Does ovarian stimulation for IVF increase the risk of cancer?

One of the common concerns that women who are about to embark on in vitro fertilisation treatment have is the hypothetical risk of getting gynaecological cancer as a side effect of hormone stimulation.

Since in vitro fertilisation began, a number of different studies have been published that indicate that the risk of getting breast cancer, cancer of the ovaries, the endometrium and the uterus is no greater in these cases.

The exception was an isolated study published over a decade ago, the design of which was widely criticised. It suggested that there was a potential link between a certain kind of cancer of the ovaries and clomiphene, a pharmaceutical drug that has been used to stimulate ovulation for over fifty years.

This potential link was not confirmed in posterior studies.

Índice

1 Scientific evidence
2 Bibliography

Scientific evidence

A systematic review and meta-analysis (a study that gathers information from a number of different studies) was published in the prestigious journal RBMOnline. It was entitled “Does ovarian stimulation for IVF increase gynaecological cancer risk? A systematic review and meta-analysis”

The research involved 178,396 women who had in vitro fertilisation treatment. Ten studies analysed the risk of cancer of the ovaries (167,640 women) and breast cancer (151,702 women) and six studies analysed cancer of the endometrium (166,672 women) and cancer of the uterus (114,799 women).

The meta-analysis did not find any link between ovarian stimulation for in vitro fertilisation treatment and an increase in the risk of getting breast cancer or cancer of the ovaries, endometrium and uterus, including hormone sensitive tumours.

This research work involves the largest number of cases published to date and, in addition to other previous studies, it reaffirms the safety of IVF and the absence of an added risk of gynaecological cancer.

Bibliography

Risk of ovarian cancer in women treated with ovarian stimulating drugs for infertility..Cochrane Database Syst Rev® . 2013 Aug 13;(8)
Does ovarian stimulation for IVF increase gynaecological cancer risk? A systematic review and meta-analysis..Reprod Biomed Online® . 2015 Jul;31(1):20-9.
Melanoma risk after ovarian stimulation for in vitro fertilization. Human Reproduction® . 2015 May;30(5):1216-28.
Does fertility treatment increase the risk of uterine cancer? A meta-analysis.Eur J Obstet Gynecol Reprod Biol® . 2015 Dec;195:52-60
Risk of Colorectal Cancer After Ovarian Stimulation for In Vitro Fertilization..Clin Gastroenterol Hepatol® . 2016 May;14(5):729-37.e5. doi: 10.1016/j.cgh.2015.12.018. Epub 2015 Dec 12.
Ovarian stimulation and risk of breast cancer in Swedish women. Fertility and Sterility® . 2017 Jun 6. pii: S0015-0282(17)30367-9.

Dr Rafael Bernabeu, Medical Director at Instituto Bernabeu.