NORFOLK -- At the home of America's first test tube baby, the Jones Institute in Norfolk, reproductive endocrinologist, Dr. Laurel Stadtmauer, looks through a microscope and explains the process of in vitro fertilization in layman's terms.
"You have to pick up one sperm and you have to wack the tail to slow it down and catch the sperm. Put in this little needle and then inject it into the egg."
Her description makes the embryologist in the lab laugh. She prides herself on completing anywhere from 20 to 100 in vitro fertilizations a week.
But baby-making is delicate business there, as Dr. Stadtmauer knows how much her infertile patients endure to be able to get to the point where they create eggs. She analyzes the Dutch study performed over 10 years of 20,000 women who received IVF treatment versus those who didn't.
Overall, the researchers found rates of non-fatal "borderline ovarian tumors" were increased four-fold and rates of malignant tumors were increased two-fold compared to other women seeking fertility treatment who did not undergo IVF.
"They are on a serious mix of medicines. You shouldn't take fertility medication lightly. You should be under the care of a physician."
Stadtmauer says there are patients that will go to their OBGYN and get a prescription of simpler medications to stimulate ovulation. She advises ovaries monitored by fertility specialists are better protected since they monitor follicle growth.
At the Jones Insititute, their team will not do more than three to four treatments in a year to let the ovaries rest and repair itself. Doctors often prescribe birth control as a way to "calm them down" after intense stimulation.
Because there is still a need for a more conclusive study, she advises choosing a doctor who will run a full reproductive hormonal profile. The point is for fertility specialists to target which hormones need supplementation with medicine. The faster they identify this, the faster a woman will get pregnant without the need of multiple medically-induced ovulation cycles.
"The danger is more in multiple exposures of over long periods of time, instead of one big exposure at one time. The more stress to the ovary, the more chances of something going wrong; which is what cancer is, something that grows out of control," Stadtmauer stated.
But part of the problem when studying IVF and ovarian cancer risk is that infertile women already have a slightly higher risk of ovarian cancer than women who are able to conceive naturally.
The question remains: is it infertility or IVF treatments that may raise ovarian cancer risk?
"It's a very important question because there are so many going through fertility medication." says Dr. Stadtmauer.
Flora van Leeuwen, a professor at the Netherlands Cancer Institute in Amsterdam, and colleagues, wrote about their investigation in the October 26 online issue of Human Reproduction.
The researchers concluded that further studies with much larger numbers of participants are now needed. Van Leeuwen says doctors should tell women about this risk but not overstate it.
FACT:
The world's first "test tube" baby was Louise Brown, born in 1978 in Oldham, Greater Manchester, UK. The physiologist who helped her parents conceive through IVF was Robert G. Edwards who won the Nobel Prize in Physiology or Medicine in 2010.
