation for IVF: impact on ovarian, endometrial and cervical cancer—a systematic review and meta-analysis

Siristatidis, Charalampos; Sergentanis, Theodoros N.; Kanavidis, Prodromos; Trivella, Marialena; Sotiraki, Marianthi; Mavromatis, Ioannis; Ψαλτοπούλου, Θεοδώρα; Skalkidou, Alkistis; Petridou, Eleni

doi:10.1093/humupd/dms051

Cited by 146 publications

(95 citation statements)

References 167 publications

(211 reference statements)

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“…85 Finally, a recent published meta-analysis study that evaluated 9 cohort studies and involved a total sample size of 109,969 women exposed to IVF showed a significant positive association between IVF and endometrial cancer, but when infertile women were used as a reference group, this association no longer existed. 33 …”

Section: Endometrial Cancer and Ivfmentioning

confidence: 99%

Reproductive Factors and the Risk of Endometrial Cancer

Ali

2014

Int J Gynecol Cancer

107

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Endometrial cancer is the most common malignancy of women in developed countries, and its incidence is 10 times higher than in developing countries. Endometrial cancer is most common in the sixth and the seventh decades of life; thus, postmenopausal women have a higher risk of developing the disease compared with premenopausal women. The increased incidence and prevalence of endometrial cancer can be explained by the increase in life expectancy, increased caloric intake, increased obesity rates, and other changes in lifestyle and reproductive factors. Among the reproductive factors, the risk of endometrial cancer is positively correlated with a younger age at menarche and late age at menopause, infertility, null parity, age of the first child, and long-term use of unopposed estrogens for hormone replacement therapy. Protection against endometrial cancer has been detected with increase parity, the use of combined oral contraceptives, and increased age of women at last delivery. The relationship between endometrial cancer risk and miscarriage, abortion, ovulation induction drugs and in vitro fertilization is still controversial.

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Section: Endometrial Cancer and Ivfmentioning

confidence: 99%

Reproductive Factors and the Risk of Endometrial Cancer

Ali

2014

Int J Gynecol Cancer

107

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“…COS is performed to improve cumulative pregnancy rates during assisted reproductive technologies (ART) as it leads to the development and maturation of many follicles and oocytes [7]. However, this stimulation is related to supraphysiologic hormonal levels that are associated with modifications in the periimplantation endometrium [8,9], biochemical and morphologic endometrial alterations, and endometrial advancement [10,11].…”

Section: Introductionmentioning

confidence: 99%

Freeze-all cycle for all normal responders?

Roque

Valle

Guimarães

et al. 2016

J Assist Reprod Genet

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Purpose The purpose of this study is to evaluate the freeze-all strategy in subgroups of normal responders, to assess whether this strategy is beneficial regardless of ovarian response, and to evaluate the possibility of implementing an individualized embryo transfer (iET) based on ovarian response. Methods This was an observational, cohort study performed in a private IVF center. A total of 938 IVF cycles were included in this study. The patients were submitted to controlled ovarian stimulation (COS) with a gonadotropin-releasing hormone (GnRH) antagonist protocol and a cleavage-stage day 3 embryo transfer. We performed a comparison of outcomes between the fresh embryo transfer (n = 523) and the freezeall cycles (n = 415). The analysis was performed in two subgroups of patients based on the number of retrieved oocytes: Group 1 (4-9 oocytes) and Group 2 (10-15 oocytes). Result(s) In Group 1 (4-9 retrieved oocytes), the implantation rates (IR) were 17.9 and 20.5% (P = 0.259) in the fresh and freeze-all group, respectively; the ongoing pregnancy rates (OPR) were 31 and 33% (P = 0.577) in the fresh and freezeall group, respectively. In Group 2 (10-15 oocytes), the IR were 22.1 and 30.1% (P = 0.028) and the OPR were 34 and 47% (P = 0.021) in the fresh and freeze-all groups, respectively. Conclusion(s) Although the freeze-all policy may be related to better in vitro fertilization (IVF) outcomes in normal responders, these potential advantages decrease with worsening ovarian response. Patients with poorer ovarian response do not benefit from the freeze-all strategy.

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“…5 In our most recently published meta-analytical approach on the topic, 8 we attempted to maximize the caution regarding the degree of overlap between studies, as well as about other elaborate issues pertaining to the interpretation of findings, such as the notion of reference category, separate effect estimates including and excluding the first year of follow-up, adequateness of the whole follow-up period, and de novo calculation of indices pertaining to effect size. Indeed, the approach to the interplay between IVF and cancer risk may be a methodologically challenging field, the nuances of which may considerably affect the size and interpretation of study findings, that is, why it should be handled with caution.…”

Section: Methodological Remarks On the Recent Meta-analysis Examiningmentioning

confidence: 99%

Response on

Piek

2013

International Journal of Gynecological Cancer

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Controlled ovarian hyperstimulation for IVF: impact on ovarian, endometrial and cervical cancer—a systematic review and meta-analysis

Cited by 146 publications

References 167 publications

Reproductive Factors and the Risk of Endometrial Cancer

Reproductive Factors and the Risk of Endometrial Cancer

Freeze-all cycle for all normal responders?

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