Background

The role of female sex hormones in the pathogenesis of malignant melanoma (MM) remains controversial. Although 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 affect 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 compared with 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 for MM among IVF users compared with the general population. Two studies found an increase in MM in clomiphene users, and 4 studies found an increase in MM among patients who were gravid or parous either before or after IVF.

Conclusion

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

中文翻译：

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体外受精后黑色素瘤的风险：文献综述

背景

女性性激素在恶性黑色素瘤（MM）发病机理中的作用仍存在争议。尽管黑素细胞似乎具有激素反应性，但雌激素对MM细胞的作用尚不清楚。现有的临床数据不能始终证明妊娠增加的内源激素或口服避孕药和激素替代增加的内源激素会影响MM的患病率和预后。

客观的

我们试图检查体外受精（IVF）和黑色素瘤之间的潜在关联。

方法

进行了文献综述。据报道，与普通人群相比，IVF与黑色素瘤风险之间的相关性是主要结局。次要结局包括按试管婴儿治疗方案类型和亚组分类的关联，例如产妇与未产妇。

结果

共有11项研究符合我们的纳入标准。五项研究发现，与普通人群相比，试管婴儿使用者的MM风险没有增加。两项研究发现克罗米芬使用者的MM有所增加，而4项研究发现IVF之前或之后的妊娠或双胎患者的MM有所增加。

结论

所审查的研究并未揭示所有不育女性中IVF和MM之间的一致关联模式。但是，这些数据表明，在接受IVF治疗的绝大部分患者中，MM的潜在风险增加。需要高质量的研究，包括控制良好的MM危险因素的大量MM病例，以充分评估IVF和MM之间的关系，尤其是在无产妇中。