P-158: ART and Gynecological Cancer: Report of Our Experiences and Literature Review

Background: Infertility is an important and common problem in couples that needs to assisted reproductive technology (ART) or the other drug therapies. Infertility has been known as a risk factor for ovarian cancer, breast cancer and endometrial cancer but there is a question about the relationship of these cancers to infertility itself or drugs and methods of infertility treatment. Materials and Methods: We evaluated all risk factors in patients with breast cancer, ovarian cancer and endometrial cancers who referred to Gynecological Oncology Clinic in Shahid Sadoughi Hospital within 2002-2012. In a retrograde study, we investigated the history of primary infertility and ART before diagnosis of cancers in patients. Results: We registered 92 patients with endometrial cancer, 84 patients with advanced epithelial ovarian cancer and 113 patients with breast cancer. 39.1% of patients with endometrial cancer who were obese body mass index (BMI>30) and 18.8% of patients with normal (BMI=25-29) had infertility history. ART was found in 7.3% of all patients with endometrial cancer. In 28.4% of patients with epithelial ovarian cancer, female infertility has been also diagnosed and in 14.1% ART was found. Clomiphen therapy with or without HCG and HMG was the most common drugs which was used for patients with ovarian cancer. 16.5% of all patients with breast cancer had infertility problem, and in 7.3% of them ART was diagnosed. Conclusion: Although infertility was diagnosed as an important and fairly common risk factor in endometrial, ovarian and breast cancer, but some other factors are more important. Age, body mass index and cause of infertility are also important. Finding the association of ART to gynecological cancers need some other long cohort studies which follow the infertile women who get the ART or drug therapy for over 15-20 years. The other studies in this field cannot answer to our question about increasing gynecological cancer due to ART. We think BMI and age are co-factors to cancers which should added to infertility or ART. We had better discus this relationship to the partners and have a multidisciplinary management for obese infertile women who had had polycystic ovarian syndrome or age more than 35 years. Breast cancer screening should be investigated in infertile women after 35 years because breast is the most common site of primary cancers which send metastasis to ovaries.