Is there any link between fertility treatments and cancers?

Emobileclinic Patient’s corner

Emobileclinic Specialist

 Fear is always entertained by anyone seeking fertility treatment. People are scared about having a healthy baby- we often hear are IVF babies real ones? ; the fear of possible multiples babies, and most recently the risk of developing cancer from fertility treatments. Nice question with recent trend of chemicals and its hazardous effect. However fertility treatments are

safe. Millions of women are affected with infertility and  Dr. Alan B. Copperman, director of the Division of Reproductive Endocrinology and Infertility at Mount Sinai Hospital said “more than seven million women right now are dealing with infertility.” It would have be disastrous if treatments cause cancers! There are various drugs like Gonal-F, which helps ovaries produce eggs by providing follicle stimulating hormone and  Follistim which is used to stimulate the ovaries to produce eggs, also by using follicle stimulating hormone, and Menopur, which stimulates egg growth with a combination of follicle stimulating hormone. Luteinizing hormone is known as one of the most successful ways of treating infertility but they do not cause cancer as there is “no evidence of fertility treatments causing cancer”. Our reporter also reported no negative conclusions on researches in this regard. Fertility drugs are as old as 70 years and if there were risk for cancers, the medical community would have known about it by now.

There are some things you need to know about treating infertility with drugs because of the fear that surrounds infertility, its treatments, and its outcomes. Importantly is to know the real diagnosis of what is causing your Infertility.  It is important to figure out what is causing infertility. Do not make assumptions based on age or using other people as yardstick. Age is also an important factor. “A woman has a physiological age and a chronological age,” says  Copperman . This could also be pranky as the results are not always the same . One would expect a woman lesser than 35 to produce good eggs but a woman older than that could be better in that regard. A reproductive endocrinologist, will provide you with a targeted diagnosis. You cannot afford to overlook pretreatment investigations before starting your fertility treatment. Your doctor will investigate your uterus, eggs or ovarian reserve before commencement of treatments. Semen analysis will also be carried out to check the quality of the sperm. Other things you must note are mentioned below.

 Discussion of Treatment Risks With Your Physician

 The bottom line is when it comes to your health, you need to realize that everybody is different. Dr. Shayma Master Kazmi, a medical oncologist and hematologist with the Cancer Treatment Centers of America in Philadelphia, told Parents that even women who are at risk for breast cancer can undergo fertility treatment. “Every woman needs to discuss her individual risks and benefits with her provider,” she said. Never take medical advice from a friend, website, or medical journal. Only your doctor can help you discuss risks of any treatment.
Decrease cancer risks By staying vigilant of general health

 It is also important to note that women who are trying to conceive get so focussed on fertility, “that they tend to forget their Pap smear, their mammogram, their dental checkup, and other general health care,” Austin told Parents. “A woman’s overall health affects pregnancy, so part of the fertility team’s job is to remind women they still need to take care of those things.” In short, everything in your body is connected, and there’s no better time to be vigilant about your health than when you are trying to conceive.

 IVF and Ovarian Cancer

 During the 2015 American Society of Reproductive Medicine (ASRM) conference, Dr. Alastair Sutcliffe of Institute of Child Health at University College London presented a study looking at the cancer risk in women who had gone through IVF treatment. The study included over 250,000 British women and spanned treatment cycles between 1991 and 2010. The good news was that they found no increased risk of breast or uterine cancer in the former IVF patients. However, the bad news is that the study found an increased risk in ovarian cancer.
While women who had never gone through IVF had an 11 in 10,000 chance of developing ovarian cancer, the IVF patients had a 15 in 10,000 risk. The risk is small but important to recognize.
Similar to the above, the general consensus is that the increased risk is not caused by IVF treatment itself but the fact that the women needed treatment. Infertility and the need for IVF are suspected as the risk. Not the fertility drugs used during treatment.
Having said this, the study also found that the cancer risk was higher in the first three years after treatment. So, it is not possible to completely rule out that the fertility drugs played a role in the cancer risk. Close monitoring in the years after IVF treatment is highly required.

 What are the risk factors for ovarian cancer?

 Different cancers have different risk factors. For example, unprotected exposure to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for a number of cancers. But risk factors don’t tell us everything. Having a risk factor, or even several risk factors, does not mean that you will get the disease. And many people who get the disease may not have had any known risk factors.
Even if a woman with ovarian cancer has a risk factor, it is very hard to know how much that risk factor may have contributed to the cancer. Researchers have discovered several specific factors that change a woman’s likelihood of developing epithelial ovarian cancer. These risk factors don’t apply to other less common types of ovarian cancer like germ cell tumors and stromal tumors.
Age: ovarian cancer is rare in women younger than 40. Most ovarian cancers develop after menopause. Half of all ovarian cancers are found in women 63 years of age or older.
Obesity: obese women (those with a body mass index of at least 30) have a higher risk of developing ovarian cancer.
Reproductive history: women who have been pregnant and carried it to term before age 26 have a lower risk of ovarian cancer than women who have not. The risk goes down with each full-term pregnancy. Women who have their first full-term pregnancy after age 35 or who never carried a pregnancy to term have a higher risk of ovarian cancer. Breastfeeding may lower the risk even further.

 Birth control: women who have used oral contraceptives (also known as birth control pills or the pill) have a lower risk of ovarian cancer. The lower risk is seen after only 3 to 6 months of using the pill, and the risk is lower the longer the pills are used.
Gynecologic surgery: tubal ligation (having your tubes tied) may reduce the chance of developing ovarian cancer by up to two-thirds. A hysterectomy (removing the uterus without removing the ovaries) also seems to reduce the risk of getting ovarian cancer by about one-third.
However, because infertility itself is a risk factor for cancer, follow-up after an infertility diagnosis is important. Women with primary infertility, who never become pregnant and give birth, as well as women diagnosed with endometriosis , may particularly have an increased risk of developing cancer. PCOS, a common cause of infertility, is also known to come with an increased risk of developing endometrial cancer.

Sources

•  https://www.romper.com/p/do-fertility-drugs-cause
•  Knapton, Sarah. ” IVF women third more likely to develop ovarian cancer .” The Telegraph.
•  Kashyap S, Moher D, Fung MF, Rosenwaks Z. Assisted reproductive technology and the incidence of ovarian Cancer: a meta-analysis. Obstetrics and Gynecology.2004 Apr; 103(4):785-94.