Increasing risk of breast cancer in ivf cases

Mohammad Keykhaei,1 Shaghayegh zokaei,2 Dariush d. farhud,3,* Marjan zarif yeganeh,4

1. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
2. School of Advanced Medical Sciences, Islamic Azad University, Tehran Medical Branch, Tehran, Iran
3. School of Public Health, Tehran University of Medical sciences, Tehran, Iran
4. Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Introduction

Since the birth of the first ‘test-tube’ baby, in the early 1980s, ivf have been used as a method for solving infertility problems. according to global statistics, due to fertility problems of millions of couples, a large number of them annually visit ivf centers to carry out infertility treatment, and also ovulation-inducing drugs have been used for various types of infertility. by using some methods, such as assisted reproductive technology (art), surgery and medication, or intrauterine insemination, infertility problems can be cured. studies conducted in netherlands and the united states show the high consumption of fertility drugs and gonadotropin and sudden increase in fertility health care between the 1980s and 90s. for a long period of time, many studies, especially historical cohorts, have been focused on the future effects of assisted reproductive technologies (art) in women under these treatments and their offspring. based on the studies, infertility and non-breastfeeding can affect the risk of breast cancer and gynecologic cancers, but with regard to research on the effects of ivf treatment, these methods can increase the risk of developing breast cancer. there is an association between ovulation induction and a significant increased risk of breast cancer. in a study of 43,313 women, the association of ovulation stimulant drugs in infertility treatment with mammographic density was investigated. they came to the conclusion that these people have more dense tissue in their breast, which can affect the risk of breast cancer. furthermore, womens age, known as a risk factor for breast cancer, at the onset of ivf is also highlighted in another study, so that women over the age of 30 significantly increase the risk of breast cancer by initiating ivf cycles, although another study in western australia has reported a different outcome. it has pointed to an increase in breast cancer in young women who have taken ivf compared to those of other ages or those who did not have ivf .breast cancer is a process that is highly related to hormonal effects. as the ovary affects the function of the breast by producing steroid hormones, any doses of gonadotrophin hormones and fertility drugs that affect ovary to multiply ovulation, has an influence on breast, too. in infertility treatment processes to stimulate the growth of multiple follicles and induce ovulation, gonadotropins, like hcg and hmg, and clomiphene citrate have been used, and this stimulation of ovary can affect the levels of endogenous estrogen, which may cause cancer risk. it should be noted that the probability of this cancer is also greater in women whose ivf cycles are more than 6 or last more than 6 months because they have a longer exposure to the effects of human menopausal gonadotropin (hmg).

Methods

This is a review article and we are referring and collecting more than one hundred articles worldwide, which followed the hypothesis that the use of ivf drugs could lead to breast cancer, and our findings completely confirm this.

Results

With this in mind, mothers who are going to have infertility treatments, should be evaluated “personalized medicine” and family history of breast cancer, prior to treatment.

Conclusion

In summary, infertility treatment methods, like ivf, that are now popular can be effective in increasing the risk of breast cancer. breast cancer can be largely hereditary and affected by hormones. drugs used in ivf, such as clomiphene citrate and gonadotropins increase level of lh and fsh. which in turn raises estrogen levels. increasing estrogen, which is an important female sex hormone, can increase the expression of genes and following that the risk of breast cancer. according to studies with a large sample size, women with a long term treatment in ivf, especially more than a year, are more likely to be exposed to fertility drugs and the repeated therapeutic cycles can probably raise the development of breast cancer in future. it should also be taken into consideration that women with family history of breast cancer or susceptible to it are more likely to develop breast cancer after being treated with in vitro fertilization than normal people. so what’s important is the awareness of the treatment process, probable risks and the “personalized medicine” of the patients.

Keywords

Breast cancer, ivf, clomiphene citrate, gonadotropins, personalized medicine