Doctors talk about the connection between oncology and IVF

Doctor of Medical Sciences, Professor, Head of the Department of New Medical Technologies, M. A.F. Tsyba, branch of the Federal State Budgetary Institution “National Medical Research Center of Radiology” of the Ministry of Health of Russia, obstetrician-gynecologist and oncologist

For example, experts from the Israeli health service Maccabi conducted a study that involved nearly 90 women who became pregnant with IVF. All study participants had only 41 cases of ovarian cancer, 38 cases of endometrial cancer and 501 cases of breast cancer. This is exactly the same as it was found in women with natural pregnancy.

Even more revealing is the situation in Sweden, a country where a great deal of attention is paid to health care. Since 1932, all citizens of this country have been included in a special register, thanks to which scientists have access to data on the health of everyone. Including 1,8 million women who used either ovulation stimulation or an IVF program to achieve pregnancy. 

The data on the health of this group of women were compared with data on the health of 2 million mothers who became pregnant without using assisted reproductive technologies. It turned out that women who used the IVF program, get all types of cancer no more often than those who managed to get pregnant in the “usual” way. Most of the deviations were due to the fact that women who resorted to IVF had health problems even before pregnancy.

Where do the rumors come from

There are many scientific articles about IVF, because doctors are constantly conducting research to check the potential danger of the procedure, to eliminate the slightest risks. And the results of research are often interpreted and illuminated in a one-sided way. For example: according to one of the IVF protocols at the stage of preparation, expectant mothers are prescribed hormonal medications. This triggers the maturation of several eggs at once and increases the chances that among the resulting embryos there will be a perfectly healthy one. Moreover, breast cancer depends on the level of female sex hormones: the more hormones in the body, the higher the risk of getting sick. Scientists suggested that hormonal stimulation during IVF can provoke breast cancer, and this was immediately reported in the media.

“This is also why, before the IVF procedure, doctors conduct a very thorough and detailed examination of the patient,” notes Elena Kalinina… “This allows disease detection and risk minimization.” 

It’s also about the increased attention to the lives of celebrities. If a young and beautiful star suddenly becomes terminally ill, it causes a flurry of publications and discussions, which is, in general, logical. However, due to the insufficient level of competence, people can rarely judge the relationship between IVF and cancer. 

“An attempt to link IVF and brain cancer, glioblastoma, is a good example. Scientists have no evidence that this very rare tumor is associated with IVF. At the same time, it so happened that tumors were found in both Zhanna Friske and Anastasia Zavorotnyuk, – explains Marina Kiseleva… – And since it is known that both stars were preparing for IVF, it is tempting to link these two circumstances. But then what about the fact that opera singer Dmitry Hvorostovsky, humorist Mikhail Zadornov and pianist Mikhail Kogan died of brain cancer? After all, male celebrities certainly didn’t do IVF ”.

The real risks of IVF 

IVF has limitations and contraindications. Therefore, the health status of the couple is carefully studied and tests are prescribed, which must be passed before the procedure.

Elena Kalinina formulated four objective risks:  

# 1: ovarian hyperstimulation syndrome

This is an individual reaction to hormonal drugs, as a result of which many more eggs mature at the same time than necessary. Because of this, the ovaries increase in size, and fluid can accumulate in the abdomen and lungs. To avoid the problem, before the start of stimulation, the woman must be carefully examined, and the stimulation itself must be carried out under strict medical supervision.

# 2: multiple pregnancies

In the 90s, when in our country it was not yet possible to conserve “extra” embryos, all viable embryos could be transferred to a woman – and then pregnancy with triplets, quadruplets and even fives often occurred. This complicated the course of pregnancy, led to premature birth and other problems. 

According to clinical guidelines, doctors today transfer no more than two embryos into the uterus. It is forbidden to carry more, this is directly stipulated in the order of the Ministry of Health No. 107n, which regulates the work of reproductologists in our country. In this case, the likelihood of pregnancy does not decrease. 

Typically, only one embryo is transferred to a woman after genetic preimplantation testing. The genetic test makes it possible to screen out embryos with the “wrong” number of chromosomes and with hereditary diseases, for example, with cystic fibrosis and hemophilia, in time. All this reduces the likelihood of miscarriage and increases the chances of carrying a healthy baby.

# 3: risk of intra-abdominal bleeding that may accompany egg retrieval

Fortunately, the likelihood of complications is very low – no higher than 1,4%. The risk can be reduced by not letting the woman go home immediately after the puncture, but observing her condition for several hours. This will allow you to identify and correct possible problems in time.

# 4: ectopic pregnancy

The embryo in a nutrient medium is transferred into the uterus under strict ultrasound control. Within 1-2 days, it must be implanted into the wall of the uterus. However, sometimes, in very rare cases, the embryo does not find a place in the uterus, and together with the outflow of fluid it can end up in the lumen of the fallopian tube and implant there – this is how an ectopic pregnancy occurs. That is why doctors carefully monitor each IVF at all stages of the procedure, including after embryo transfer – this allows them to help the patient on time.

How to reduce your risk

Reproductologist, member of the European and Russian associations of human reproduction

“The risks of IVF performed in a good clinic are not that big. As I tell my patients: “The main risk of IVF is pregnancy.”

IVF helps to increase the chance of success:

• a healthy lifestyle – you need to provide yourself with proper nutrition, exclude smoking and alcohol;

• undergo all the tests and examinations recommended by the doctor – this will help identify problems that can either interfere with pregnancy or complicate it. In this case, the doctor is obliged to clearly explain why he prescribes this or that examination;

• To speak openly and honestly with a doctor – it is very important not to hide any information about the state of your health and the health of your loved ones. It is important to tell about all diseases, bad habits, medical and cosmetic procedures that a woman does outside the clinic.

“Suppose a patient read somewhere that it would be useful to do hirudotherapy before taking an egg. But in the saliva of leeches there is a substance hirudin, which slows down blood clotting, – gives an example Lyubov Izmailova… “If the patient does not warn the doctor about visiting the hirudotherapist, there will be a risk of intra-abdominal bleeding, which will be extremely difficult to stop.” 

Everything else depends on the skills and knowledge of the doctor. The best thing that an expectant mother can do is to trust the doctor and follow all his recommendations.