Fertility treatment is associated with multiple meningiomas and younger age at diagnosis
Meningiomas are more common in females and 70–80% express the progesterone receptor, raising the possibility that highdose exogenous estrogen/progesterone exposure, such as occurs during fertility treatments, may increase the risk of developing a meningioma. The goal of this study was to report the incidence of prior fertility treatment in a consecutive series of female meningioma patients.
A retrospective review (2015–2018) was performed of female patients with meningioma, and those with prior fertility treatment were compared to those without fertility treatment using standard statistical methods.
Of 206 female patients with meningioma, 26 (12.6%) had a history of fertility treatments. Patients underwent various forms of assisted reproductive technology including: in vitro fertilization (50.0%), clomiphene with or without intrauterine insemination (34.6%), and unspecified (19.2%). Median follow up was 1.8 years. Tumors were WHO grade I (78.6%) or grade II (21.4%). Patients who underwent fertility treatments presented at significantly younger mean age compared to those who had not (51.8 vs. 57.3 years, p = 0.0135, 2tailed Ttest), and on multivariate analysis were more likely to have multiple meningiomas (OR 4.97, 95% CI 1.4–18.1, p = 0.0154) and convexity/falx meningiomas (OR 4.45, 95% CI 1.7–11.5, p = 0.0021).
Patients in this cohort with a history of fertility treatment were more likely to present at a younger age and have multiple and convexity/falx meningiomas, emphasizing the importance of taking estrogen/progesterone exposure history when evaluating patients with meningioma. Future clinical studies at other centers in larger populations and laboratory investigations are needed to determine the role of fertility treatment in meningioma development.
KeywordsFertility Fertility treatment Meningioma Estrogen Progesterone Risk factor
This work was supported by the Linda Wolfe Meningioma Research Program Project and the National Cancer Institute of the National Institutes of Health (1F32CA213944-01) to S.T.M.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interests related to this study.
The study was approved by the institutional review board at the author’s institution (IRB#13-12587). After reviewing the study, the institutional review board deemed the study minimal risk and waived the need for informed consent by each subject.
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