Standard ovulation induction may promote Ca in predisposed women.(Gynecology)

MONTREAL -- Ovulation induction for in vitro fertilization may promote the growth of breast cancer in patients who are predisposed to the disease, suggest results of a case series of seven IVF patients later diagnosed with the disease.

"A breast cancer family history should be included in the pre-IVF work-up, and women with a positive history should be considered candidates for an alternate IVF stimulation protocol," recommended Kutluk Oktay, M.D., who reported the findings in a poster at the joint annual meeting of the American Society for Reproductive Medicine and the Canadian Fertility and Andrology Society.

In a case series of seven breast cancer patients who had undergone ovarian stimulation for in vitro fertilization (IVF), Dr. Oktay's team found more than half (57%) had a family history of breast cancer. It is normally expected that only about 10% of breast cancer patients will have a family history of the disease.

All women had estrogen-and progesterone-receptor-positive breast cancer, when normally it is expected that about 40% of breast cancer patients will have this type of disease, said Dr. Oktay, of Cornell University in New York.

Ovulation induction exposes women to supraphysiologic levels of estrogen, which may be problematic in women with a family history of breast cancer, Dr. Oktay suggested.

"Not that IVF necessarily causes their cancer, but it may promote it," he said in an interview. "Counseling should include the fact that if you have a family history of breast cancer, this may increase your ...