Infertility Linked With Increased Ovarian Cancer Risk

A study in Great Britain found that women diagnosed with infertility were at an increased risk for ovarian cancer. The study looked at women who underwent assisted reproductive therapy (ART) and included more than a quarter million women.

Specifically, women diagnosed with female factor infertility, especially endometriosis, had significantly increased risk for developing ovarian cancer, according to results presented by Alastair Sutcliffe, MD, PhD, of the Institute of Child Health, University College London, at the 71st Annual Meeting of the American Society for Reproductive Medicine (ASRM).

In order to obtain follow-up data on cancer outcomes, deaths, and emigrations, Sutcliffe and colleagues linked records taken from the Human Fertilisation & Embryology Authority detailing all women who had undergone ART between 1991 and 2010 with the National Health Service Central Registers. The researchers then stratified cancer incidence in the group by age and calendar period and compared it with expectations derived from annual age-specific national rates during the same time period.

The researchers found that 386 ovarian cancers occurred in the group of 255,786 women during a median of 8.8 years follow-up.

Overall, there was an increased risk for developing ovarian cancer among all women undergoing ART (standardized incidence ratio [SIR], 1.37 [95% confidence interval (CI), 1.24–1.51]).

No increased risk was seen with an increasing number of ART cycles, and the risk for developing ovarian cancer was highest within the first 3 years after the first ART cycle (SIR, 1.54 [95% CI, 1.27–1.88]), the researchers found.

Interestingly, no increased risk for ovarian cancer was seen among women undergoing ART for male factor infertility (SIR, 1.05 [95% CI, 0.86–1.28]). However, a significant increased risk was observed in women undergoing ART for female factor infertility (SIR, 1.62 [95% CI, 1.42-1.84]), especially those women with endometriosis (SIR, 2.35 [95% CI, 1.80–3.07]).

In addition, the researchers found an increasing risk for ovarian cancer with decreasing parity (P_trend = .002). Those women who had no live births at the end of the ART had the greatest risk for disease (SIR, 1.54 [95% CI, 1.34–1.76]).

Owen Davis, MD, president-elect of ASRM said in a prepared statement, “Dr. Sutcliffe and his colleagues have made an important contribution to our knowledge of the connection between infertility and ovarian cancer in the context of ART. It appears that ovarian cancer risk is increased in some women who have had ART treatment. However, women who underwent ART for non-female infertility diagnosis did not have an increased risk of ovarian cancer. This is reassuring because it suggests that ovarian cancer is not caused by ART per se, but rather is associated with the underlying infertility diagnosis.”