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Do Fertility Drugs Cause Breast Cancer

Fertility Drugs Do Not Raise Breast Cancer Risk Study Finds

Do Fertility Treatments of Fertility Drugs Cause Breast Cancer?

Women who took a fertility drug called Clomid dont have any higher risk of breast cancer, even 30 years later, than women who did not, a new study shows.

The findings should reassure women worried that they would pay down the road for having taken the drug, which stimulates the production of eggs.

Overall, our data show that use of fertility drugs does not increase breast cancer risk in this population of women, which is reassuring, says Louise Brinton, who heads research on hormone-related cancer at the National Cancer Institute.

In 2009, another team of researchers showed the drugs also did not appear to raise the risk of ovarian cancer.

It is a hard risk to study, because women who are infertile have a higher risk of cancer, so its been difficult to show whether the drugs raise the risk. Brintons study, published in the journal Cancer Epidemiology, Biomarkers and Prevention, shows women who did not conceive despite taking fertility drugs had nearly twice the risk of breast cancer compared with women who did not take fertility drugs.

And women who took 12 or more cycles of Clomid, known generically as clomiphene, also had a small increased risk, the study of 9,800 women showed.

The observed increase in risk for these small subsets of women may be related to persistent infertility rather than an effect of the medications, said Brinton. Nevertheless, these findings stress the importance of continued monitoring of women who are exposed to fertility drugs.

What Can Cause Fertility Problems

When a couple makes a baby, this is called conceptionor reproduction. When a baby is conceived naturally, a lot of things must take place for it to happen. For example, we know a female is born with all the eggs she will ever have and theyre stored in her ovaries. Any change in how the ovaries work, or a change in a hormone that’s needed to release an egg from the ovary during monthly cycles , can cause conception not to happen. In other words, there can be a body system malfunction that can change a woman’s fertility and affect her ability to get pregnant and carry a child through a pregnancy. Certain health problems, including cancer, can affect these things.

Females can be diagnosed as infertile if:

  • The ovaries dont contain healthy eggs
  • Hormones that are needed to help with egg release are disrupted
  • A tumor or other problem might press on the ovaries or uterus and cause them not to work properly
  • Damage to other parts of the reproductive system prevents eggs from being released, fertilized, or implanted
  • A fertilized egg cannot grow inside the uterus
  • Something happens that won’t allow a fetus to be carried through the full pregnancy, causing a miscarriage

In many cases, cancer surgery or treatments can be more likely than cancer itself to interfere with some parts of the reproductive process and affect your ability to have children. Different types of surgeries and treatments can have different effects. The risk of infertility varies depending on:

How Has This Been Linked With Breast Cancer Risk

Controlled ovarian stimulation increase the amount of the sex hormones estrogen and progesterone to higher levels than is normally found in the body.

Controlled ovarian stimulation increase the amount of the sex hormones estrogen and progesterone to higher levels than is normally found in the body. Since these hormones have been linked to breast cancer risk, this fertility treatment has been suspected to increase the risk of breast cancer.

Previous studies have not found a clear association between controlled ovarian stimulation and breast cancer risk, but they have been limited by short follow-up time and few breast cancer cases.

Since these treatments are relatively new, most women who have gone through them are still below the age at which breast cancer is usually diagnosed. It is also difficult to separate effects of the treatment from that of the underlying infertility.

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Other Types Of Cancer

An Australian study showed no increase in the risk of malignant melanoma , and two studies from the Netherlands showed no increase in the risk of either malignant melanoma or colorectal cancer . Four studies that examined overall cancer risk found no increase in association with fertility treatment , .

Relationship Between Steroid Hormones And Cancer

Fertility drugs do NOT increase cancer risk, study finds ...

In general, cancer occurs as a result of the division of mutated cells. Therefore, the hormone and any factor that stimulates the growth of the cells can affect the occurrence of cancer . The relationship between steroid hormones and some types of cancers, such as breast and endometrium cancers, is well-documented . Estrogen, progesterone, and testosterone are steroid hormones that are produced following a series of biological responses and are derived from cholesterol. Estrogen, which is one of the most important female sex hormones, is produced in the ovaries, the adrenal cortex, and the placenta, and leads to the growth of the reproductive system and the development of sexual traits . Based on the results of studies, free estradiol and albumin-bounded estradiol are associated with an increased risk of breast cancer and can enhance the progression of metastatic breast cancer . High levels of estradiol and estrogen hormones in women with breast cancer contribute to the progression of metastatic breast cancer . Estrogen can contribute to the onset of cancer by affecting the mitosis duplication of epithelial cells. Increasing mitotic activity can play a role in increased probability of mutation and DNA damage, and reduced apoptosis and growth of early tumors .

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Cohort Identification And Data Collection

A cohort of women with infertility problems referred to Danish hospitals or private fertility clinics in the period 1965 to 1998 was established. All gynecological departments and all private fertility clinics in Denmark were included. Patients were identified from medical files, microfilms, or index cards. In addition, we included patients with an infertility diagnosis recorded in the National Patient Registry, a nationwide registry of virtually all somatic discharges in Danish Hospitals since 1977. Both women with primary and secondary infertility were included in the study. A total of 54,379 women were included in the infertility cohort.

Identification Of The Subcohort

In a case-cohort design, the experience of all cases is compared with the experience of a randomly selected subcohort . In the present study, a subcohort of 1,360 women were randomly selected from the cohort in four strata for the age at entry to the infertility cohort and five strata for the year of entering the infertility cohort , equaling 20 strata.

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Does Fertility Treatment Raise Breast Cancer Risk

Breast Cancer Diagnosis for Giuliana Rancic Raises Questions About In Vitro Fertilization

Oct. 18, 2011 — When E! News anchor Giuliana Rancic made her breast cancer diagnosis public, there was speculation about whether fertility treatment might have been a factor.

On NBC’s Today show, Rancic, 37, said she got a mammogram when her doctor strongly recommended it before starting another round of IVF . On their reality TV show, Rancic and her husband, Bill, have chronicled their previous fertility treatments.

Rancic’s diagnosis has raised questions about whether fertility treatment can increase the risk for breast cancer. WebMD got answers from fertility and breast cancer specialists.

Borderline Ovarian Tumors And Ivf

Do Fertility Drugs increase your Breast Cancer Risk?

The Cochrane review did find a possible increased risk of borderline ovarian tumors in women who went through IVF treatment. This risk was not present after Clomid or Clomid with gonadotropins treatment alone. The treatment of borderline ovarian tumors isnt as intense and involved as with typical ovarian tumors, and the prognosis for women with a borderline tumor is very good.

A 2015 study tried to further investigate the possible risk of borderline ovarian tumors and fertility treatment. What they found was that there was no strong link between borderline ovarian tumors and fertility drug use.

There may be a possible connection between borderline ovarian tumors and progesterone supplementation.

Researchers found that the risk of borderline ovarian tumors was higher for women who used progesterone compared to those who never did and higher in women who had four or more cycles of progesterone supplementation.

That said, the number of women in the study with borderline tumors was small. Follow-up studies with larger groups of women are needed.

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Ovarian Cancer Risk Factors From Infertility Treatments

According to the Practice Committee of ASRM, the majority of studies have shown no significant increase in ovarian cancer following the use of fertility drugs when compared with infertile controls and/or the general population. Because ovarian cancer typically presents much later in life, a woman should always remind her doctor that she did fertility treatment so that proper surveillance can be performed, as new studies may shed greater clarity on the long-term risks.

Borderline ovarian cancers, a unique subset of ovarian cancer, are slow, 95% curable and are also not associated with fertility treatments in most studies. Several studies have shown a slight increase in borderline tumors, but any increase is small. And these tumors are slow-growing and have a favorable prognosis if treated.

Will Breast Cancer Treatment Affect My Fertility

Some treatments for breast cancer, such as chemotherapy, can affect your ability to become pregnant.

Having breast cancer treatment may mean you have to think about your fertility sooner than you had planned. While your main concern is probably treating your breast cancer, if having children of your own is important to you then procedures to preserve your fertility such as IVF or freezing eggs can be offered.

Its important to talk to your treatment team about this before your breast cancer treatment begins.

On our page about Options for preserving fertility before and during breast cancer treatment you can watch videos about people’s experiences of this.

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Can You Become Pregnant While Taking Hormone Therapy

Hormone therapies are used in women whose breast cancer is oestrogen receptor positive .

Some of the most commonly used hormone therapy drugs for pre-menopausal women with breast cancer are:

In most pre-menopausal women who take tamoxifen, the ovaries continue to work. When you start taking tamoxifen it may stimulate ovulation and could make you more fertile. However, getting pregnant on tamoxifen is not recommended.

For some women, continued use of tamoxifen means periods become less regular, lighter or stop altogether. Generally, your periods will start again once you stop taking tamoxifen, as long as you have not gone through the menopause naturally while taking the drug. However, it may take four to five months for your periods to become regular again.

Goserelin switches off the production of oestrogen from the ovaries. Its often combined with other hormone therapies used to treat breast cancer, such as tamoxifen or aromatase inhibitors.

Hormone treatment is usually taken for five years or longer. While youre taking hormone treatment youll be advised not to get pregnant as it may harm a developing baby. Even if your periods stop while youre taking hormone therapy you could still get pregnant.

Due to the length of time its taken for, the side effects of hormone therapy may hide the signs of a natural menopause. It may only be when you finish taking it that you realise youve started or been through the menopause.

Couldn’t The Increased Levels Of Estrogen In Fertility Treatments Increase Risk For Breast Cancer

Q& A: Does fertility treatment affect breast cancer risk ...

Exposure to estrogen and progestin after menopause has been linked to increased risk for breast cancer for women in their 50s and 60s, but fertility drugs do not expose women to estrogen at that age, says Samantha Pfeifer, MD. She is chair of the practice committee at the American Society for Reproductive Medicine.

Pfeifer says fertility drugs raise estrogen levels for up to seven days at a time. “Estrogen levels are not significantly raised for a prolonged period of time.”

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Endometrial Cancer & Fertility Treatment

Unopposed estrogen is a risk factor for endometrial cancer. Fertility treatment, however, uses both estrogen and progesterone, therefore it is not considered unopposed in most cases. Obesity and hyperinsulinemia , which are causally linked to ovulation problems, can cause unopposed estrogen, thereby making the background risk for cancer higher than in the general population. Nine studies and three reviews were used to evaluate the risk of endometrial cancer and fertility drugs and a majority showed no increased risk of cancer for any type of drug used for fertility.

Malignant melanoma, cervical, thyroid and colon cancers, and non-Hodgkin lymphoma were also not found to have sufficient data to suggest that they would be causally related to fertility treatment.

Do Fertility Treatments Bring Higher Risk Of Invasive Breast Or Uterine Cancer

“Did they have long-term downstream effects in terms of risks of cancers?

Fertility treatments come with repeated shots of hormones, but does that mean they also come with an increased risk of cancer?

Not necessarily, according to a study published recently in the British Medical Journal.

With assisted reproductive technology , women are exposed to high levels of estrogen and progesterone during each cycle of treatment, in which hormones are used to stimulate egg growth and release into the womb. Often multiple cycles are needed to produce a successful pregnancy. Those hormones are known risk factors for breast, uterine, and ovarian cancers when they appear in excess.

To evaluate the risks of these cancers, Alastair Sutcliffe, a professor at University College London Institute of Child Health, and his research team followed more than 250,000 British women for an average of nine years, averaging nearly two treatment cycles overall, and monitored how many of them developed cancer.

What we were really interested in is for the ladies — did they have long-term downstream effects in terms of risks of cancers? Sutcliffe, who also published a 2013 complementary study in New England Journal of Medicine about the risk of cancer in children born from ART, told ABC News.

There was a higher rate of invasive and borderline ovarian tumors, although these were in women with pre-existing risk factors, such as endometriosis, and therefore not surprising.

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Ascertainment Of Exposure And Potential Confounders

For all infertile women developing breast cancer and the members of the subcohort, we collected hospital files and medical records on all available infertility-related medical visits. For 31 cases, the records could not be found, and for 10 cases the cause of infertility was found to be previous sterilization, leaving 331 cases for analysis. In the subcohort, we had to exclude 93 women for whom the records could not be found, 8 women where the infertility diagnosis could not be confirmed, and 33 women where the cause of infertility was previous sterilization, leaving 1,226 women in the subcohort . Of the 1,226 women in the subcohort, 24 women were diagnosed with breast cancer in the follow-up period. These women are therefore included both as cases and as members of the subcohort in the analyses.

About Medicines To Stimulate The Ovaries

Does Infertility Cause Cancer?

Medicines that stimulate the ovaries to release eggs have been used to treat infertility since the early 1960s. The medicines work much the same way the hormone estrogen does: they cause the ovaries to develop eggs and release them.

But doctors and women have had concerns that, because the medicines work similarly to estrogen, they also could make hormone-receptor-positive breast cancer develop and grow. Still, results from earlier studies on fertility drugs and breast cancer risk have been mixed.

There are two types of medicines that stimulate the ovaries to release eggs:

  • Clomiphene citrate is a pill taken by mouth once a day for 5 days, starting on day 5 of a womans menstrual cycle.
  • Gonadotropins are hormones that regulate ovarian and testicular function. There are three human gonadotropins: follicle stimulating hormone , luteinizing hormone , and chorionic gonadotropin . To stimulate the ovaries, doctors may give you an injection of FSH alone or combined with LH.

Sometimes doctors use a combination of clomiphene and gonadotropins for certain fertility procedures, such as in vitro fertilization.

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How Should I Make The Decision

  • Do I have a family history of cancer?
  • How comfortable am I taking risks?
  • How important is it to me to have a biological child? Would adopting or not having a child be an option?
  • How many cycles of IVF am I willing to undergo?
  • How good are my odds of success, according to my doctor?
  • Have I tried other, less invasive, treatment options?
  • What is the success rate for the clinic I am considering?

What Did You Set Out To Investigate And What Were Your Key Findings

We wanted to investigate if infertility and fertility treatments influence mammographic breast density, which is a strong marker for breast cancer risk. Mammographic density refers to the amount of dense fibroglandular tissue in the breast, and previous research has found that women with dense breasts have a higher risk of developing breast cancer compared to women with non-dense breasts.

In a large cohort of women attending mammographic screening, we used self-reports of fertility history and fertility treatment to identify all women with a history of infertility and those that had received fertility treatment.

We found that women with a history of infertility had slightly higher dense volume than other women.

We found that women with a history of infertility had slightly higher dense volume than other women. Among infertile women, those who had gone through controlled ovarian stimulation had higher dense volume than those who had not received any hormone treatment.

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