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Could IVF Increase Your Cancer Risk?

Photograph by Twenty20

I was 24 years old the first time I did in vitro fertilization—only then it wasn't for me. I was an egg donor, and I went through the full process of injecting myself with hormones and undergoing minor surgery for the extraction of my eggs. Twice. My second donation took place six months after my first.

At the time, I was identified as an "ideal" donor. I was told my ovaries were perfect, and that I would have no problem having babies when my time came.

A year after my second donation, I was being told a different story. Now, I had Stage IV endometriosis and was told my fertility had become a now or never proposition; that a hysterectomy was in my very near future.

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I was 27 years old the first time I did IVF for myself. By then, my odds weren't looking good; the quality of my eggs had diminished from "excellent" to "fair" in just three years.

That IVF cycle failed. So did the next, just a few months later.

By 28, I had injected myself full of hormones in the pursuit of a baby (first for someone else, then for myself) a total of four times.

Because my egg donations were considered a contributing factor to the severity of my condition by every single doctor who ever saw my before-and-after records, I often wondered just what those hormones might have done to my body. I became active in an online support group for donors, and came across an astonishing number of stories similar to my own (other donors who developed severe complications with endometriosis after donating), as well as stories that involved complications I hadn't personally dealt with. One woman developed ovarian cancer shortly after donating, while in her mid-20s. She had no family history and was far younger than the typical ovarian cancer diagnosis. And all of us wondered … could her donations have done this to her?

There is no one willing to dedicate the time and money to long-term studies that might bring into question the safety of these treatments that produce so much profit.

Of course, we had no way of knowing for sure. Even with the number of us who had developed endometriosis (an estrogen dependent condition) after donating, we could only speculate. With very little research into the safety of the drugs we had been given, and no research at all dedicated to the long-term health effects to donors (who are a different population entirely from the average recipient), there was nothing definitive to point to and say, "There it is. The undeniable proof that our gut instincts about these hormones have been right all along."

And then, a preliminary study came out from the UK last month that purported women who had undergone IVF were one-third more likely to develop ovarian cancer than those who had never injected themselves with the same hormones.

After reading it, I was sad, angry and irritated with an American medical system that has not contributed to this research in any way. Because in America, the infertility industry is for-profit, which means there is no one willing to dedicate the time and money to long-term studies that might bring into question the safety of these treatments that produce so much profit.

For the record, an increased risk of one third actually isn't drastic when you consider the average woman has a only 1.5 percent risk of developing ovarian cancer. So IVF might increase that risk to 2 percent. The research did find that the younger a woman pursues IVF, the greater her risk will be (which … great). But it also found that repeat usage of IVF does not further increase the risk, and that the women who were pursuing IVF as a result of male-factor infertility did not have any increased risk. Which does beg the question of whether IVF is contributing to the increased risk, or if women pursuing IVF might already just have some increased risk factors against them.

Now, it's important to note that with ovarian cancer (really, with most cancers) there doesn't necessarily have to be one definitive "cause." A while back, I interviewed a genetic counselor about breast cancer, and she explained the theory of bricks and pebbles adding up to the development of cancer. A brick might be a strong family history, while a pebble might be a smaller environmental contributor.

So basically, it would make sense if what we are seeing with IVF is that it is acting as a pebble, not a full-on brick. For women who already have a backlog of pebbles (things like their period starting young, never having children or heavy drinking, and some infertility-related conditions) it could be the final factor pushing those risks over the edge.

Or it could be just a coincidence, related only because women pursuing IVF are women who already have a buildup of pebbles that contribute to cancer risk.

One more thing to keep in mind with this most recent study is that the timeline within which the research has been conducted is still fairly limited. They only followed women for 8.8 years after IVF. Most of those women wouldn't yet be at the "average" age for ovarian cancer diagnosis (63). Most cancer is sporadic, the product of many pebble-like risk factors adding up over decades, and sporadic cancer takes longer to develop. So if what we are seeing now is an increased risk for younger women, most of whom are still a decade or two away from the average age of diagnosis, it's possible that we'll see that risk go up even more as these women get closer to their 60s. Which would add to the pebble theory.

Right now, it's all still pretty much speculation. Even with this, one of the largest studies to date on the issue of cancer and IVF, there are more questions than answers. This hopefully at least highlights the need for more research, not just about cancer, but also about some of the many other potential concerns and conditions that have been raised regarding what these hormones may be doing to our bodies.

For women, and their families, who have been diagnosed with one of those conditions shortly after IVF, it's also hard to ignore the "coincidence" of it all.

We just don't know enough. And we're relying on other countries, where IVF is a part of the government health system, to do that research for us. Because here? Those who might otherwise be integral to completing that research don't want to be involved in anything that could cut into their bottom line.

And that's the real problem. Not that IVF could potentially contribute to a one-third increase in the risk of ovarian cancer development, but that the research we have into the long-term safety of these drugs is sorely lacking. And while a lot of women pursuing IVF would probably continue down that path, regardless of what the risks might be, they still deserve to have some definitive answers.

They still deserve to know.

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So there you have it. IVF may, or may not, increase your risk of cancer development, and of other conditions that have yet to be studied. It's the same crapshoot it's always been.

But for women, and their families, who have been diagnosed with one of those conditions shortly after IVF, it's also hard to ignore the "coincidence" of it all. Especially when their stories aren't totally isolated.

The research matters. And there are questions that need to be answered.

It's just unfortunate that the US fertility industry doesn't seem interested in pursuing those answers here at home.

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