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By Georgina Mills

In vitro fertilisation (IVF), the process by which eggs are fertilised in the lab, is a relatively new but increasingly widespread treatment in the past 20 years. And while many studies have focused on its correlation with birth defects in the child, few have examined its consequences on the mother. Now, a paper published in Human Reproduction by van Leeuwen et al. reports that IVF can cause an increased risk of ovarian malignancy – of particular concern, ovarian cancer.

Ovarian cancer is the fifth most common cancer amongst women and often has a late diagnosis, as the symptoms are indistinct. If caught early the prognosis is fairly good, but when detected in the advanced stages, as is normally the case, it can spread rapidly with devastating consequences.

The study, evaluated by Faculty Member Paul Lin, investigated the risk of ovarian malignancy in a cohort of 19,146 subfertile women in the Netherlands who received IVF treatment between 1983 and 1995, compared with 6,006 subfertile women who did not. The paper describes a mean follow up period of 14.7 years, examining medical records for both invasive and borderline tumours in the subfertile groups as well as the general population. A small but significant risk was shown for borderline tumours in the IVF group versus both comparison populations, with a smaller risk (but increasing with time from IVF treatment) for invasive ovarian cancer.

Findings such as these are often hard to interpret – should couples undergoing IVF be concerned? This study is due to be extended, but meanwhile, evaluator Lin cites its significance given the study’s impressive cohort numbers and length of follow up. He classifies it as “controversial” but recommends that IVF patients should be made aware of the small increased risk — from 0.45% to 0.71% after the age of 55 – of developing ovarian malignancies.