FERTILITY THERAPY IN THE SETTING OF A HISTORY OF INVASIVE EPITHELIAL OVARIAN-CANCER

A link between fertility drugs and epithelial ovarian cancer has been suggested by at least one case-control study, and by multiple case rep orts of such tumors developing following fertility drug therapy, We re port the case of a woman with stage IC grade 1 mucinous epithelial ova rian cancer who died of recurrent disease shortly after receiving gona dotropin therapy for ovulation induction. The patient was initially tr eated with a staging procedure, unilateral salpingo-oophorectomy, and 3 courses of cytoxan and carboplatinum. Over the next 3 years she unde rwent 2 cycles of ovulation induction with exogenous gonadotropins. Fi ve months after the second cycle, the patient presented with a bowel o bstruction and extensive recurrence of disease, Two months later she d ied despite extensive surgical debulking, and cis-platinum and Taxol c hemotherapy. Although a causal relationship between fertility therapy and ovarian cancer has not been established, this case report suggests ovulation induction may be inadvisable in a woman with a prior diagno sis of invasive epithelial ovarian cancer. (C) 1995 Academic Press, In c.