There is major controversy over the alleged association between neoplasms and IVF treatment. There is no clear evidence proving this claim is right or wrong. Some research shows there is a slightly increased occurrence of neoplasms in several cases. However, it is not clear whether these cancers are directly linked with infertility or IVF. In any case, women who are have induced ovulation (IVF) performed should have been thoroughly screened for the likelihood or early neoplasms. Meanwhile, there are cases with diagnosed neoplastic disease and infertility, where IVF may take place and there have been case reports of women who gave birth following treatment for the disease.
The studies conducted so far show no evidence that medications used in infertility or induced ovulation (IVF) have an increased chance of causing cancer (clomiphene citrate, gonadotropins, GnRH agonists, GnRH antagonists, progesterone). The likelihood for cancer is related to the patient’s history and, particularly, we refer to breast, endometrial, cervical, and ovarian cancer. Therefore, each woman to undergo IVF should have her breast palpated, a digital mammography, a breast ultrasound, a vaginal ultrasound, a test PAP, and in case of differential diagnosis, an ovarian Doppler, and cancer marker testing (CEA, Ca 125, α-foetal haemoglobin, β-chorionic).
In recent years, radiotherapy and chemotherapy used to treat cancer have shown remarkable results. Therefore, the attempt to preserve such patients’ reproductive potential before proper treatment is initiated is of major importance. With regard to the male factor, sperm freezing prior to treatment initiation is almost standard practice. Sperm freezing may take place even during chemotherapy. With regard to the female factor, thins are complicated. In cases where disease progression allows it, genetic material (ovarian tissue freezing) or egg and embryo freezing may take place before treatment. These embryos may be placed in the woman’s uterus once she is healed from cancer.
These are the cases where “drug-free IVF” (In Vitro Maturation – IVM), “natural cycle” and “ovarian tissue freezing” are applied. Following treatment and depending on its type, it will be assessed whether or not IVF is allowed. In this case, the “natural cycle” may be applied. A technique applied in recent years is frozen egg or embryo transfer. Moreover, if a woman undergoes surgery for gynaecological cancer and has her uterus removed, there is the option to place embryos in another woman’s uterus (surrogate uterus). In conclusion, IVF drugs cannot be “blamed” for inducing neoplasms. However, pre-IVF screening is absolutely necessary. Also, in cases of diagnosed neoplasm, it is possible to have a child using IVF and proper treatment.
Dr. Elias Gatos
Surgeon Gynaecologist – Obstetrician
EmBIO Scientific Director