{
    "abstract": "Does hormone stimulation during assisted reproductive technology (ART) treatment increase the risk of ovarian cancer?\nNo increased risk of ovarian cancer was found among ART-treated women, with the exception of ART-treated women with endometriosis.\nPrevious studies on the association between ovarian stimulation during ART and ovarian cancer have shown conflicting results. The risk of ovarian cancer varies according to the cause of infertility, and only a few studies on ART treatment and risk of ovarian cancer have had sufficient data to address this issue. Endometriosis has been linked to an increased risk of ovarian cancer.\nWomen undergoing ART treatment during 1994-2015 were registered in the Danish IVF register. Data were linked with data from the Danish Cancer Register and socio-demographic population registers using an individual person identification number assigned to people residing in Denmark.\nAll women undergoing ART treatment were age-matched with a random sample of the female background population and followed for up to 22\u00a0years. After relevant exclusions, the population consisted of 58\u2009472 ART-treated women and 625\u2009330 untreated women, all with no previous malignancies. Ovarian cancer risk was assessed using multivariable cox regression analyses with adjustment for educational level, marital status, parity and treatment year. Results are shown as hazard ratios (HRs) with corresponding CIs.\nIn total, 393 (0.06%) women were diagnosed with ovarian cancer during follow-up (mean 9.7\u00a0years). Women treated with ART had an increased risk of ovarian cancer (HR 1.20, 95% CI 1.10-1.31), which diminished over time. The increased risk was apparent among women with female factor infertility (HR 1.36, 95% CI 1.25-1.48), whereas no female factor infertility was associated with a lower risk (HR 0.87, 95% CI 0.76-1.00). The risk was increased among women with endometriosis (HR 3.78, 95% CI 2.45-5.84), whereas no increased risk was found among ART-treated women with polycystic ovary syndrome, other female causes of infertility and unexplained infertility.\nThe association between ART treatment and ovarian cancer is likely influenced by increased detection due to multiple ultrasound scans during ART treatment.\nUndergoing ART treatment without the presence of endometriosis was not associated with an increased risk of ovarian cancer, which is reassuring. Whether ART treatment increases the risk of ovarian cancer among women with endometriosis needs further investigation.\nThis work was supported by a PhD grant to D.V. from the Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. Funding for establishing the Danish National ART-couple II cohort was achieved from Ebba Rosa Hansen Foundation. The funders had no influence on data collection, analyses or results presented. The authors have no conflicts of interest to declare.",
    "authors": [
        {
            "affiliation": "Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen K, Denmark.",
            "firstname": "D",
            "initials": "D",
            "lastname": "Vassard"
        },
        {
            "affiliation": "Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen K, Denmark.",
            "firstname": "L",
            "initials": "L",
            "lastname": "Schmidt"
        },
        {
            "affiliation": "Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen NV, Denmark.",
            "firstname": "C H",
            "initials": "CH",
            "lastname": "Glazer"
        },
        {
            "affiliation": "Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen K, Denmark.",
            "firstname": "J",
            "initials": "J",
            "lastname": "Lyng Forman"
        },
        {
            "affiliation": "Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen K, Denmark.",
            "firstname": "M",
            "initials": "M",
            "lastname": "Kamper-J\u00f8rgensen"
        },
        {
            "affiliation": "Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, DK-2100 Copenhagen \u00d8, Denmark.",
            "firstname": "A",
            "initials": "A",
            "lastname": "Pinborg"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",
    "doi": "10.1093/humrep/dez165",
    "journal": "Human reproduction (Oxford, England)",
    "keywords": [
        "ART treatment",
        "assisted reproduction",
        "cohort study",
        "endometriosis",
        "epidemiology",
        "infertility",
        "observational study",
        "ovarian cancer",
        "ovarian hormone stimulation",
        "polycystic ovary syndrome"
    ],
    "methods": null,
    "publication_date": "2019-10-11",
    "pubmed_id": "31600391",
    "results": null,
    "title": "Assisted reproductive technology treatment and risk of ovarian cancer-a nationwide population-based cohort study.",
    "xml": "<Element 'PubmedArticle' at 0x788504903b50>"
}