目的:探讨促排卵药物与卵巢癌的关系。
方法:系统评价和荟萃分析。
方法:不适用。
方法:曾经或从未接受过卵巢诱导的无卵巢癌妇女。
方法:对以下数据库进行了广泛的电子搜索:PubMed,EMBASE,MEDLINE,谷歌学者,Cochrane图书馆和CNKI,从成立到2022年1月。共有34项研究符合我们的纳入标准,并被纳入最终的荟萃分析。使用比值比(OR)和随机效应模型来估计合并效应。采用纽卡斯尔-渥太华量表评估纳入研究的质量。漏斗图和Egger检验用于评估发表偏倚。
结果:排卵诱导(OI)组和对照组(CT)之间新诊断的交界性卵巢肿瘤(BOT)和浸润性卵巢癌(IOC)考虑到生育结果,OI周期和特定的OI药物。
结果:主要是,OI组和CT组之间IOC和BOT的发生率没有显着差异。其次,OI治疗并没有增加多胎妇女IOC和BOT的风险,它也没有增加未分娩妇女的IOC风险。然而,在接受OI治疗的未产妇中,BOT的风险似乎更高.第三,在暴露于OI的女性中,未产女性的IOC和BOT风险高于多产女性.第四,IOC的风险没有随着OI周期的增加而增加.最后,暴露于特定OI药物也不会增加IOC和BOT的风险.
结论:总体而言,OI治疗并没有增加大多数女性IOC和BOT的风险,无论OI药物类型和OI周期。然而,接受OI治疗的未产妇女患卵巢癌的风险更高,需要对其进行严格的监测和持续的后续行动。
OBJECTIVE: To explore the association between ovulation induction drugs and ovarian cancer.
METHODS: Systematic
review and meta-analysis.
METHODS: Not applicable.
METHODS: Women without ovarian cancer who ever or never underwent ovarian induction.
METHODS: An extensive electronic search of the following databases was performed: PubMed, EMBASE, MEDLINE, Google Scholar, Cochrane Library and CNKI, from inception until January 2022. A total of 34 studies fulfilled our inclusion criteria and were included in the final meta-analysis. The odds ratio (OR) and random-effects model were used to estimate the pooled effects. The Newcastle-Ottawa Scale was used to assess the quality of included studies. Funnel plots and Egger tests were used to assess publication bias.
RESULTS: New diagnosed borderline ovarian tumor (BOT) and invasive ovarian cancer (IOC) between ovulation induction (OI) group and control (CT) group considering fertility outcome, OI cycles and specific OI drugs.
RESULTS: Primarily, there was no significant difference in the incidence of IOC and BOT between the OI and CT groups. Secondly, OI treatment did not increase the risk of IOC and BOT in the multiparous women, nor did it increase the risk of IOC in the nulliparous women. However, the risk of BOT appeared to be higher in nulliparous women treated with OI treatment. Thirdly, among women exposed to OI, the risk of IOC and BOT was higher in nulliparous women than in multiparous women. Fourthly, the risk of IOC did not increase with increasing OI cycles. Lastly, exposure to specific OI drugs also did not contribute to the risk of IOC and BOT.
CONCLUSIONS: Overall, OI treatment did not increase the risk of IOC and BOT in most women, regardless of OI drug type and OI cycle. However, nulliparous women treated with OI showed a higher risk of ovarian cancer, necessitating their rigorous monitoring and ongoing follow-up.