The aetiology of ovarian cancer is multifactorial with both endogenous and exogenous
risk factors playing an important role. The exact pathogenesis of ovarian cancer is still not well understood,
despite the number of hypotheses published. Due to an increase in the number of women
using fertility drugs, much attention has been focused on the long-term health effects of such drugs.
Although fertility drugs facilitate the ovulation process, it is however associated with a significant
increase in hormone concentrations, placing exposed women at increased risk of gynaecological
cancer. Many clinical and epidemiological studies have examined the association between fertility
drugs and ovarian cancer risk. Results from these studies have been contradictory, as some studies
have reported an increased risk of ovarian cancer while others reported no increased risk. Nevertheless,
recent studies have shown that women who used fertility drugs and did not conceive had a
higher risk of developing ovarian cancer, compared to women who used fertility drugs and conceived
and delivered successfully. This review discusses the effect of fertility drugs on the risk of
developing ovarian cancer, providing details on four possible scenarios associated with fertility
treatment. In addition, the limitations of previous studies and their impact on our understanding of
the association between fertility drugs and ovarian cancer have also been highlighted.
Keywords: Ovulation, nulliparity, inflammation, oxidative stress, ovarian cancer, fertility drugs.
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