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Τετάρτη 25 Ιουλίου 2018

Melanoma risk after in vitro fertilization: A review of the literature

Publication date: Available online 25 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Juliana Berk-Krauss, Amy Kalowitz Bieber, Maressa C. Criscito, Jane M. Grant-Kels, Marcia S. Driscoll, Martin Keltz, Miriam Keltz Pomeranz, Kathryn J. Martires, Tracey N. Liebman, Jennifer A. Stein

Abstract
Background

The role of female sex hormones in the pathogenesis of malignant melanoma (MM) remains controversial. While melanocytes appear to be hormonally responsive, the effect of estrogen on MM cells is less clear. Available clinical data does not consistently demonstrate that increased endogenous hormones from pregnancy, or increased exogenous hormones from oral contraceptive pills and hormone replacement, impact MM prevalence and outcome.

Objective

We sought to examine potential associations between in vitro fertilization (IVF) and melanoma.

Methods

A literature review was conducted. Primary outcomes were reported as associations between IVF and melanoma risk, as compared to the general population. Secondary outcomes included associations stratified by type of IVF regimen and subgroup, such as parous versus nulliparous patients.

Results

Eleven studies met our inclusion criteria. Five studies found no increased risk of MM among IVF users as compared to the general population. Two studies found an increase in MM in clomiphene users. Four studies found an increase in MM among patients who were gravid or parous either before or after IVF.

Conclusions

The reviewed studies do not reveal consistent patterns of association between IVF and MM among all infertile women. However, the data indicates that there may be an increased risk of MM in ever-parous patients treated with IVF. High-quality studies, which include a large number of MM cases and control for well-established MM risk factors, are needed to adequately assess the relationship between IVF and MM, particularly among ever-parous women.



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