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Fertility drugs and cancer
Title: Risk of cancer after use of fertility drugs with in-vitro
fertilisation
Author: A. Venn, et al.
Address: Victoria, Australia
Source: Lancet 354: 1586-1590 (November) 1999
Summary: Researchers investigated the incidence of invasive cancer of the
breast, ovary, and uterus in a cohort of patients who had undergone IVF and
examined whether cause of infertility or exposure to fertility drugs to induce
superovulation was associated with an increased cancer risk. The observed number
of cancers was compared with the expected number calculated by application of
age-standardized general-population cancer rates to the cohort. The group
consisted of 29,700 women: 20, 656 were exposed to fertility drugs and 9,044 were
not. 143 breast cancers, 13 ovarian cancers, and 12 cancers of the uterus
occurred among these women. For breast and ovarian cancer the incidence was no
greater than expected . The incidence of uterine cancer was no higher than
expected in the exposed group but was significantly higher in the unexposed
group. Women with unexplained infertility had significantly more cancers of the
ovary and uterus than expected. Analysis of cancer incidence within 12 months of
exposure to fertility drugs with IVF showed that incidence was significantly
higher than expected for breast and uterine cancer. Unexplained infertility was
associated with an increased risk of a diagnosis of ovarian or uterine cancer.
The rate of uterine cancer was significantly higher than expected among 9,083
women who registered for IVF but were not treated. Ovarian and uterine cancers
were more common than expected in women with unexplained infertility,
irrespective of their IVF treatment status. There is a possibility that fertility
drugs used for superovulation in IVF may promote the development of pre-existing
cancers.
Comment: This is the most important study to date on this important issue.
The data and conclusions are consistent, the evidence is overwhelming in support that
fertility drugs due not cause ovarian cancer. It is very difficult to assess how
much emotional damage has been caused by the earlier studies possibly showing a
weak association of cancer and fertility drug use.
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