Slight Increase Risk in Ovarian Cancer with Use of Fertility Drugs
Findings from a newly published study should reassure women and their doctors. The study found little association between the use of infertility drugs like Clomid and ovarian cancer.
The study appears in the latest issue of the journal BMJ Online First. The researchers followed 18,970 women who had invitro fertilization (IVF) procedures from 1983 to 1995, and 7,536 subfertile women evaluated from 1980 to 1995 but who did no undergo ovarian stimulation.
After 15 years of follow-up, investigators documented 61 ovarian malignancies. This was in comparison to the 38.4 that would have been expected. A ration of 1.59. After excluding patients whose ovarian malignancies were diagnosed within a year of their IVF procedures, the ratio remained elevated at 1.49.
In vitro fertilization procedures modestly increase the risk of ovarian cancer, primarily borderline tumors with low malignant potential, data from a large cohort study suggests.
Women who underwent ovarian stimulation had about a 50% increase in the relative risk of ovarian tumors compared with the general population. However, the risk remained less than 1% (o.72%) compared with a risk of 0.45% in the general population.
"So, what do you tell the VF patient who comes to your office and asks whether her risk of ovarian cancer is increased?" Dr. Burger asked. "Well, you can tell her the risk after IVF is slightly increased, but it is still increased."
Ovarian cancer usually occurs in women over age 50, but it can also affect younger women. Its cause is unknown. Ovarian cancer is hard to detect early. Often women with ovarian cancer have no symptoms or just mild symptoms until the disease is in an advanced stage and hard to treat.
Symptoms of ovarian cancer are nonspecific and mimic those of many other more common conditions, including digestive and bladder disorders. A woman with ovarian cancer may be diagnosed with another condition before finally learning she has cancer. Common misdiagnoses include irritable bowel syndrome, stress and depression.
The key seems to be persistent or worsening signs and symptoms. With most digestive disorders, symptoms tend to come and go, or they occur in certain situations or after eating certain foods. With ovarian cancer, there's typically little fluctuation - symptoms are constant and gradually worsen.
Burger C, et al "The risk of borderline and invasive ovarian tumors after ovarian stimulation for in vitro fertilization in a large Dutch cohort after 15 years of follow-up" Gynecol Oncol 2009; 112(Suppl 1): Abstract 6