Risk of cancers associated with the use of ovulation induction agents for the treatment of infertility: a narrative systematic review

Abstract Background There is a scarcity of evidence on the carcinogenic risk associated with the use of ovulation induction agents (OIAs) for the treatment of infertility. We aimed to appraise the observational and interventional studies that describe the correlation between OIAs and the risk of developing various cancers in patients receiving infertility treatment. Materials and methods PubMed/MEDLINE, SCOPUS, Embase, and Cochrane Library were searched from inception to December 2024. The observational studies that assessed the risk of cancers following the use of OIAs in patients with infertility were considered for this review. The studies included OIA combined with any other technique were excluded. Jonna Briggs Institute Checklist was employed to assess the methodological quality of the included studies. The synthesized evidence was narratively summarized as the data were highly heterogeneous. Results A total of 30 studies out of 4705 records from different parts of the world were included in this review. There was conflicting evidence on the risk of breast cancer, ovarian cancer, endometrial cancer, and uterine cancer. However, there was a significantly increased risk of non-Hodgkin lymphoma and thyroid cancer. In contrast to this, there is a significantly reduced risk of colorectal cancer associated with the use of OIA among infertile women. Conclusion The current evidence suggests that there is no clear evidence of all types of cancer risk associated with OIA use among those with infertility. Further research is needed with a special emphasis on specific OIA and its time of administration in a diverse set of populations. Trial registration PROSPERO CRD42023449708.