Cancer through hormone transfer in artificial insemination

Hormone delivery in artificial insemination promotes ovarian cancer

27/10/2011

If hormones are injected as part of an artificial insemination, this represents a significant intervention in the hormone balance, which appears to significantly increase the risk of ovarian cancer.

As scientists from the Netherland Cancer Institute in Amsterdam found in a recent study, hormone supplements to stimulate the ovaries before artificial insemination increase the risk of ovarian tumors, especially so-called borderline tumors. Although the likelihood of benign or malignant ovarian tumors remains very low, hormone treatment is associated with more than 60% increased disease risk, the researchers report in the latest issue of the journal „Human Reproduction“.

Increased borderline tumors after hormone treatments
In particular, the so-called borderline tumors are significantly more common in women who received hormone treatment in the context of artificial insemination, as compared to women who have no corresponding hormone transfer, so the statement of the team of researchers to Flora van Leeuwen from the Netherland Cancer Institute. Borderline tumors form a special form of ovarian cancer in which the tissue can not be clearly identified as benign or malignant. However, the tissue alterations, also referred to as borderline tumors, are not to be underestimated by the renowned expert in reproductive medicine, Professor Michael Ludwig from Hamburg. So be „Borderline tumors are often bilateral and require surgery“, What „usually a removal of the ovary“ meant, said Professor Ludwig. Overall, however, the risk of corresponding tumors is also in the women who, after unfulfilled desire for a child „In vitro fertilization“ (IVF) with hormone treatment decided relatively small, explained the experts. The hormone stimulation to stimulate the ovaries serves to increase the number of oocytes to allow artificial insemination. The treatment is always a major intervention in the hormone balance and was therefore for some time suspected of possibly bringing negative health consequences. Flora van Leeuwen and colleagues have now confirmed this suspicion in their current study.

Hormone therapy favors ovarian cancer
In the course of their investigation, the Dutch researchers analyzed the data of 19,146 women who were treated with hormones during an IVF between 1983 and 1995. In addition, 6,006 women, who also had reduced fertility but had not received hormone treatment, served as a control group. The result: The likelihood of ovarian cancer later in life increases with hormone therapy by more than 60 percent. However, the risk of disease at age 55 is 0.45 percent for the control group and 0.71 percent for the women who have undergone hormone treatment, which is relatively low overall, explained Prof. Ludwig. For example, after just 15 years, only 77 study participants had tumors on the ovaries, with 61 of them undergoing hormone treatment as part of artificial insemination, explained Flora van Leeuwen and colleagues. Sixteen women suffering from ovarian cancer were in the control group. According to the researchers, 42 of the tumors could be identified as a malignant form of cancer, 35 were classified as borderline tumors. Thus, the Hamburg expert Prof. Ludwig confirmed that the increase in risk of ovarian cancer by the hormone treatment „not to be dismissed“ is.

As the team around Flora van Leeuwen emphasized, their results point in a clear direction, but further studies are needed to confirm and substantiate the findings to date. According to the Dutch researchers, it should also be borne in mind that the current study has analyzed the effects of hormones (gonadotrophins) and IVF therapy up to 1995, but has since introduced milder methods of stimulating the ovaries. According to Professor Ludwig, additional studies must also clarify whether hormone treatment increases the risk of tumors or whether women with fertility problems are already at increased risk of developing ovarian cancer „bear in themselves“. Because the current investigation has found no effects of an increased dose of hormones or multiple artificial inseminations on the risk of cancer. Therefore, it remains unclear, according to Prof. Ludwig, whether only the hormone treatment is responsible for the increased occurrence of ovarian tumors.

Consider ovarian cancer risk in artificial insemination
In the opinion of experts such as Prof. Ludwig or Jenny Chang-Claude of the German Cancer Research Center (DKFZ), the results of the Dutch researchers should always be taken into account in the future treatment of patients who have had an IVF behind them. Prof. Ludwig emphasized that women should urgently be advised of long-term screening after IVF therapy. This also applies to women who for other health reasons, such as a locked fallopian tube, could not get pregnant and decided against artificial insemination. For the early diagnosis of tumors on the ovaries serve a special ultrasound examination, which, however, is not taken over in Germany by the statutory health insurance. For the IVF itself, the current investigation remains without consequences for now, the experts explained. Richard Kennedy of the International Federation of Fertility Societies (IFFS), who also advocated continued observation of the affected women, said that the IFFS maintained their position, „that the long-term risks are low.“ Couples or women who have no option to witness a child in the normal way should be aware of the risks „In vitro fertilization“ Nevertheless, always be aware and also consider the now discovered possible connections with the occurrence of ovarian tumors - even if they discard these at the end due to the desire to have children. (Fp)

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