Study: Does IVF increase a woman’s risk for breast cancer?
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This study is about:
Whether breast cancer risk increases after in vitro fertilization ().
Why is this study important?
use did not become common until the 1980s. Because of this, much is unknown about its long-term effects, including how it affects breast cancer risk.
- The number of breast cancer cases that occurred in women who had was similar to:
- The number of breast cancer cases that occurred in women who did not have (but had a different fertility treatment)
- The number of breast cancer cases that would be expected in women in the general population.
What does this mean for me?
This study suggests that treatment does not increase a woman’s risk for developing breast cancer. However, because most of the study population was younger than age 60, more work needs to be done to see whether or not postmenopausal breast cancer risk is increased after . Patients who are having trouble conceiving and are considering should talk to their healthcare provider.
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Kotsopoulos J, Librach CL, Lubinski J, et al. “Infertility, treatment of infertility, and the risk of breast cancer among women with and mutations: a case-control study.” Cancer Causes Control. 2008 Dec; 19(10): 1111-19.
van den Belt-Dusebout AW, Spaan M, Lambalk CB, et al. “Ovarian Stimulation for In Vitro Fertilization and Long-term Risk of Breast Cancer.” JAMA. 2016; 316 (3): 300-12.
FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.
This article is relevant for:
Woman at average risk for breast cancer who have or are considering undergoing In Vitro Fertilization
This article is also relevant for:
Healthy people with average cancer risk
Women under 45
Women over 45
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IN DEPTH REVIEW OF RESEARCH
The hormones estrogen and progesterone are known to affect breast cancer risk. Because the process of in vitro fertilization () temporarily alters the levels of these hormones, healthcare providers and researchers have expressed concerns about the effect of on breast cancer.
Although other studies have looked at the effect may have on breast cancer risk, many of these past studies had a short follow-up time after , or did not compare breast cancer rates in women who had to women who did not use but were also having difficulty conceiving.
Alexandra van den Belt-Dusebout and her colleagues from the Netherlands Cancer Institute and other institutions published work in the July 2016 Journal of the American Medical Association (JAMA) that assessed the long-term risk of breast cancer for women who had .
Researchers of this study wanted to know:
Does a woman’s breast cancer risk increase after undergoing ?
Population(s) looked at in the study:
The 25,108 women in this study were part of the Omega study cohort of women who were being treated for difficulty conceiving in clinics in the Netherlands between 1980 and 1995. The group included 19,158 women who had undergone , whether or not it resulted in a successful pregnancy, and 5,950 women who underwent fertility treatments other than , such as artificial insemination, tubal surgery, and other hormonal treatments. None of the women had cancer before their treatment. Women in the study were followed for about 21 years after their treatment to see if they developed breast cancer.
- The number of women who developed breast cancer after was not significantly different from the number of women who developed breast cancer, but not after having . This suggests that did not influence breast cancer risk:
- 3% of women who underwent developed breast cancer by age 55.
- About 3% of women who did not undergo (but had a different fertility treatment) developed breast cancer by age 55.
- The number of women who developed breast cancer after was not significantly different compared to the number of women who were expected to develop breast cancer in the general population.
This study is based of treatment procedures used until 1995. Current procedures differ slightly in the number and length of some cycles.
For most women in the study, the researchers did not know their age at menopause or menopausal status at the end of their follow up. The researchers stated that, “If IVF-treated women reach earlier menopause than women in the general population, breast cancer risk after may have been underestimated.”
This study looked at women in the general population, and did not ask about the women’s family history of cancer or mutation status that might affect cancer risk, so we do not know if these results apply to carriers of or other mutations that increase breast cancer risk. However, these results are similar to a previous study done on breast cancer risk in mutation carriers who had or took other fertility medications. But this study population was small, and the researchers emphasized the need to interpret their results with caution and to see if they could be confirmed with a larger study.
The results of this study suggest that in vitro fertilization does not increase a woman’s risk of developing breast cancer. However, because of the limitations of the study, more work needs to be done in a population that includes postmenopausal women, so that researchers can assess postmenopausal breast cancer risk in women who use current procedures and confirm these findings. Women who are having trouble conceiving should talk to their healthcare provider to determine what options are best for them.
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- What are the risks associated with ?
- How will affect my breast/ovarian cancer risk?
- Is safe after breast cancer?
- Are there alternative fertility treatments?
- Will my insurance cover the costs associated with ?
The following research studies related to fertility preservation are enrolling patients.
Fertility preservation studies for women
- NCT01503190: The Immune System's Response to Young Women's Breast Cancer. This an observational trial looking at tissue samples from patients with Pregnancy-Associated Breast Cancer (PABC) versus non-PABC to understand how the immune system responds.
- NCT05443737: Evaluation of a Telehealth Oncofertility Care Intervention in Adolescent and Young Adult Cancer Patients. The purpose of this study is to evaluate the effectiveness of an intervention to improve young cancer survivors' oncofertility care.
- NCT0301168: Fertility Preservation Using Tamoxifen and Letrozole in Estrogen Sensitive Tumors Trial (TALES). Infertility as a result of cancer treatment effects long-term quality of life in survivors of reproductive-age cancers. This trial will study different options for fertility preservation in patients with estrogen-receptor-positive breast cancer.
- NCT00823654: Serum Biomarkers to Characterize the Effects of Therapy on Ovarian Reserve in Premenopausal Women With Breast Cancer or Mutations. This study will look at how cancer treatment affects the ovaries. Researchers will review blood samples before, during and after cancer treatment to look at levels of hormones that are produced by the ovaries and ask patients to fill out questionnaires about their menstrual cycles (periods), overall health and pregnancies.
- NCT01788839: Longitudinal Sexual and Reproductive Health Study of Women With Breast Cancer and . This study looks at how cancer treatment affects sexual and reproductive function. The patient will be asked to give a blood sample to see if and how cancer treatment affects the ovaries and the ability to have children (fertility). These blood draws are optional; patients can participate in the study questionnaire even if they choose not to have their blood drawn.
- NCT01558544: Cryopreservation of Ovarian Tissue. The study hopes to contribute to the development of technologies of ovarian tissue freezing-thawing the preserve fertility. The study is open to women who will undergo treatment or surgery for cancer or women with an inherited mutation who are considering undergoing risk-reducing surgery.
- NCT01788839: This study's goal is to see how cancer treatment affects sexual and reproductive function. Participants will also be asked to participate in optional blood tests to see if and how cancer treatment affects the ovaries and the ability to have children.
Fertility preservation for men
- NCT02972801: Testicular Tissue Cryopreservation for Fertility Preservation. Testicular tissue cryopreservation is an experimental procedure where testicular tissue is retrieved and frozen. This technique is reserved for young male patients, with the ultimate goal that their tissue may be used in the future to restore fertility when experimental techniques emerge from the research pipeline.
If you are in your reproductive years and have been diagnosed with cancer, or you are considering steps to lower your cancer risk that will interfere with your fertility, you should request referral to a fertility expert.
- The Oncofertility Consortium maintains a national database of healthcare providers with expertise in fertility preservation and treatment of people who are diagnosed with cancer or at high risk for cancer due to an inherited mutation.
- Register for the FORCE Message Boards to get referrals from other members. Once you register, you can post on the Find a Specialist board to connect with other people who share your situation.
Who covered this study?
No breast cancer risk seen with IVF
Medpage Today This article rates 4.0 out of 5 stars
The Washington Post
Fears about IVF and cancer may be unfounded This article rates 4.0 out of 5 stars
The New York Times
I.V.F. does not raise breast cancer risk, study shows This article rates 3.5 out of 5 stars
Study: IVF is not linked to increased risk of breast cancer This article rates 3.5 out of 5 stars