Ovarian Stimulation: Is There a Long-Term Risk for Ovarian, Breast and Endometrial Cancer?

Abstract

Adverse effects have been related to infertility treatments. Infertility in general, and female infertility in particular, is a well established risk factor for cancer development, especially ovarian, breast and endometrial cancer. This article addresses the possible association between infertility and cancer development, with an emphasis on the influence of infertility treatments, through a meticulous search of the literature published thus far. While results regarding the possible association of infertility, ovulation induction medications and invasive ovarian cancer show no increased risk and are reassuring, results for increased risk for breast cancer and endometrial cancer following exposure to ovarian stimulation medications are inconclusive. Larger population studies with longer periods of follow-up and better adjustment for confounding factors are needed.

In vitro fertilization is associated with an increased risk of borderline ovarian tumours

“…A number of authors [14,[21][22][23] have suggested that this apparent increase in risk may not be causal, but rather due to surveillance bias. Surveillance bias is a case of "the more you look, the more you find"; the premise being that women who have IVF will be examined more often than women who do not, providing more opportunities for detection.…”

Assessing pre‐implantation embryo development in mice provides a rationale for understanding potential adverse effects of ART and PGD procedures

“…The understanding of mice pre-implantation embryo development provides a rationale to analyze current results of ART and PGD procedures (such as the increased risk for alterations in imprinting and other defects already observed in clinical and epidemiological studies), in the light of their potential molecular mechanisms and epigenetic processes. Moreover, the genetic and epigenetic processes already known to be involved in these events suggest that following these techniques not only mothers [Calderon-Margalit et al, 2009;Lerner-Geva et al, 2010] but also their apparently normal newborn infants might be carrying lifetime health risks.…”

The Tissue Specific Role of Estrogen and Progesterone in Human Endometrium and Mammary Gland

“…However, there are publications, which have not found a relation between infertility treatments and any cancer development (Potashnik et al, 1999, Doyle et al, 2002Dor et al, 2002;Lerner-Geva et al, 2010;Brinton et al, 2004). For example, a case-control study (1380 pairs) showed no risk for IVF treatment even among women who carry mutations in breast cancer susceptibility gene 1 (BRCA1) or BRCA2 gene (Kotsopoulos et al, 2008).…”