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  • Print publication year: 2013
  • Online publication date: August 2013

22 - Primary care treatment of subfertility and what every health professional needs to know about assisted reproductive technology

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Summary
Over the past 50 years, there have been hundreds of clinical studies investigating whether hormonal contraception changes the risk of cancer among users. Most of the epidemiological evidence comes from observational case control and cohort studies examining cancer risk among users of combined oral contraceptives (COCs). Although women may be at increased risk of several cancers (breast, cervix, liver and thyroid) whilst using this contraceptive method, the effects appear to be transient, disappearing within a few years of stopping. Conversely, COCs protect against several other cancers (ovary, endometrium and colorectum), with the benefits persisting for many years after stopping. This sustained protection may produce major public health benefits over time, through reduced overall cancer incidence and mortality. Limited data suggests that users of progestogen-only contraceptives (especially injectables and implants) experience a similar pattern of cancer risks and benefits as COC users.

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Contraception
  • Online ISBN: 9781107323469
  • Book DOI: https://doi.org/10.1017/CBO9781107323469
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References

1. World Health Organization. WHO Laboratory Manual for the Examination of Human Semen and Sperm – Cervical Mucus Interaction, 3rd edn. Cambridge, UK: Press Syndicate of the University of Cambridge, 1992.
2. Check JH. Antisperm antibodies and human reproduction. Clin Exp Obstet Gynecol 2010; 37: 169–74.
3. McIntyre M, Hsieh TC, Lipshultz L. Varicocele repair in the era of modern assisted reproductive techniques. Curr Opin Urol 2012; 22(6): 517–20.
4. Najmabadi H, Huang V, Yen P, et al. Substantial prevalence of microdeletions of the Y-chromosome in infertile men with idiopathic azoospermia and oligospermia detected using a sequence-tagged site-based mapping strategy. J Clin Endocrinol Metab 1996; 81: 1347–52.
5. Ramasamy R, Lin K, Gosden LV, et al. High serum FSH levels in men with nonobstructive azoospermia does not affect success of microdissection testicular sperm extraction. Fertil Steril 2009; 92(2): 590–3.
6. Rotterdam European Society of Human Reproduction and Embryology (ESHRE)/American Society for Reproductive Medicine (ASRM) Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81: 19–25.
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