Certain risk factors can increase a person’s chances of developing ovarian cancer. Several researchers have conducted studies in order to determine whether in vitro fertilization (IVF) can lead to a higher risk of ovarian cancer.

IVF is a type of treatment used to help a person conceive a child. It is one form of assisted reproductive technology (ART). In the United States, about 1 out of 50 babies born each year are conceived with ART.

Current research shows that IVF is not strongly linked to a person’s risk for developing ovarian cancer.

IVF: The Basics

IVF may be used when a couple is infertile. (Infertile couples are those who did not get pregnant after at least 12 months of unprotected sex.) People who choose to use IVF may have health conditions that make it hard to get pregnant, such as a damaged fallopian tube, endometriosis, or uterine fibroids. IVF may also be an option for older people trying to conceive or for those who want to preserve their fertility before cancer treatments.

If you are undergoing IVF, you will likely have to go through several steps:

• Ovulation stimulation — You take medications that encourage your ovaries to make multiple egg cells.
• Testing — You undergo ultrasounds (imaging tests) or blood tests to find out when your eggs are ready to be removed.
• Egg retrieval — You undergo a minor surgical procedure in which a needle is inserted into your ovary and your eggs are collected.
• Sperm retrieval — Your doctor collects a sperm sample from your partner or donor.
• Fertilization — Your health care team combines egg and sperm cells in the laboratory to create fertilized embryos.
• Embryo transfer — A doctor places embryos into your uterus.

Fertility Medications

Taking drugs that help your body ovulate (produce and release egg cells) is a part of many different ART treatments, including IVF. Medications may include:

• Clomid or Serophene (clomiphene citrate or CC)
• Pregnyl (human chorionic gonadotropin or hCG)
• Follistim (follicle stimulating hormone or FSH)
• Menopur (human menopausal gonadotropins or hMG)
• Factrel (gonadotropin-releasing hormone or GnRH)

IVF and Ovarian Cancer

Some scientists think that the more a person ovulates, the higher their risk of ovarian cancer. However, this is not yet well understood, and research is ongoing.

The link between ovulation and ovarian cancer risk has led to concerns about IVF, because fertility medications can cause a person to ovulate more often. In the past, some studies have found that IVF drugs may increase someone’s ovarian cancer risk. However, newer, larger studies have failed to find a connection between the two.

Older Research Into Fertility Drugs

In the 1990s, a few studies concluded that people who used IVF drugs like CC, hCG, or GnRH developed ovarian cancer more often than those within the general population.

However, many of these studies were unreliable. The studies were often small, or didn’t last long enough to look at long-term risk for cancer. In some cases, researchers did not account for other variables that could affect the conclusions.

New Studies Analyzing the Effects of IVF

Newer research contradicts some of these older results. For example, a study published in 2021 analyzed ovarian cancer risk among a very large group of people in the Netherlands. More than 30,000 women had undergone ART, including IVF.

About 10,000 of those studied were infertile, but had not used ART. The study found that people in both groups developed ovarian cancer at similar rates.

Researchers have also written review articles that combine data from many large studies. In one 2013 review that included information from 25 studies and more than 180,000 women, researchers reported that most studies did not show that IVF was linked to a greater chance of being diagnosed with most types of ovarian cancer.

A more recent review, this one published in 2019, included additional studies. The researchers concluded that use of fertility drugs might lead to a slightly increased risk of ovarian cancer. However, they noted that more research was needed in order to be able to say for sure that there was a link. The researchers also said that overall, few people developed ovarian tumors, whether they used IVF or not.

Why Do Different Studies Show Different Results?

Many older studies did not consider variables that could affect the final conclusions. In most cases, researchers compared ovarian cancer rates in infertile people using fertility drugs to people in the general population. The studies did not look at ovarian cancer rates in infertile people who did not use fertility drugs.

Now researchers speculate that infertility itself — not necessarily IVF treatments — leads to a higher risk of ovarian cancer. Studies have found that people with fertility problems are more likely to develop ovarian cancer whether they have undergone IVF or not.

Past research has found that never giving birth, or doing so for the first time later in life, are ovarian cancer risk factors. People who have gone through IVF are more likely to never give birth, or they do so later. Therefore, an infertile person’s ovarian cancer risk may be increased if they never give birth to children, but is most likely not affected by fertility drugs or procedures.

IVF and Risk of Borderline Ovarian Tumors

IVF may increase a person’s risk of a certain type of ovarian tumor called a borderline tumor or tumors of low malignant potential (LMP). In a study of Dutch people, researchers analyzed their ovarian cancer risk and found:

• Infertile people who use ART are more than twice as likely to develop borderline ovarian tumors compared with the general population.
• Infertile people who do not undergo ART are also a little less than twice as likely to be diagnosed with borderline ovarian tumors than are those who are infertile and don’t use these treatments.

Borderline tumors contain cells that are abnormal, but not fully cancerous. These cells grow and divide more quickly than healthy ovarian cancer cells, but not as fast as cancer cells. They also don’t spread into nearby tissues. Borderline tumors usually come with a better outlook than malignant or invasive (cancerous) ovarian tumors, and usually do not require the use of chemotherapy.

Fertility Treatments and Other Types of Cancer

Researchers have also conducted studies analyzing whether fertility drugs can increase a person’s chances of developing other tumor types. Many of these studies have found that these treatments don’t seem to increase a person’s risk for other cancers, including breast cancer, thyroid cancer, and non-Hodgkin lymphoma (a type of blood cancer).

Fertility treatments may even lower people’s risk of some types of cancer. Some studies have found lower rates of cervical cancer in those who use IVF. Researchers think this may be because infertile people undergo cervical examinations more often. And because those who never give birth to children have a slightly lower risk of cervical cancer. Additionally, using fertility drugs that contain estrogen can possibly help protect against colon cancer.

Not all of these studies have been conclusive. It’s possible that in the future, researchers could find a stronger link between IVF and cancer. However, current data doesn’t show a clear relationship.

Talk With Others Who Understand

MyOvarianCancerTeam is the social network for people with ovarian cancer and their loved ones. On MyOvarianCancerTeam, more than 3,000 members come together to ask questions, give advice, and share their stories with others who understand life with ovarian cancer.

Have you undergone IVF treatments? Share your experiences in the comments below, or start a conversation by posting on your Activities page.