For Women Having IVF, Infertility Status and Diagnosis Determine Ovarian Cancer Risk

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October 20 , 2015
by: ASRM Office of Public Affairs
Published in ASRM 2015 Annual Meeting Press Release

Baltimore, MD – British researchers conducting an extensive record review and linkage found that in a large cohort of women who had assisted reproductive technology treatment (ART), the risk of ovarian cancer is related to the number of children they have had, their diagnosis of female factor infertility- especially endometriosis, and being of a younger age when starting IVF.

At the 71st Annual Meeting of the American Society for Reproductive Medicine, Dr. Alastair Sutcliffe is presenting results from a large registry study in which records of all women who had an assisted reproductive technology (ART) procedure in Britain between 1991 and 2010 were linked to the National Health Service Central Registers for England, Wales and Scotland records for cancer cases and outcomes, deaths and emigrations.

In the ART group, ovarian cancer incidence was stratified by age and calendar period and compared with the matched age-specific cancer rates from the larger population for the time period. Factors that could influence the action of ART were accounted for: repeated ART cycles, age at first exposure to ART, how many children a woman had, and her diagnosis of infertility. In 255,786 women who underwent ART, 386 ovarian cancers were recorded. Compared to the general population, ART patients had a one-and-a-third times greater likelihood of developing ovarian cancer.

Female factor diagnoses, especially endometriosis, increased patients’ risk for ovarian cancer.However, women who were not themselves diagnosed with infertility, who used ART to address a male-factor infertility diagnosis, had no greater risk of ovarian cancer than the general population.

The number of IVF cycles a woman had undergone made no difference in her risk of developing ovarian cancer. But whether or not she had had children and how many children she had did influence her risk. Patients with fewer live births were at greater risk; and those who had no live births after treatment were at the greatest risk of developing ovarian cancer. The younger a woman was when she began ART treatment, the greater her chances were of developing ovarian cancer, and the risk of developing cancer was the greatest within the first three years of treatment.

President-Elect of ASRM, Owen Davis, MD, commented, “Dr. Sutcliffe and his colleagues have made an important contribution to our knowledge of the connection between infertility and ovarian cancer in the context of ART. It appears that ovarian cancer risk is increased in some women who have had ART treatment. However, women who underwent ART for non-female infertility diagnosis did not have an increased risk of ovarian cancer. This is reassuring because it suggests that ovarian cancer is not caused by ART per se, but rather is associated with the underlying infertility diagnosis. By identifying specific characteristics which contribute to this increased risk
, this study will help us to better evaluate and advise our patients. Continuing research is needed to further elucidate the associations between underlying causes of infertility, the impact of successful pregnancies or the lack of them, ART treatments, and cancer.”

O-93 A. G. Sutcliffe et al, “Ovarian Tumor Risk in Women After Assisted Reproductive Therapy (ART); 2.2 Million Person Years of Observation in Great Britain.”

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