Fertility
Fertility treatment not tied to cancer risk, research finds
Fertility treatment was not linked to a higher overall risk of invasive cancer in women, a large Australian study has found.
The study, published today in JAMA Network Open, analysed health records of more than 417,000 women and found some specific cancers were slightly more common, while others were less common.
The researchers said the findings need to be interpreted with caution, and in the context of the many factors that influence cancer risk.
Adrian Walker, joint lead author from UNSW’s Centre for Big Data Research in Health, said the overall findings were reassuring, with women who receive fertility treatment not having a higher total incidence of cancer than other women.
“Women who’ve had assisted fertility should continue to participate in routine cancer screening programs they’re eligible for,” he said.
“And they should discuss their cancer risk with their doctor, to understand how else they can reduce their risk.”
The study analysed national health and cancer records from 417,984 Australian women who underwent medically assisted reproduction between 1991 and 2018.
This included IVF, intrauterine insemination and treatment with the fertility drug clomiphene. Cancer outcomes were examined over an average of 10 years.
The researchers compared how often cancer occurred in these women with how often it occurred in Australian women of the same age and in the same calendar years.
While the overall cancer rate was not higher, some specific cancers were slightly more common in women who had fertility treatment, while others were less common.
Uterine and ovarian cancer were slightly more common, as was melanoma. A non-invasive form of breast cancer was also more common in women who had IVF, but invasive breast cancer was not increased.
At the same time, some cancers, including cervical and lung cancer, were less common.
“It is very normal for a specific group of people to have a slightly different cancer profile from the general population,” Walker said.
“But as we see here, that doesn’t mean that their overall risk is increased.”
Claire Vajdic, professor at UNSW’s Kirby Institute and study lead, said the findings need to be interpreted carefully.
“This study focused on comparing rates of cancer in different populations, not whether fertility treatments themselves cause cancer.
“As such, we must consider the pre-existing risks of cancer in these populations when interpreting the findings.
“Women with infertility who are having or have had treatment, like all women, should ensure that they have regular check-ups, and seek further evaluation if they have concerns about unusual symptoms.”
Of the cancers that occurred at a higher rate than in the general population, uterine cancer was between 23 per cent and 83 per cent more common, depending on the type of fertility treatment.
Ovarian cancer was around 18 per cent to 23 per cent more common in women who had IVF or related treatments, while melanoma was about 7 per cent to 15 per cent more common.
On the other hand, some cancers were less common. Cervical cancer rates were about 40 per cent lower than in the general population, and lung cancer rates were about 30 per cent lower.
However, when the researchers looked at the actual number of additional cases, the difference was small. Across the cancers that were more common, the largest increase amounted to three to seven extra cases per 100,000 women per year.
So even where a relative increase was observed, the overall chance of developing cancer remained low.
Very few medical treatments are without risk, but the elevated cancer incidence here is low,” Vajdic said.
The researchers said there could be many reasons why certain cancers were more common in women who had fertility treatment.
“Women who need fertility treatment may differ from other women in ways that affect cancer risk,” Vajdic said.
Certain underlying causes of infertility, such as endometriosis and polycystic ovary syndrome, are known to increase the risk of uterine and ovarian cancers.
The researchers showed Australian women who underwent fertility treatment were more likely to live in major cities and be socioeconomically advantaged.
Although not examined in this study, women having fertility treatment are also more likely to have fair skin and be less likely to smoke. Additionally, before starting fertility treatment, doctors must check that women are up to date with any recommended routine cancer screening.
All these factors will contribute to the cancer patterns observed in this study, including reduced lung cancer rates and reduced cervical cancer rates.
“What this study does is describe cancer patterns we’re seeing at a population level,” Walker said.
“It doesn’t tell us the risk of receiving treatment, or the risk for individual women who undergo treatment.”
Because many women in the study were still relatively young at the end of follow-up, the researchers said longer follow-up would provide additional insights.
“Continued cancer awareness is important as this population ages,” Vajdic said.
The researchers concluded that cancer risk after fertility treatment was not higher overall, and that further research to better understand differences in incidence for individual cancers will help women and their doctors make informed decisions.
Onto Health has acquired Levy Health, a fertility software company providing precision diagnostics and patient intake for reproductive medicine.
The acquisition, fuelled by Onto Health’s US$20m Series A fundraise in April, supports its plan to build scalable, tech-enabled infrastructure for reproductive medicine.
Onto founder Roohi Jeelani, MD, called it the first of several moves in the company’s expansion strategy in a LinkedIn post, adding that there was “more coming soon”.
She said: “This isn’t just an acquisition, it’s proof of how we’re building Onto: physician-led, tech-enabled, and built to scale without losing the personal touch fertility patients deserve.”
Headquartered in Chicago, Onto Health combines evidence-based fertility care with artificial intelligence-driven diagnostics, clinical automation and longevity science.
AI-driven diagnostics use software to analyse patient information and support clinical decision-making, rather than replace clinicians.
Levy Health, founded in Berlin with US offices in San Francisco, helps medical providers identify endocrine disorders more quickly and helps clinics streamline fertility workups.
Endocrine disorders affect the body’s hormone system, which can influence ovulation, menstrual cycles and fertility.
Co-founder Caroline Mitterdorfer said joining Onto would expand Levy Health’s fertility care tools to more clinics and patients, helping physicians focus on patient care.
Onto opened its first clinic in Chicago in February, with plans for three more in the greater Chicago area.
The company said in April that it would use its new funding, led by Artis and Humania, to support additional operations in the US and expand into the Gulf Cooperation Council.
The Gulf Cooperation Council includes six Arab states bordering the Persian Gulf.
Softening ageing ovaries could help women remain fertile for longer, early animal research suggests.
Fertility declines with age for several reasons, including poorer egg quality, fewer ovarian follicles and the gradual stiffening of ovarian tissue.
Existing fertility treatments, including hormone therapy and in vitro fertilisation, mainly address hormonal imbalances or help eggs mature or become fertilised.
Scientists are now examining whether changing the physical structure of the ovaries could provide another route for future fertility treatments.
Stuart A. Cook, of the Cardiovascular and Metabolic Disorders Programme at Duke-National University of Singapore Medical School, published an accompanying commentary on the research.
Researchers led by Shixuan Wang at Huazhong University of Science and Technology in Wuhan, China, collected healthy ovarian tissue from younger, middle-aged and older women.
They also examined samples from patients with polycystic ovary syndrome, known as PCOS, premature ovarian insufficiency, or POI, and endometriosis.
PCOS is a hormonal condition that can disrupt ovulation. POI occurs when the ovaries stop working normally before the age of 40, while endometriosis causes tissue similar to the womb lining to grow elsewhere in the body.
Tests of protein levels and gene activity found higher levels of the inflammatory protein interleukin-11, or IL-11, in ageing and diseased ovaries.
In laboratory experiments, the researchers exposed ovarian fibroblasts to IL-11. Fibroblasts are cells that produce connective tissue.
The protein caused the cells to produce excess collagen, a structural material that can build up during scarring and make tissue stiffer.
The researchers then genetically modified mice so they could not respond to IL-11. The animals developed less ovarian stiffening and maintained better ovarian function as they aged.
Similar results were seen in mouse models of PCOS and POI caused by chemotherapy.
In the final part of the experiment, older mice and rats were injected with a nanoparticle treatment containing small interfering RNA, or siRNA, designed to switch off IL-11.
The treatment made the animals’ ovaries less stiff and improved fertility.
Pregnancy rates among older mice rose from 25 per cent to 50 per cent, while average litter sizes also increased.
More rats treated with the therapy became pregnant and produced larger litters.
The approach remains highly speculative and will require considerably more research before its safety or effectiveness in women can be established.
However, the researchers said blocking the inflammatory pathway could eventually form the basis of new fertility treatments.
They said: “We propose that anti-IL-11 therapy represents a promising translational strategy for delaying ovarian ageing.”
W Group has opened applications for W Accelerate with Merck KGaA and M Ventures, inviting reproductive and maternal health startups, scaleups and spinouts to pitch for direct access to global pharma partnership and strategic investment.
Selected companies will pitch on 5th October, competing for the chance to accelerate their growth through commercial partnerships, investment, or both.
This is the third time Merck KGaA, a global leader in reproductive health, has partnered with W Group on the programme, which exists to close the innovation and investment gap in women’s health by connecting the sector’s most promising startups directly with the corporates and investors positioned to scale them.
What Merck KGaA and M Ventures are looking for
This year’s call is focused on breakthrough solutions in female infertility, fertility preservation, adenomyosis, endometriosis, polyendocrine metabolic ovarian syndrome (PMOS), ovarian insufficiency, preeclampsia and pregnancy comorbidities.
New for this round, applicants choose between three pathways depending on what they need from the programme:
- The Partnership Lane, for companies seeking commercial collaborations and strategic relationships
- The Investment Lane, for founders looking to connect with investors and secure funding to scale
- The Dual Lane, for innovators pursuing both partnership and investment opportunities
How the Accelerate event works
Selected companies get a 1:1 pitch practice session ahead of time, then a private 30-minute session with Merck KGaA and M Ventures leadership on the day itself, small-group sessions with regulatory and investment strategy experts, an “Ask Merck Anything” roundtable, and a VIP networking reception.
Key dates
- Open call launches: 8th July
- Open call closes: 2nd September
- Notification of successful companies: 11th September
- Pitch day: 5th October
Applications are open now at wplatform.typeform.com/to/KGzviBQM.
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