Assisted Reproductive Technology in Breast and Gynecologic Malignancies: Cancer Risk, Fertility Preservation, and...

Area of Science:

• Reproductive Endocrinology
• Gynecologic Oncology
• Oncology

Background:

• Assisted reproductive technology (ART) use is rising globally.
• Concerns exist regarding ART's association with malignancies and fertility preservation (FP) safety in cancer survivors.
• Hormonal stimulation in ART raises questions about hormone-sensitive cancer risks.

Purpose of the Study:

• To evaluate the association between ART and malignancies.
• To assess the safety and outcomes of fertility preservation strategies in cancer survivors.
• To provide evidence-based guidance for individualized patient care.

Main Methods:

• Review of registry-based studies and meta-analyses.
• Analysis of large cohorts examining cancer risk post-ART.
• Evaluation of observational data on fertility preservation outcomes and recurrence risk.

Main Results:

• No consistent increase in breast or endometrial cancer risk linked to ART.
• Cervical cancer risk not associated with ART.
• Ovarian cancer risk primarily linked to infertility and endometriosis, not ART.
• Fertility preservation strategies are safe in selected early-stage cancers.
• Favorable pregnancy outcomes reported after breast and cervical cancers.
• Limited but possible outcomes in endometrial and ovarian cancers.
• No clear increase in recurrence risk observed in carefully selected patients.

Conclusions:

• Current evidence suggests ART is largely safe concerning major gynecological and breast malignancies.
• Fertility preservation is a viable option for many cancer survivors.
• Individualized treatment, proactive counseling, and multidisciplinary care are crucial for optimizing outcomes.