Considering IVF? First consider the ovarian cancer link

While infertility is on the rise and estimates say that over 80% of couples have trouble getting pregnant, IVF has allowed infertile couples to produce their own biological offspring, yet it is not risk-free, and one of the larger threats is the potential for ovarian cancer.

In a study published in the journal Gynecologic Oncology, women who undergo IVF treatments may be at increased risk of borderline ovarian tumors. The study was completed by researchers from The University of Western Australia. Researchers investigated an entire population of women between 20 and 44 years of age seeking infertility care between 1982 and 2002.

Several factors were taken into account before revealing the final connection, including parity, socio-economic status, age and diagnosis of conditions that could affect fertility.  Based on the number of women diagnosed with borderline ovarian tumors, women undergoing IVF treatment were 2.46 times more likely to develop borderline ovarian tumors than women who did not undergo IVF treatment. Researchers claim the risk factors for borderline ovarian tumors are different than those associated with invasive ovarian cancer.

In another study, IVF treatment may be associated with ovarian tumor growth later in life. According to researchers, women who undergo IVF treatment are four times more likely to develop ovarian tumors and two times more likely to develop malignant tumors.

Researchers used medical records from slightly more than 19,000 women undergoing IVF treatment in the Netherlands. The medical records of women receiving IVF treatment were compared to medical records of 6,000 women who did not receive IVF but sought out fertility help. When the two groups were compared for risk factors and ovarian tumor growth, doctors reported the following results:

  • Women who received IVF treatment were at higher risk of developing ovarian tumors during the follow-up timeframe of just less than 15 years.
  • Ovarian cancer risk increased, but not significantly.
  • Ovarian tumor risk increased 4 times in the IVF group compared to the control group.
  • Ovarian cancer risk increased 2 times in the IVF group compared to the control group.

At the root of the increased risk is ovarian stimulation. During IVF treatment, ovaries are stimulated to mature and release more eggs. This stimulation may cause an increased risk of malignancies, but further research is needed to prove any significant dangers to women undergoing IVF.

Researchers note that doctors should inform patients of the increased risk, but they should not overplay the risks.  If a woman is informed of all potential risks (and every woman should be informed by her doctor), it is ultimately up to her to decide whether she wants to pursue it.

When should you see an infertility healthcare professional? Sooner rather than later

Couple together

In general, it’s recommended to see an infertility specialist after 12 months of trying unsuccessfully to get pregnant if you are under 35 years of age or after 6 months if you are over 35 years of age.

Many couples have a health history that warrants consulting a healthcare professional either before or early in the process of trying to get pregnant. Here are some circumstances in which you should see a fertility specialist:

If the woman has:

  • Irregular no menstrual periods
  • Negative luteinizing hormone tests
  • History of sexually transmitted infection
  • Prior pelvic or abdominal surgery for any reason
  • Prior history of infertility

If the male partner has:

  • Known problems with the testicles or genitals
  • Hypospadias (opening of the urethra not in the end of the penis)
  • Sexually transmitted infection
  • Problems with ejaculation
  • Prior history of infertility

Should social egg freezing become the norm?

What is social egg freezing?

Social egg freezing is a way to postpone motherhood due to career advancement, lack of a partner, or simply just not being ready to be a mother yet as opposed to freezing your eggs for medical reasons. In the past, egg freezing was only offered to women who had medical issues such as cancer and wanted to preserve their eggs to start a family after treatment. However, now more women are postponing motherhood and deciding to preemptively freeze their eggs via vitrification, the fast freezing process that prevents ice crystal formation; protecting cells from damage.

The service is widely available at fertility clinics and typically offered to women 38 years of age and younger who want to keep the option of having a healthy baby at a later date. The idea of social egg freezing is that if you can preserve eggs by freezing them, you can not only use them later on when the time is right for you, but you can enjoy life without the looming biological clock ticking. With infertility affecting approximately 6.1 million individuals throughout the United States, many women feel that there is no time to take chances, although social egg freezing offers no absolute assurance.

What are the risks of social egg freezing?

Side Effects from IVF: While there are no hard studies on the outcome of social egg freezing, there are certain risks involved with harvesting and freezing your eggs, most of which arise from the stimulation of the ovaries. According to the Canadian American Medical Journal, common and controllable symptoms include “fatigue, nausea, headaches, abdominal pain, breast tenderness and irritability, but these adverse effects can usually be well-controlled.” Yet, up to 2% of patients “may experience severe ovarian hyperstimulation syndrome, resulting in blood clots, shortness of breath, abdominal pain, dehydration and vomiting that necessitates admission to hospital.”

Pregnancy Complications: Another risk stems simply from being pregnant in advancing years. The older a woman conceives, the higher her risk for gestational diabetes, preeclampsia, cesarean delivery and preterm delivery of a baby with low birth weight. Further studies need to be done to weigh the risk to babies born from frozen eggs.

Financial: One last risk of social egg freezing is the financial gamble. IVF can cost tens of thousands of dollars and may need to be repeated in several cycles. Currently, only 15 states cover IVF cost through health insurance. The Society for Assisted Reproductive Technology reports that the live birth rate for each new IVF cycle ranges from 41 to 43 percent for women under age 37, and from 13 to 18 percent for women over 40. A basic IVF cycle costs around $12,000, not including fertility drugs and testing. Some women worry that they have not frozen enough eggs and become ‘addicted’ to freezing more and more eggs, just in case.

Emotional: Social egg freezing may seem like a great idea to ensure motherhood or at least postpone the possibility, but it’s not foolproof. Pregnancy is not guaranteed. In addition, a woman has to decide how many eggs she wants to freeze before she begins and as her age advances, her egg quality declines. It is entirely possible for none of the frozen eggs to produce any healthy pregnancies.

The Controversy: According to the U.K. journal Human Fertility, “there have been relatively few research studies which explore either women’s awareness and understandings of social egg freezing or the reasons why women consider or undertake egg freezing.” Some say that freezing eggs when you are perfectly healthy is not ideal and that perhaps IVF should be saved for extreme cases that involve cancer or other reproductive challenges. After all, pregnancy is much less taxing when you are young and healthy, and inducing the hyperstimulation of your ovaries is not a natural or risk-free process. Yet, at the same time, it has become more and more acceptable for women to put off motherhood for the sake of their career. To this end, companies such as Apple and Facebook now offer to cover the costs of egg freezing for their employees.