The researchers with the National Institutes of Health have found that women who started taking fertility drugs and went through IVF around their 24th birthday were found to have a 56 per cent greater chance of developing breast cancer than those in the same age group who went through treatments without IVF.
Many studies have attempted to pinpoint what the actual risk is, with some showing a reduction in risk, others showing increased risk, and others even showing no change at all.
Ovulation-stimulating fertility drugs temporarily elevate estrogen levels in women, and estrogen is known to play an important role in breast cancer. While some studies report increased breast cancer risk following infertility treatment, other analyses have been inconclusive.
But there was no increased risk for women who started fertility treatments when they were about 40 years old, regardless of whether they had IVF or not, according to the Australian study
The researchers said: ‘For younger women there is some cause for concern, because it appears that they may face an increased risk of breast cancer after IVF treatment.’
The findings were based on a study of more than 21,000 women and published in the journal Fertility and Sterility.
Study author Louise Stewart from the University of Western Australia said younger women might see an increased risk of breast cancer because they are exposed to higher levels of circulating estrogen during their cycles of IVF treatment.
However, experts who reviewed the study said it has flaws and is far from conclusive.
Two other experts took issue with the study’s methodology.
“It is hard to draw a conclusion as to whether or not treatment for infertility increases the risk of breast cancer from this study,” said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City. She said these types of cases-vs.-control group studies are somewhat unreliable, and she pointed out that while some prior studies looking at fertility drugs and breast cancer have found a link, others have not.
For his part, Dr. Paul Tartter, a breast surgeon at St. Luke’s & Roosevelt Hospital Center in New York City, noted that “previous studies have not found an increased risk [of breast cancer for women on fertility treatment]. Only one previous study noted a slightly increased risk, which was not statistically significant.”
Because of the complexities in assessing the relationships of fertility drugs to cancer risk, it is clear that additional research will be needed to fully understand the associations. Case–control studies can generate hypotheses, but further resolution of relationships is ultimately dependent on cohort studies that obtain detailed information on drug exposures and clinical indications for usage before the disease onset. These studies are complicated by diverse and changing treatments, which could have unique effects. Because of such complexities, results from individual investigations must be cautiously interpreted and weighed against the considerable benefits associated with fertility drug usage, including a high probability of carrying pregnancies to term, which can lead to substantial long-term reductions in breast cancer risks.
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