Journal of the European Society for Gynaecological Endoscopy


Does ovulation induction increase the risk of gynecological cancer?

H.N. Sallam1,2, M. Abdel-Bak3, N.H. Sallam1,2

1Department of Obstetrics and Gynaecology, the University of Alexandria; 2Alexandria Fertility Center; 3Alexandria Regional Center for Women’s Health and Development, Alexandria, Egypt.

Correspondence at:

Ovulation induction, cancer, ovarian cancer, breast cancer, endometrial cancer, gynecologic cancer, clomiphene citrate, gonadotrophins, HMG, controlled ovarian hyperstimulation, infertility, trophoblastic disease

Published online: Jan 14 2014


The risk of developing gynaecological cancer following ovulation induction therapy in infertile patients is not easy to determine due to many confounding factors. These include the fact that infertility in itself is a known risk factor for some of these cancers, that these patients are subjected to increased surveillance compared to the general population and that the drugs used for ovulation induction are sometimes used in combination. Notwithstanding these limitations, most of the studies have not confirmed a link between these drugs and invasive ovarian cancers, although some studies have suggested that the risk of borderline ovarian tumors may be increased. Investigations regarding breast cancer risk have produced inconsistent results and more information on the subject is warranted. On the contrary, many studies suggest that drugs used for ovulation induction may increase the risk of uterine cancers. More large well-designed studies are still needed to further clarify the effects on cancer risk of these drugs and will allow more in-depth subgroup analysis based on both patient and disease characteristics.