Infertility in women and moderate alcohol use.

OBJECTIVE. The purpose of this study was to investigate the relationship between moderate alcohol intake and fertility. METHODS. Interviews were conducted with 3833 women who recently gave birth and 1050 women from seven infertility clinics. The case subjects were categorized based on the infertility specialist's assignment of the most likely cause of infertility: ovulatory factor, tubal disease, cervical factor, endometriosis, or idiopathy. Separate logistic regression models were used to assess the relationship between alcohol use and each type of infertility, adjusted for age, infertility center, cigarette smoking, caffeine use, number of sexual partners, use of an intrauterine device (for tubal disease), and body mass index and exercise (for ovulatory factor). RESULTS. We found an increase in infertility, due to ovulatory factor or endometriosis, with alcohol use. The odds ratio for ovulatory factor was 1.3 (95% confidence interval [CI] = 1.0, 1.7) for moderate drinkers and 1.6 (95% CI = 1.1, 2.3) for heavier drinkers, compared with nondrinkers. The risk of endometriosis was roughly 50% higher in case subjects with any alcohol intake than in control subjects (OR = 1.6, 95% CI = 1.1, 2.3, at moderate levels; OR = 1.5, 95% CI = 0.8, 2.7, at heavier levels). CONCLUSIONS. Moderate alcohol use may contribute to the risk of specific types of infertility.     

Infertility, fertility drugs, and ovarian cancer: a pooled analysis of case-control studies

Controversy surrounds the relations among infertility, fertility drug use, and the risk of ovarian cancer. The authors pooled interview data on infertility and fertility drug use from eight case-control studies conducted between 1989 and 1999 in the United States, Denmark, Canada, and Australia. Odds ratios and 95% confidence intervals were calculated, adjusting for age, race, family history of ovarian cancer, duration of oral contraception use, tubal ligation, gravidity, education, and site. Included in the analysis were 5,207 cases and 7,705 controls. Among nulligravid women, attempts for more than 5 years to become pregnant compared with attempts for less than 1 year increased the risk of ovarian cancer 2.67-fold (95% confidence interval (CI): 1.91, 3.74). Among nulliparous, subfertile women, neither any fertility drug use (odds ratio (OR) = 1.60, 95% CI: 0.90, 2.87) nor more than 12 months of use (OR = 1.54, 95% CI: 0.45, 5.27) was associated with ovarian cancer. Fertility drug use in nulligravid women was associated with borderline serous tumors (OR = 2.43, 95% CI: 1.01, 5.88) but not with any invasive histologic subtypes. Endometriosis (OR = 1.73, 95% CI: 1.10, 2.71) and unknown cause of infertility (OR = 1.19, 95% CI: 1.00, 1.40) increased cancer risk. These data suggest a role for specific biologic causes of infertility, but not for fertility drugs in overall risk for ovarian cancer.     

Risk factors for uterine fibroids among women undergoing tubal sterilization

Uterine leiomyomas are reported to be the most common benign gynecologic tumors affecting premenopausal women, and they are often associated with considerable morbidity. The purpose of this study was to identify risk factors for uterine fibroids among women undergoing tubal sterilization. Cases comprised women aged 17-44 years whose uterine fibroids were first visualized at the time of tubal sterilization (1978-1979 or 1985-1987) or who reported a history of uterine fibroids (n = 317). Controls were randomly selected from women with no laparoscopic evidence of or history of fibroids (n = 1,268). Adjusted odds ratios were estimated using unconditional logistic regression separately for White (n = 1,235) and African-American (n = 350) women. Risk factors for White women included: age 40-44 years (odds ratio (OR) = 6.3; 95% confidence interval (CI): 3.5, 11.6), > or =5 years since last delivery (OR = 1.9; 95% CI: 1.1, 3.1), lifetime cigarette smoking of > or =1 pack/day (OR = 1.6; 95% CI: 1.1, 2.3), menstrual cycle length of >30 days (OR = 1.6; 95% CI: 1.1, 3.3), and menstrual bleeding for > or =6 days (OR = 1.4; 95% CI: 1.0, 2.0). Parous women were at reduced risk compared with nulliparous women (OR = 0.2; 95% CI: 0.1, 0.3). Advancing age was the only significant risk factor for African-American women (ages 40-44 years, OR = 27.5; 95% CI: 5.6, 83.6). Current oral contraceptive use and elective abortion were not associated with fibroids.     

Chlamydial antibodies and tubal infertility

Prevalence of Chlamydia trachomatis antibodies was studied in infertile women with and without tubal obstruction, and in a control group of pregnant women in a Central-African country with a high infertility rate. In comparison with the control group, tubal infertility patients were significantly more likely to have serum antibodies of 1:64 or greater with an age-adjusted odds ratio of 7.8 (95% confidence interval (CI) 3.2-19.1). Infertile women without tubal obstruction had antibody titres similar to the control group with an odds ratio of 1.1 (95% CI: 0.6-1.9). In the tubal infertility group there was a kind of dose-response relationship between chlamydial antibodies and the severity of tubal damage and pelvic adhesions on laparoscopy, with odds ratios of 3.2 (95% CI: 0.7-14.8), 6.2 (95% CI: 1.9-21.6) and 18.1 (95% CI: 6.0-68.5) in the group with mild, moderate and severe pelvic adhesions respectively. This survey adds more evidence to the hypothesis that C. trachomatis is a major agent responsible for tubal infertility in Central Africa.     

Infertility and breast cancer: a population-based case-control study

To investigate whether a history of infertility affects a woman's risk of developing breast cancer, the authors analyzed case-control data collected between 1980 and 1982 as part of the Cancer and Steroid Hormone Study. The 4,730 cases were women aged 20-54 years with a first diagnosis of breast cancer ascertained from eight population-based cancer registries; the 4,688 controls were women randomly selected from the general population of these same eight areas. After controlling for age, age at first birth, and parity, the odds ratio (OR) for breast cancer associated with infertility was 1.01 (95% confidence interval (CI) 0.89-1.15) among gravid women. Controlling for age, the odds ratio was 0.82 (95% CI 0.59-1.14) among nulligravid women. Women who reported that the reason for their infertility was a problem with their ovaries had a risk similar to that for women without a history of infertility (OR = 0.75, 95% CI 0.48-1.24). Women whose physicians reported that the reason for their infertility was anovulation or Stein-Leventhal syndrome also had risks similar to those for women without a history of infertility (OR = 1.26 (95% CI 0.67-2.34) and OR = 1.13 (95% CI 0.46-2.78), respectively). Menopausal status, age at menarche, history of spontaneous abortions, drinking or smoking behavior, use of exogenous hormones, or family history of breast cancer did not appreciably alter the observed odds ratios. If infertility has an effect on breast cancer that is independent of age at first birth, then the effect is small.     

输卵管性不孕的高危因素分析

目的:探讨输卵管性不孕(TFI)的病因,并为其预防和临床治疗提供参考依据。方法:采用病例-对照研究方法,病例组为在弋矶山医院确诊为输卵管性不孕妇女,对照组为在妇产科人流妇女。两者均填写统一调查表,并检测衣原体(CT)、支原体(UU)。资料采用非条件Logistic回归分析。结果;病例组衣原体、支原体感染(25.7%、18.8%)明显高于对照组(6.7%、2.5%)。危险因素为:初次性生活年龄20岁(OR:3.373)、性伴侣数1人(OR:3.056)、人流史(OR:1.057)、输卵管妊娠史(OR:6.579)、宫颈炎(OR:2.890)、盆腔炎史(OR:6.488)、结核史(OR:4.986)、阑尾炎史(OR:4.915)。结论:UU、CT感染,初次性生活年龄过小、性伴侣多、输卵管妊娠史、宫颈炎、盆腔炎史、结核史、阑尾炎史是输卵管性不孕的危险因素。人流史与TFI无显著相关。     

女性不孕症影响因素的病例对照研究

目的 探讨已婚育龄妇女不孕症的影响因素及其变化情况.方法 采用以省级医院为基础的配对病例对照研究,按年龄(±2岁)配对,共收集383对病例和对照,进行统一的问卷调查.用EpiData 3.0软件建立数据库,应用SPSS 11.5软件进行单因素和多因素条件logistic回归分析.结果 多凶素条件logistie回归分析表明,盆腔感染性疾病史(0R=7.078,95%CI:3.462～14.467)、末次妊娠产后或流产后并发症史(0R=3.674,95%CI:1.690～7.986)、药物治疗史(0R=23.576,95%CI:12.324～45.102)、痛经(0R=1.622,95%CI:1.161～2.266)、性交痛(0R=2.447,95%CI:1.201～4.986)、每月性生活次数(0R=1.416,95%CI:1.048～1.913)及精神压力(0R=2.146,95%CI:1.662～2.771)可能是女性不孕症的危险因素,而文化程度(0R=0.522,95%CI:0.391～0.696)可能为其保护因素.结论 预防和治疗盆腔感染,严格掌握治疗药物的适应证,重视生殖健康的宣传教育,提倡晚婚晚育,避免婚前性生活等可能减少女性不孕症的发生.     

Contraceptive usage, knowledge and correlates of usage among female emergency department patients

OBJECTIVES: For female emergency department (ED) patients, we sought to assess the prevalence of contraceptive usage as well as the extent of contraceptive knowledge and to determine if demographic and sexual health history factors, comprehension of contraceptive methods and moral/religious opinions on contraception were associated with current usage of birth control pills (BCPs), prior usage of emergency contraception (EC) and frequency of condom usage. METHODS: English-speaking female ED patients aged between 18 and 55 years at a northeastern United States urban ED were surveyed on their usage, comprehension and opinions regarding BCPs, EC and condoms. RESULTS: Of the 539 respondents (64.6% were aged 相似文献   

Contraceptive and reproductive risk factors for cervical intraepithelial neoplasia in American Indian women

OBJECTIVES: To evaluate contraceptive and reproductive risk factors for cervical intraepithelial neoplasia (CIN) in southwestern American Indian women. METHODS: We conducted a clinic-based case-control study. Cases were American Indian women with biopsy-proven CIN I, CIN II or CIN III. Controls were from the same clinics and had normal cervical epithelium. All subjects underwent structured interviews focused on contraceptive and reproductive factors. Laboratory assays included polymerase chain reaction (PCR)-based tests for cervical human papillomavirus (HPV) infection. RESULTS: We enrolled 628 women in the study. The strongest risk factors for CIN II/III included HPV infection (adjusted odds ratio [OR] = 7.9, 95% CI : 4.7-13.2), and low income (OR = 3.1, 95% CI : 1.7-5.7). The use of an intrauterine device (IUD) ever (OR = 3.0, 95% CI : 1.4-6.1) and currently (OR = 4.1, 95% CI : 1.1-14.6), and > or = 3 vaginal deliveries (OR = 5.2, 95% CI : 2.4-11.1) were associated with CIN II/III. History of infertility was also associated with CIN II/III (OR = 2.1, 95% CI : 1.0-4.2). CONCLUSIONS: The data suggest that history of infertility, IUD use and vaginal deliveries were associated with CIN among American Indian women.     

Hormone and fertility drug use and the risk of neuroblastoma: a report from the Children's Cancer Group and the Pediatric Oncology Group.

Previous epidemiologic studies have suggested an association between maternal sex hormone use during pregnancy, including infertility medication, and an increased risk of neuroblastoma in the offspring. The authors conducted a case-control interview study from 1992 to 1996 that included 504 children less than 19 years of age whose newly diagnosed neuroblastoma was identified by two national collaborative clinical trials groups in the United States and Canada, the Children's Cancer Group and the Pediatric Oncology Group. Controls, matched to cases on age, were identified by random digit dialing. No association was found for use of oral contraceptives before or during pregnancy (first trimester odds ratio (OR) = 1.0, 95% confidence interval (CI): 0.5, 2.1). The odds ratio was slightly elevated for history of infertility (OR = 1.4, 95% CI: 0.9, 2.1) and ever use of any infertility medication (OR = 1.2, 95% CI: 0.7, 2.2). Specifically, ever use of clomiphene was associated with a 1.6-fold increased risk (95% CI: 0.8, 3.0) but not periconceptionally or during the index pregnancy. A suggestive pattern was found for gender of the offspring, with an increased risk for males but not for females after exposure to oral contraceptives or clomiphene. This study did not find consistent and large increased risks for maternal use of hormones, but the suggestion of an association for male offspring requires further consideration.     

不孕不育特征与夫妻双方高血压患病风险的关联研究

目的 了解不孕不育夫妇高血压患病现况,探讨不孕不育特征与两性高血压患病风险的关联。方法 本研究依托不孕不育队列开展。不孕不育特征包括是否患不孕不育、不孕不育类型、原因及年限。采用多因素logistic回归模型,分性别分析不孕不育特征与高血压的关联。结果 1 312对不孕不育夫妇中,不孕症女性和不育症男性高血压患病率均显著高于同性别对照组（女:18.6% vs. 13.2%;男:21.5% vs. 14.3%）。女性不孕（OR＝1.64,95％CI:1.13～2.38）、双方共同原因不孕症（OR＝2.15,95％CI:1.11～4.15）、继发性不孕（OR＝1.58,95％CI:1.17～2.13）和不孕年限≥3年（OR＝1.96,95％CI:1.29～2.97）会显著增加女方高血压患病风险;男性不育（OR＝1.79,95％CI:1.29～2.48）、双方共同原因不育症（OR＝1.69,95％CI:1.12～2.56）、继发性不育（OR＝1.52,95％CI:1.00～2.39）和不育年限≥3年（OR＝1.97,95％CI:1.23～3.14）会显著增加男方高血压患病风险。结论 确诊不孕不育、继发性不孕不育、双方共同原因不孕不育及长不孕不育年限是不孕不育夫妇患高血压的风险因素。     

Partner characteristics,intensity of the intercourse,and semen exposure during use of the female condom

The objective of this study was to assess how characteristics of the intercourse and the couple relate to semen exposure during use of the female condom. From 1996 to 1998, 210 women in Birmingham, Alabama, were trained to use the female condom and follow study procedures during a group session and individually practiced inserting the device. The outcome was semen exposure as defined by comparing pre- and postcoital prostate-specific antigen levels in vaginal fluid. Women who had high income levels had lower rates of semen exposure (odds ratio (OR) = 0.3, 95% confidence interval (CI): 0.2, 0.7), while those in a relationship of less than 2 years were at greater risk (OR = 2.4, 95% CI: 1.3, 4.1). Couples with a large disparity in vaginal fundus size and penis size were at increased risk of semen exposure (OR = 2.7, 95% CI: 1.2, 6.0). Engaging in very active intercourse also increased the risk (OR = 1.7, 95% CI: 1.1, 2.6). Thus, the protective effect of the female condom appears to be a function of user- and intercourse-specific characteristics. Future studies of male condom efficacy should focus on collecting detailed data about the users and characteristics of intercourse to predict failure accurately.     

Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control,population-based study in France

This case-control study was associated with a regional register of ectopic pregnancy between 1993 and 2000 in France. It included 803 cases of ectopic pregnancy and 1,683 deliveries and was powerful enough to investigate all ectopic pregnancy risk factors. The main risk factors were infectious history (adjusted attributable risk = 0.33; adjusted odds ratio for previous pelvic infectious disease = 3.4, 95% percent confidence interval (CI): 2.4, 5.0) and smoking (adjusted attributable risk = 0.35; adjusted odds ratio = 3.9, 95% CI: 2.6, 5.9 for >20 cigarettes/day vs. women who had never smoked). The other risk factors were age (associated per se with a risk of ectopic pregnancy), prior spontaneous abortions, history of infertility, and previous use of an intrauterine device. Prior medical induced abortion was associated with a risk of ectopic pregnancy (adjusted odds ratio = 2.8, 95% CI: 1.1, 7.2); no such association was observed for surgical abortion (adjusted odds ratio = 1.1, 95% CI: 0.8, 1.6). The total attributable risk of all the factors investigated was 0.76. As close associations were found between ectopic pregnancy and infertility and between ectopic pregnancy and spontaneous abortion, further research into ectopic pregnancy should focus on risk factors common to these conditions. In terms of public health, increasing awareness of the effects of smoking may be useful for ectopic pregnancy prevention.     

Risk factors for enteric perforation in patients with typhoid Fever

A case-control study was performed using the records of patients hospitalized for typhoid fever at Dicle University Hospital, Diyarbakir, Turkey, between 1994 and 1998. Case patients with enteric perforation were compared with control patients with typhoid fever but no enteric perforation. Risk factors for perforation were determined using logistic regression modeling. Forty case patients who had surgery because of typhoid enteric perforation were compared with 80 control patients. In univariate analyses, male sex (p = 0.01), age (p = 0.01), leukopenia (p = 0.01), inadequate antimicrobial therapy prior to admission (p = 0.01), and short duration of symptoms (p = 0.01) were significantly associated with perforation. In multivariate analysis, male sex (odds ratio (OR) = 4.39, 95% confidence interval (CI): 1.37, 14.09; p = 0.01), leukopenia (OR = 3.88, 95% CI: 1.46, 10.33; p = 0.04), inadequate treatment prior to admission (OR = 4.58, 95% CI: 1.14, 18.35; p = 0.03), and short duration of symptoms (OR = 1.22, 95% CI: 1.10, 1.35; p = 0.001) were significant predictors of perforation. A short duration of symptoms, inadequate antimicrobial therapy, male sex, and leukopenia are independent risk factors for enteric perforation in patients with typhoid fever.     

Previous pulmonary diseases and risk of lung cancer in Gansu Province, China

BACKGROUND: Although active smoking is well established as the main cause of lung cancer, there is accumulating evidence that history of prior lung diseases may be an independent risk factor for lung cancer. METHODS: A population-based case-control study in Gansu Province, China identified 886 lung cancer cases (656 male, 230 female) diagnosed between January 1994 and April 1998. A standardized interview collected information on a variety of potential risk factors including a history of physician-diagnosed non-malignant lung diseases (pulmonary tuberculosis, chronic bronchitis/emphysema, asthma, pneumonia), age and year in which each condition was first diagnosed, and any therapy or hospitalization received. RESULTS: Pulmonary tuberculosis (odds ratio [OR] = 2.1, 95% CI : 1.4-3.1) and chronic bronchitis/emphysema (OR = 1.4, 95% CI : 1.1-1.8) were associated with increased risk of lung cancer, after adjustment for active smoking and socioeconomic status. The OR for asthma (OR = 1.4, 95% CI : 0.9-2.1) and pneumonia (OR = 1.5, 95% CI : 1.0-2.3) were also elevated. The risk of lung cancer remained significant for pulmonary tuberculosis and chronic bronchitis/emphysema when analysis was limited to the pathologically confirmed cases and self-responders. CONCLUSIONS: This study provides additional evidence that previous pulmonary tuberculosis and chronic bronchitis/emphysema are causally related to lung cancer, although the precise mechanism is still unclear. The results for asthma and pneumonia, while suggestive of a positive association, did not reach the traditional level of statistical significance and should be interpreted with caution.     

Incidence of appendicitis during pregnancy

BACKGROUND: The aetiology and pathogenesis of appendicitis remains unknown. A relation with female sex hormones has been proposed because of a lower incidence among women and incidence variations during the menstrual cycle, but studies have given inconsistent results. Pregnancy constitutes a period of dramatic increases in levels of female sex hormones, but the incidence of appendicitis during childbearing is not known. METHODS: Case-control study of pregnancy status at the time of appendectomy of 53 058 women and of 53 058 population-based age-matched controls. Cases and controls were identified by linkage of the Swedish Inpatient Register and the nation-wide census. Pregnancy status at the time of operation was obtained by linkage with the Swedish Fertility Register. Differences in pregnancy status were analysed using conditional logistic regression and expressed as odds ratios (OR) with 95% CI. RESULTS: Fewer patients than expected with appendicitis were pregnant compared with the controls, especially in the third trimester (OR = 0.49, 95% CI : 0.30-0.79 for perforated and OR = 0.33, 95% CI : 0.28-0.39 for non-perforated appendicitis). CONCLUSIONS: The reduced incidence of appendicitis suggests a protective effect of pregnancy, especially in the third trimester.     

Relation of contraceptive and reproductive history to ovarian cancer risk in carriers and noncarriers of BRCA1 gene mutations

In the general population, ovarian cancer risk is inversely associated with oral contraceptive use, tubal ligation, and childbearing. Among carriers of BRCA1 gene mutations, the data are conflicting. The authors identified women diagnosed with incident invasive epithelial ovarian cancer in the San Francisco Bay Area of California from March 1997 through July 2001. They compared the contraceptive and reproductive histories of 36 carrier cases and 381 noncarrier cases with those of 568 controls identified by random digit dialing who were frequency matched to cases on age and race/ethnicity. In both carriers and noncarriers, reduced risk was associated with ever use of oral contraceptives (odds ratio = 0.54 (95% confidence interval (CI): 0.26, 1.13) for carriers and 0.55 (95% CI: 0.41, 0.73) for noncarriers), duration of oral contraceptive use (risk reduction per year = 13% (p = 0.01) for carriers and 6% (p < 0.001) for noncarriers), history of tubal ligation (odds ratio = 0.68 (95% CI: 0.25, 1.90) for carriers and 0.65 (95% CI: 0.45, 0.95) for noncarriers), and increasing parity (risk reduction per childbirth = 16% (p = 0.26) for carriers and 24% (p < 0.001) for noncarriers). These data suggest that BRCA1 mutation carriers and noncarriers have similar risk reductions associated with oral contraceptive use, tubal ligation, and parity.     

Risk factors for female infertility in an agricultural region

BACKGROUND: Recent studies have suggested that agricultural occupations or exposure to pesticides may impair female fertility. METHODS: The Fertility Risk Factor Study retrospectively examined agricultural and residential exposures and the risk of female infertility. Cases and controls (N = 322 each) came from women who sought treatment at a large group medical clinic in Wisconsin. Women and their male partners provided information on health, occupational and lifestyle exposures in response to a telephone interview during 1997-2001. RESULTS: Mixing and applying herbicides 2 years before attempting conception was more common among infertile women (odds ratio [OR] = 27; 95% confidence interval [CI] = 1.9-380), as was the use of fungicides (OR = 3.3; CI = 0.8-13). Residing on a farm, ranch or in a rural area during this time period was protective of female fertility. Households supplied with central Wisconsin groundwater were at less risk for infertility than households using municipal sources (OR = 0.6; CI = 0.4-0.9). Behavioral risk factors included alcohol consumption (OR = 1.8; 1.2-2.5), smoking (1.6; 0.9-2.9), passive smoke exposure (1.8; 1.2-2.5), steady weight gain in adult life (3.5; 2.0-6.1), and having a male partner over the age of 40 (4.5; 1.2-16.3). Drinking 3 or more glasses of milk per day was protective of female fertility (0.3; 0.1-0.7). CONCLUSION: These results suggest that certain agricultural, residential and lifestyle choices may modify the risk of female infertility.     

Risk factors for symptoms of allergic rhinitis in adolescents in Castellón, Spain]

OBJECTIVE: To estimate the risk factor for symptoms of allergic rhinitis in adolescents in Castellón, Spain. METHODS: A cross-sectional population based study of Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC) conducted in 2002 among adolescents from 13-14 years of age. The ISAAC questionnaire was used to define cases of allergic rhinitis. Logistic regression models were used to estimate odds ratio (OR) and their 95% confidence intervals (95%CI). RESULTS: Participation was 66.8% (3,995 adolescents of the 5,981 total). The prevalence of rhinoconjunctivitis symptoms in the last 12 months was 16.5% and the prevalence of nasal allergy at some point was 7.4%. Logistic regression showed that rhinoconjunctivitis was associated with being female (OR = 1.63; 95%CI: 1.33-2.00); a mother who smokes in the home (OR = 1.32; 95%CI: 1.08-1.63); a history of sinusitis (OR = 2.02; 95%CI: 1.51-2.70); and living on a street with heavy truck traffic (OR = 1.58; 95%CI: 1.02-2.44). Likewise, nasal allergy was associated with a family history of allergic rhinitis (OR = 2.62; 95%CI: 1.90-3.63); a history of sinusitis (OR = 2.65; 95% CI: 1.77-3.96); a history of bronchitis (OR = 1.68; 95%CI: 1.19-2.36); and social class, with a steady decline when comparing higher classes to lower classes. CONCLUSIONS: Various environmental risk factors were associated with the symptoms of nasal allergies, which points to the importance of implementing specific preventive measures.     

Breast cancer risk and ovariectomy, hysterectomy, and tubal sterilization in the women's contraceptive and reproductive experiences study

Removal or impairment of ovaries before menopause may affect a woman's breast cancer risk by altering her cumulative exposure to ovarian hormones. The Women's Contraceptive and Reproductive Experiences Study, a population-based, multicenter case-control study of incident invasive breast cancer, recruited women aged 35-64 years (4,490 cases and 4,611 controls) who provided data on ovariectomy, hysterectomy, and tubal sterilization during in-person interviews. Controls were frequency-matched to cases by age, race, and study site. Unconditional logistic regression analysis was used. Women who had not undergone premenopausal reproductive surgery were the referent group. Bilateral ovariectomy was associated with reduced breast cancer risk overall (odds ratio (OR) = 0.59, 95% confidence interval (CI): 0.50, 0.69) and among women <45 years of age (ORs ranged from 0.31 to 0.52), but not among those who were older at surgery. It was also associated with a reduced risk for estrogen and progesterone receptor-positive tumors (OR = 0.63, 95% CI: 0.52, 0.75) but not receptor-negative tumors. Hysterectomy with ovarian conservation (OR = 0.83, 95% CI: 0.72, 0.96) and hysterectomy with partial ovary removal (OR = 0.73, 95% CI: 0.59, 0.91) were also associated with lower risk. No association with breast cancer risk was observed with tubal sterilization only or partial ovariectomy without hysterectomy. Reproductive organ surgeries may alter ovarian hormone levels, thereby affecting breast cancer risk.