The study found no causal association between assisted reproduction and ovarian cancer risk

July 3, 2018

After several years of worry that the hormonal stimulation of the ovaries required for IVF may increase the risk of ovarian cancer, a national cohort study from Denmark concluded that any perceived increase in risk is a statistical bias resulting from a vigilant diagnosis at the time of treatment. The researchers were unable to make a causal association between treatment and the fertility drugs used and any excess risk of ovarian cancer.

The study matched all women who had IVF in Denmark between 1994 and 2015 with ten women in the population analyzed that Assisted Reproduction (ART) treatment 'n'. was not associated with an increased long-term risk of ovarian cancer that would be expected if it were caused by ovarian stimulating hormones "

. FIV or ICSI and 549,210 women without treatment, are presented today at the 34th Annual Meeting of ESHRE in Barcelona by Professor Gynecologist Anja Pinborg of the Department of Fertility at Rigshospitalet, University Hospital Copenhagen, Denmark. Each of the women was followed up to a first diagnosis of cancer, death or end of study in 2015.

The results showed a slightly higher overall risk of cancer. ovary in ART women (0.11%) than in non-ART women (0.06%). However, the analysis also showed comparatively higher rates of ovarian cancer in nulliparous women and in women with a female cause of infertility. In contrast, antiretroviral treatment where the cause of infertility was in the male partner (or even unexplained) was associated with a lower risk of ovarian cancer. It was these abnormalities in the analysis that indicated that any increase in risk observed was not associated with ovarian stimulation per se, but rather with parity status, with the cause of infertility and with to vigilance.

used in assisted procreation was a risk factor for ovarian cancer, although any causal biological mechanism has never been fully explained. This view is based on an observation that the increase in ovarian activity (as in nulliparity or late menopause) increases the risk. In contrast, it has been shown that pregnancy or the use of oral contraceptives, which inhibit ovarian activity, reduces the risk. Nevertheless, and despite these proposals, the increase in age and genetic factors (such as a hereditary mutation of the two BRCA genes) remain the most clearly associated risk factors, although the disease remains complex in his cause and late in his diagnosis.

a population study, which cut across Denmark's comprehensive national registers of cancer and reproductive health, found that any excess risk for women was highest in the first two years after treatment, but risk gradually decreased over the period studied. 12 years after treatment was similar to that of the basic group of the general population. "This trend, say the authors, suggests an influence of detection bias during antiretroviral therapy."

"We found that the increased risk of ovarian cancer in women with assisted reproduction treatment was only present in diagnosed women, "said Pinborg." And in a general population, we have seen that ovarian stimulation does not appear to increase the risk of ovarian cancer. "

She described the results as "reassuring", adding, "I would advise infertile women considering antiretroviral therapy. Ovarian stimulation itself introduces no excessive risk of ovarian cancer. She also noted that while the relative risks appear high among some groups of women, the absolute risk of diagnosing ovarian cancer with a beng remains low.