Female infertility, infertility-associated diagnoses, and comorbidities: a review

Abstract

Purpose

The purpose of the study is to evaluate existing literature for possible associations between female infertility, infertility-associated diagnoses, and the following areas of disease: psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction.

Methods

The design of the study is a literature review. The patients were women included in 26 selected studies due to a diagnosis of infertility or a reproductive disorder associated with infertility. This study has no interventions, and the main outcome measure is the association between female infertility or a related diagnosis and psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction.

Results

Female infertility and related reproductive disorders may have ramifications for women beyond reproductive health. An analysis of publications shows that women with infertility had higher rates of psychiatric disorders and endometrial cancer than the general population [110]. Data is conflicting about whether infertile women are at increased risk for breast cancer and ovarian cancer [7, 8, 1020]. A generalized diagnosis of infertility was not clearly associated with an increased risk of cardiovascular disease or metabolic dysfunction, but women with infertility related to polycystic ovarian syndrome (PCOS) do appear more likely to develop cardiovascular disease and metabolic disorders such as diabetes than the general population [16, 2126].

Conclusions

Female infertility and associated diagnoses have overall health implications. Beyond treatment of patients’ immediate reproductive needs, healthcare professionals must be aware of the broader health impact of specific causes of infertility in order to provide accurate counseling regarding long-term risk.

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Correspondence to Brent Hanson.

Additional information

Capsule There is a growing body of literature addressing the impact of female infertility on long-term health. This review evaluates 26 studies, investigating possible correlations between infertility and psychiatric illness, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction. Overall, higher rates of psychiatric illness and endometrial cancer were seen in infertile women. It is unclear whether infertility results in increased rates of breast cancer and ovarian cancer, and data are conflicting regarding correlations between generalized infertility and cardiovascular disease and metabolic dysfunction. This study summarizes current literature and can guide practitioners in counseling infertile patients.

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Hanson, B., Johnstone, E., Dorais, J. et al. Female infertility, infertility-associated diagnoses, and comorbidities: a review. J Assist Reprod Genet 34, 167–177 (2017). https://doi.org/10.1007/s10815-016-0836-8

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Keywords

  • Infertility
  • In vitro fertilization
  • Malignancy
  • Somatic health
  • Fertility drugs