Ovarian cancer and ovulation induction drugs - Is there a link?

Screening for ovarian cancer in a group of women with induced ovulations wa s encouraged by recently reported controversies about a possible associatio n between the use of ovulation induction drugs and the increased risk of ov arian, carcinoma. Transvaginal color Doppler ultrasonography was applied in , screening for early stage ovarian malignoma in 110 asymptomatic women who received an ovulation induction therapy for infertility. Already reported standard parameters for discriminating malignant from benign flows, such as resistance index RI < 0.40 pulsatility index PI < 1 and morphological scor e (borders, cyst quality, septate areas, papilla and ovarian tissue echogen icity) were used. Screening included 110 women and was carried out from Apr il 1, 1198 to March 31, 1999. Seven examinees had abnormal ovarian findings . The finding spontaneously regressed in, five of them, one underwent surge ry for a persistent cyst with a benign pathohistologic diagnosis, and one w as diagnosed with early stage ovarian malignoma. RI < 0.40 was reported in one patient (0.9%) with a morphologically suspect finding and a pathohistol ogically confirmed malignoma, PI < 1 was found in 40 subjects or 36.4%, whi le malignoma was demonstrated in, one case alone. The results showed the ad vantage of RI over PI in discriminating malignant from benign structures. T he association between the use of ovulation stimulation drugs and the? incr eased risk of ovarian carcinoma remains unproved and also challenges new di lemmas. The paper cautions against undesirable, potentially serious long-te rm effects of the use of ovulation induction agents. Additional trials shou ld therefore be performed including a longterm prospective follow-up of wom en with induced ovulations.