Archives of Gynecology and Obstetrics

, Volume 287, Issue 6, pp 1187–1204 | Cite as

Ovarian epithelial tumors and reproductive factors: a systematic review

  • Susanne Schüler
  • Marvin Ponnath
  • Jörg Engel
  • Olaf Ortmann
Gynecologic Oncology



The aim of this systematic review is to summarize the current knowledge about the etiology and pathogenesis of borderline tumors ovarian cancer with special emphasis on the role of endocrine treatments and reproductive factors to establish a foundation for future studies.


We performed a systematic review on the relation between ovarian epithelial tumors (OET) and reproductive factors using the keywords: ovarian cancer, ovarian tumor, ovarian borderline tumor, age at menarche, age at menopause, parity, infertility, PCO syndrome, oral contraception, menopausal hormone therapy, fertility treatment. Totally, 3,290 abstracts were scanned for their relevance in this publication and 127 were finally included.


The incidence of ovarian epithelial cancer and ovarian borderline tumors is influenced by certain reproductive factors. The strongest protective effects are conferred by parity and use of oral contraceptive pills. Recent molecular biologic and histopathologic studies prove that OET represent a diverse group of tumors, each histologic type with a different genetic background. This is at least partly reflected in epidemiologic and clinical studies showing different risk modulating effects of reproductive factors and endocrine therapies on OET.


The etiology and pathogenesis of ovarian cancer are still not fully understood. None of the so far proposed hypothesis on the development of OET can fully account for the epidemiologic and clinical findings in the context of reproductive factors and OET development. Further research approaches are warranted and need to put more weight on the clinical and genetical diversity of OET to yield a more detailed insight into their pathogenesis.


Epithelial ovarian tumors Ovarian cancer Borderline ovarian tumors Reproductive factors Endocrine factors Age at menarche Age at menopause Parity Infertility PCO syndrome Oral contraception Menopausal hormone therapy Fertility treatment 


Conflict of interest

All authors disclose any actual or potential conflict of interest including any financial, personal or other relationships with other people or organizations within 24 months of beginning the submitted work that could inappropriately influence, or be perceived to influence, their work.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Susanne Schüler
    • 1
  • Marvin Ponnath
    • 1
  • Jörg Engel
    • 1
  • Olaf Ortmann
    • 1
  1. 1.Department of Obstetrics and GynecologyUniversity of RegensburgRegensburgGermany

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