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29-01-2025 | Infertility | Original Paper

Infertility and Risk of Ovarian Cancer in the Women’s Health Initiative

Authors: Holly R. Harris, Kimberly Lind, Sable Fest, Cynthia A. Thomson, Nazmus Saquib, Aladdin H. Shadyab, Peter F. Schnatz, Rogelio Robles-Morales, Lihong Qi, Howard D. Strickler, Denise J. Roe, Leslie V. Farland

Published in: Cancer Causes & Control

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Abstract

Purpose

There is a consistent relationship with greater ovulation frequency and increased risk of ovarian cancer. However, prior research on infertility, which may be associated with ovulation frequency through multiple mechanisms, and ovarian cancer has yielded conflicting results, possibly due to prior research conflating fertility treatment with infertility and restricting follow-up to premenopausal cases. Our objective was to determine the association between infertility and risk of postmenopausal ovarian cancer, overall and by histotype, in a population that had not received treatment with IVF.

Methods

We utilized data from the Women’s Health Initiative (n = 112,925 postmenopausal participants) with over 25 years of follow-up. At baseline, participants were asked whether they had ever tried to become pregnant for more than one year without becoming pregnant and whether a reason was found. Cox proportional hazards models were used to calculate hazard ratios (HRs) of incident adjudicated ovarian cancer comparing participants with a history of infertility to fertile participants overall and by histotype.

Results

17% of participants reported a history of infertility at baseline and 1,109 ovarian cancer cases were diagnosed during follow-up. No statistically significant association was observed between infertility and risk of any ovarian cancer (HR: 1.09, 95% CI 0.92–1.29), but those reporting infertility had a 90% higher risk of endometrioid and clear cell ovarian cancers (HR: 1.90 95% CI 1.09–3.34) compared to fertile participants. The reported reason(s) for infertility had no discernable impact on these associations.

Conclusions

Infertility may be associated with clear cell and endometrioid ovarian cancer but not other ovarian tumor histotypes.
Appendix
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Metadata
Title
Infertility and Risk of Ovarian Cancer in the Women’s Health Initiative
Authors
Holly R. Harris
Kimberly Lind
Sable Fest
Cynthia A. Thomson
Nazmus Saquib
Aladdin H. Shadyab
Peter F. Schnatz
Rogelio Robles-Morales
Lihong Qi
Howard D. Strickler
Denise J. Roe
Leslie V. Farland
Publication date
29-01-2025
Publisher
Springer International Publishing
Published in
Cancer Causes & Control
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-025-01962-z

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