Breast cancer is the most frequently diagnosed malignancy among women worldwide. Because assisted reproduction technology (ART) commonly involves controlled ovarian stimulation (COS) and temporary increases in circulating estradiol and progesterone, its possible effect on long-term breast cancer risk remains an important clinical question. This narrative review, supported by a structured literature search of MEDLINE/PubMed, Scopus, and Web of Science from January 2003 to March 2026, summarizes 31 primary observational studies with a cumulative reported sample exceeding 7.1 million participants, with follow-up extending beyond three decades in some cohorts. Most studies found no significant association between ART and breast cancer incidence. Signals of increased risk were reported in selected subgroups, including women undergoing multiple stimulation cycles, women starting treatment at younger or older ages, and some women with prolonged clomiphene citrate (CC) exposure. The review also considers evidence concerning letrozole, postpartum breast cancer risk, tumor subtype, and fertility preservation in women with breast cancer. Overall, the available evidence does not demonstrate a meaningful increase in breast cancer risk attributable to ART itself. However, substantial heterogeneity, the predominance of older treatment protocols, and the lack of long-term incidence data for contemporary letrozole-based treatment limit definitive conclusions. Prospective studies using current ART protocols and long-term, subtype-specific follow-up are needed.

M.S. Abdellah, "Reproductive Outcome after Letrozole versus Laparoscopic Ovarian Drilling for Clomiphene-Resistant Polycystic Ovary Syndrome," International Journal of Gynecology & Obstetrics 113, no. 3 (2011): 218-221, https://doi.org/10.1016/j.ijgo.2010.11.026. The above article, published online on 01 April 2011 in Wiley Online Library (onlinelibrary.wiley.com), has been retracted by agreement between the journal Editor-in-Chief, Michael Geary; and John Wiley & Sons Ltd. UK. Concerns were raised by a third party regarding the center at which this study's randomized controlled trial took place, as six similar RCTs with overlapping authors were conducted concurrently with no reference to each other. When the editorial team assessed the article, they found issues with the statistical methods and the reported data results. The tests used to analyze the different variables were not consistent throughout the study. The investigators also found the inappropriate use of one-tailed p-values. Furthermore, the methods section referred to "biochemical pregnancy," but this was not further discussed within the study. Finally, the editorial team found implausible baseline characteristics shared between the two study groups and incorrect analysis of ovulation rates. Without an adequate explanation from the authors or the study data to confirm the data and results, the editors consider the data and conclusions to be unreliable. Therefore, the article must be retracted.

T. Kazerooni, F. Ghaffarpasand, Y. Kazerooni, M. Kazerooni, and S. Setoodeh, "Short-Term Metformin Treatment for Clomiphene Citrate-Resistant Women with Polycystic Ovary Syndrome," International Journal of Gynecology & Obstetrics 107, no. 1 (2009): 50-53, https://doi.org/10.1016/j.ijgo.2009.04.022. This retraction has been issued for the above article, published online on 23 June 2009 in Wiley Online Library (wileyonlinelibrary.com), by agreement between the journal Editor-in-Chief, Michael Geary; and John Wiley & Sons Ltd. Concerns were raised by a third party regarding potentially duplicated baseline data in Table 1. Upon review by the editorial team, clear anomalies in Table 1 were confirmed, with the duplication of six mean and standard deviation values from the Metformin population group into the Placebo population group. The review of the reported data also found inconsistencies in the p-values listed in Table 3 that would be impossible given the data provided, even with accounting for decimal rounding. Because the study was undertaken in 2009, the authors were unable to locate their original dataset for confirmation of the values. Without the data, the editorial team and Wiley are unable to account for these inconsistencies as well as others noted by the editorial team during the investigation, including improper randomization procedure and an impossible sample size. As a result, the data and conclusions are considered by the editors to be unreliable. Therefore, the article must be retracted.

High-order multiple pregnancy is an unusual but serious complication of ovulation induction and is associated with significant maternal, fetal, and neonatal risks. While ovulation induction has been commonly used in the management of unexplained infertility, multifetal gestation remains an important iatrogenic outcome despite careful monitoring. In this article, we report a rare case of high-order multiple pregnancy following the induction of clomiphene citrate in a woman with unexplained secondary infertility. A 30-year-old para 1 female patient (eight years long) presented to Tadawi Medical Hospital, Khamis Mushait, Saudi Arabia, seeking pregnancy for secondary infertility. An infertility study confirmed normal hormonal status, bilateral tubal patency on hysterosalpingography, and normal semen analysis of her husband, and a diagnosis of unexplained secondary infertility was made. At the start of the stage, she underwent routine cycle monitoring using timing for intercourse and received folic acid, vitamins, and L-arginine. Induction of ovulation was accomplished by clomiphene citrate 50 mg daily for five days. On day 12, she had mild ovarian hyperstimulation, managed lightly. Initial early pregnancy evaluation showed markedly increased beta-human chorionic gonadotropin levels. Ultrasound revealed five gestational sacs that each harbored a viable fetal pole, pointing towards high-order multifetal gestation. The patient received close antenatal follow-up every two weeks. Fetal reduction was recommended due to the high maternal and perinatal risks; however, she declined. Cervical cerclage at 14 weeks gestation with Mersilene was performed because of the increased risk of cervical insufficiency. She was kept on progesterone support and was placed on dexamethasone for fetal lung maturation at 24 weeks. Serial ultrasounds revealed continuous viability of all fetuses and no gross structural anomalies. Although elective delivery was planned at 30-32 weeks, she developed preterm labor at 28 weeks and underwent cesarean section. Each neonate was born alive and placed in the neonatal intensive care unit for approximately five weeks. A rare situation with an extremely serious management challenge of high-order multiple pregnancy, including the complications post-ovulation induction and management challenges that this case presents. To facilitate these outcomes, it is critical that intensive monitoring, timely intervention, complex management, multidisciplinary effort, as well as neonatal support occur.

This study investigated the repurposing potential of clomiphene citrate as a topical therapeutic candidate for tegumentary leishmaniasis (TL) and candidiasis. Comparative in silico analyses were performed to evaluate absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties in comparison with meglumine antimoniate and amphotericin B. In addition, molecular docking was conducted to investigate the interaction of clomiphene with Leishmania spp. arginase and the Sap5 protease of Candida albicans. Clomiphene exhibited a favorable physicochemical profile, characterized by high lipophilicity, moderate skin permeability, and predicted oral bioavailability and intestinal absorption superior to those of the reference drugs. Toxicological predictions also indicated a lower systemic toxicity profile compared with conventional therapies. Molecular docking revealed favorable binding energies and interactions with key residues within the active sites of both targets. Experimental assays demonstrated that clomiphene inhibited the early stages of C. albicans biofilm formation and exhibited potent leishmanicidal activity against L. amazonensis promastigotes, with a high selectivity index in macrophages. Together, these findings indicate that clomiphene citrate represents a promising candidate for further investigation as a potential therapeutic agent against tegumentary leishmaniasis and candidiasis.