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Does IVF treatment increase the risk of ovarian cancer?

27 October 2011

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In vitro fertilisation (IVF) treatment may increase a woman’s risk of developing ovarian cancer, according to a study published in the journal Human Reproduction.

The researchers wanted to find out if ovarian stimulation, used to generate eggs in woman having IVF, increased the risk of ovarian cancer. They compared two groups: women who had had IVF treatment and women with fertility problems who hadn’t had IVF treatment. They then compared the results of both groups to the already known risk in the general population.

They found that over 15 years there was an increase in the risk of borderline ovarian tumours in the women who had IVF when compared to the general population. Borderline ovarian tumours have some features of cancer but grow slowly and can usually be treated successfully.

Also, they found a slight increase in risk of more serious, invasive ovarian cancer when comparing the women who had IVF to the women with fertility problems who hadn’t had IVF.

The researchers concluded that there is a two-fold increase in risk for ovarian tumours in women who have had IVF, although this is mostly the borderline type.

Dr Ryan Mehta, Project Clinical Director, Bupa Health and Wellbeing, commented: “The number of women who actually developed ovarian cancer in this study was small in real terms. The conclusion that a woman’s risk of ovarian cancer is doubled is misleading, as this increase is only relative to other numbers in the study and does not take into account a woman’s lifetime risk of the disease. As the researchers themselves say, in the Netherlands, a 55-year-old woman’s risk of developing ovarian cancer is 45 in 1,000; the risk increase found in this study equates to 71 women in 1,000 developing the disease

“There are many issues in this study that make it difficult to draw any viable conclusions. The comparison non-IVF group of women is not really a true control group as a large proportion of them took fertility drugs that would have had the same ovary stimulating effects. Also, interestingly, the number of cycles of IVF a woman had did not appear to increase her risk of developing ovarian cancer. It seems logical that the more ovarian stimulating treatment a woman was given, the greater her risk would be, but this wasn’t found.

“However, of most importance is the fact that this study was carried out before 1995 when the protocol for IVF was changed. This change has resulted in much milder ovary stimulating drugs now being given. Therefore, the findings of this study may not be relevant to anyone undergoing IVF or anyone who has had IVF in the last 15 years.”

The researchers looked at over 26,000 women from the Netherlands between 1983 and 1995. Almost 20,000 of the women had IVF treatment; the other 6,000 had fertility problems but did not have IVF. Each woman was asked to complete a questionnaire including information about their lifestyle, fertility problems and any previous fertility treatments. The researchers then followed up the women over a 15-year period using medical records to see how many went on to develop ovarian cancer.

Of the almost 20,000 women who had IVF, 61 developed ovarian tumours. In the general population, this number would be expected to be 38 women. In the non-IVF group of over 6,000 women, 16 developed ovarian cancer, which is exactly as would be expected in the general population.

Key facts

  • In vitro fertilisation (IVF) is a procedure where egg cells are surgically removed from a woman and mixed with sperm in a laboratory. Once the eggs have been fertilised, they are placed in the womb.
  • IFV can be carried out with a man’s own sperm and a woman’s own eggs or with eggs and sperm from a donor.
  • Medicines are used to increase the number of eggs a woman produces and to control the timing of a woman’s monthly cycle so that the eggs can be removed and fertilised on a specific day.
  • Successful fertilisation can be seen with a microscope after about 16 to 20 hours.

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Read the study

van Leeuwen FE, Klip H, Mooij TM, et al. Risk of borderline and invasive ovarian tumours after ovarian stimulation for in vitro fertilization in a large Dutch cohort. Human Reproduction 2011; online first, doi:10.1093/humrep/der322

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