Cancer in women after assisted reproductive technology

Abstract

Objective To evaluate the risk of cancer after assisted reproductive technology (ART) therapy. Design Longitudinal cohort of New York, Texas, and Illinois residents between 2004-09, treated with ART, and whose cycles were reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS). Setting Not applicable Patients Cycles of 113,226 women, including 53,859 women without prior ART treatment, were linked to their respective Cancer Registries. Standardized incidence ratios (SIR) and their 95% confidence intervals were calculated, comparing the observed to expected cancer cases based on age-specific cancer rates in the general population of each State. Among the cohort of women without prior ART therapy, hazard ratios (HR) and 95% confidence intervals were calculated for treatment parameters and reproductive history factors. Intervention None Main Outcome Measures Diagnosis of cancer, as reported to the State Cancer Registry Results Mean follow-up was 4.87 years; among women without prior ART, 450 women developed 460 cancers. Women treated with ART had significantly lower risks for all cancers (for all women: SIR 0.78, 0.73-0.83; and women without prior ART: SIR 0.75, 0.68-0.82), breast cancer, and all female genital cancers; nonsignificant lower risks for endocrine and uterine cancer; and nonsignificant higher risks for melanoma and ovarian cancer. Among women without prior ART, there were no significant increased HRs by parity, number of cycles, cumulative FSH dosage, or cycle outcome. Conclusions These results suggest no greater risks for developing cancer after nearly 5 years of follow-up compared to the general population, and to other women treated with ART. Capsule These results suggest no greater short-term risks for developing cancer compared to the general population, and to other women treated with ART.

Female infertility, infertility-associated diagnoses, and comorbidities: a review

“…The only study which did not find an increase in endometrial cancer risk in infertile women was a longitudinal cohort study published in 2015 by Luke et al which showed a decrease in risk of endometrial cancer in infertile women who received ART when compared to infertile women who did not receive ART, although this decreased risk was not statistically significant [17]. Overall, infertility related to PCOS seems to show a strong relationship with subsequent endometrial cancer risk.…”

“…These gynecologic malignancies will be discussed individually, with relevant studies included in table format. [17]. One study showed a positive correlation between a diagnosis of infertility and the development of breast cancer [14].…”

“…An analysis of publications shows that women with infertility had higher rates of psychiatric disorders and endometrial cancer than the general population [1][2][3][4][5][6][7][8][9][10]. Data is conflicting about whether infertile women are at increased risk for breast cancer and ovarian cancer [7,8,[10][11][12][13][14][15][16][17][18][19][20]. A generalized diagnosis of infertility was not clearly associated with an increased risk of cardiovascular disease or metabolic dysfunction, but women with infertility related to polycystic ovarian syndrome (PCOS) do appear more likely to develop cardioCapsule There is a growing body of literature addressing the impact of female infertility on long-term health.…”

Use of fertility medications and cancer risk: a review and update

“…Although studies examining the relationship between fertility medication use and ovarian cancer risk show mixed results, most studies do not demonstrate a significant increase in risk [10] [11] [12] [13] [14] [15] [16] [17]. In the 1990s, two studies found an association between fertility medication use and ovarian cancer [18] [19] but were limited by specific disease characteristics, such as low prevalence and late onset (i.e., 7th decade of life), study design (i.e., inappropriate use of fertile controls, limited length of follow-up, lack of control for parity and other diseases) and lack of stratification by type and duration of fertility medication use.…”

Cancer Risk in Women Treated with Fertility Drugs According to Parity Status—A Registry-based Cohort Study

“…Some studies have found associations between fertility drug use and risks of ovarian (7, 8) breast (9–11) and other cancers (12, 13), whilst others have not (14–17), including two meta-analyses (18, 19). With reproductive factors being modifiers of cancer risk at several sites, a question that remains is whether effects of fertility drugs are different among nulliparous and parous women.…”