The relation between the use of fertility drugs and cancers in women

Fertility is the inability to conceive. Doctors diagnose women as infertile who have been trying to getpregnant for a year but have not been successful. Fertility is a meaningful word that has attracted a lotof attention since the past. Fertility or the ability to have children, success in reproduction and thebeginning of a new birth for couples, and its opposite, infertility, or causing disruption in reproduction,is always It is a phenomenon that unintentionally puts many consequences in front of couples. Infertilityis also defined as the absence of pregnancy after one year of regular intercourse without the use ofcontraceptives. Statistics show that ۹% of couples around the world suffer from some type of infertility,of which ۵۶% seek medical care. Today, in the field of assisted reproductive technology, the use ofovulation stimulating drugs to overcome infertility has increased. However, there are various concernsrelated to the use of these drugs and the increased potential risk of cancer in women; therefore, in thisstudy Our attempt is to state the types of studies conducted in the field of infertility treatment usingovulation stimulating drugs and to present its effect on increasing the risk of cancer in women. Women'scancers are mainly related to hormonal causes, and since more than half of the world's population ismade up of women, considering their structural and creative role, besides being considered an importantpillar in the family, they can also play a vital role in the growth and They assume the growth of humansociety; Therefore, their health is one of the most important factors affecting the productivity of thefamily and society.Method:The current review by searching in reliable books and useful databases suchas Scopus, Elsevier, PubMed, Science Direct, Google Scholar, Mag Iran, Iran Dog, Iran Medex in theyears ۲۰۱۲ to ۲۰۲۲ with keywords such as infertility, infertility drugs, cancer, women's cancers, ovariancancer and breast cancer were performed.Findings:A pooled analysis of ۱۲ case-control studies fromthe United States found that the risk of ovarian cancer was high in women who used fertility drugs, andthat the risk was higher in nulliparous women (women who had not given birth) than in multiparouswomen. (Women who have given birth more than once), was more. One of the ۳۷ included studiesreported a twofold increase in ovarian borderline serous tumor progression in women after more thanfour courses of progesterone; however, the number of cases included in this group was very small. Acohort study also showed an increased risk of borderline ovarian tumor in infertile women treated withclomiphene citrate compared with infertile women who were not treated to conceive. Ovarianstimulating drugs that cause the growth of a significant number of follicles, create a high level ofestrogen hormone in the body of women. This hormone is naturally secreted from the ovaries, and withthe use of fertility drugs, the amount of estrogen in the blood increases, and this may cause an increasein some cancers in women. But as a result of various researches, the opposite has been observed. Theuse of fertility drugs for IVF in women who have estrogen-sensitive breast cancer and the treatment forthem may cause the recurrence of the disease. But new research has shown that fertility drugs increasethe risk of the occurrence and recurrence of cancer. They do not increase the breast. Don't forget thatthe occurrence of breast cancer in women is not only due to the use of assisted reproduction methods(ART), but this disease is also a common problem when women age.Various researches and studiesshow that women who have a history of infertility treatments have a higher percentage of dense breasttissue. Breast tissue consists of two different types of tissue. Dense and fibro glandular tissue and nondensetissue and fat, the risk of breast cancer in women who have denser breast tissue is ۴ to ۶ timesthat of other women. Women suffering from infertility have denser tissue than other women. Amonginfertile women, those who have undergone hormonal treatments such as COS or controlled ovarianstimulation have the highest amount of fibro glandular and dense breast tissue. Controlled Ovarian Stimulation or COS is part of infertility treatments. These drugs stimulate the release of eggs from theovaries. Hormonal treatments such as COS increase the level of estrogen and progesterone in the body.These two hormones increase the size and amount of mammary fibro glandular tissue through the effectof their receptors in breast tissue cells. However, researchers are still not sure whether the increase indense breast tissue in infertile women is due to hormonal treatments or the result of subsequentpregnancies. Women undergoing fertility treatments such as IVF receive drugs to stimulate theirreproductive system. As a result, they are exposed to high levels of the hormone estrogen, whichaccording to experts at the British Institute of Environmental Health is a carcinogen. Fertility drugs donot increase the risk of breast cancer recurrence. The incidence of ovarian and breast cancers in womenwho have used artificial insemination to get pregnant is small. A brief look at the health of infertilewomen shows that they are at risk of ovarian cancer, which of course is not caused by the use of fertilitydrugs. Women who have undergone IVF are more likely to develop ovarian cancer (interstitial ovarianmasses) than infertile women who have not received fertility treatments. The use of fertility drugs bywomen who have been treated for breast cancer (sensitive to estrogen hormones) may cause a recurrenceof their disease. Fertility drugs do not increase the risk of breast cancer, although they may cause thistype of cancer to come back. Taking these types of drugs slightly increases the risk of ovarian cancer.But experts do not believe that the risk of using fertility drugs is enough to endanger the overall healthof infertile women. One of these drugs that is widely used in the treatment of infertility is clomiphenecitrate, which leads to changes in the levels of FSH, LH and estrogen. Although no correlation wasfound in some studies, some also showed that this risk increases depending on the type of treatment,the type of drug used, the age of the person when it was first used, and the duration of use of thesetreatments. Another group of studies showed a relationship between certain types of causes leading toinfertility, such as lack of ovulation, progesterone deficiency, amenorrhea, and tubal problems, and theincidence of breast cancer, and the most noticeable factor is a positive family history of cancer. It is thebreast. The findings of various studies have linked the possibility of increasing the risk of uterine, breastand ovarian cancer with hormonal changes and stimulation of ovulation using clomiphene citrate andgonadotropins; however, due to the existence of vague information about the way and dosage of thedrugs, they have not been conclusively proven.Conclusion:Although several risk factors play a role in causing cancer, there seems to be aninsignificant and negligible relationship between fertility drugs and breast, ovarian, and uterine cancers.What most connects these two together is a positive family history in terms of breast cancer, and inother cancers, previous history of cancer, family history and the presence of some genes BRCA۱,BRCA۲ play a more important role in causing cancer than the use of fertility drugs.

کلیدواژه ها:

Infertility ، infertility drugs ، women's cancers.