GHOST or anyone else - How many cycles are too many?

[Kiwi expat]

Hi all

As you can see from my signature, I've been around the block - well several times at least! It's actually an abbreviated list as I'don't want to bore you with all the FETs, IUI's and laporoscopies that I've been poked and prodded with over the last 4 years...

My question is, from a medical view point, how much is too much? I am thinking of giving it one last go, but am concerned about the amount of drugs I've been pumping into my body over a relatively short period of time.

I have had 7 full medically stimulated cycles either for IUI or ICSI. Because of my age, I have been on 450 - 600 units of puregon for each cycle. I have had one fully medicated FET using lucrin injections and progynova pills. And another FET using letrozol (an anti breast cancer drug).

Would appreciate any advice - especially from a scientific background (Ghost?). How is all this medication affecting our bodies? Long term?

Many thanks

[Rotobay]

I am not Ghost but I do have a medical background and just asked this very question to my RE last week. According to him (a world renowned RE--has written books, PI'ed many clinical studies etc) there is NO danger to using all the meds.

He said they have 30 years of history with humans and numerous animal studies and there is no increase in cancer rates, no premature menopause, etc. The only danger, according to him, is if you already have a specific type of breast cancer whose growth can be accellerated by the all the hormones. But the drugs do not CAUSE cancer or any other morbidity, according to him. It will interesting to see if Ghost agrees.

[Ghost]

I am not Ghost but I do have a medical background and just asked this very question to my RE last week. According to him (a world renowned RE--has written books, PI'ed many clinical studies etc) there is NO danger to using all the meds.

He said they have 30 years of history with humans and numerous animal studies and there is no increase in cancer rates, no premature menopause, etc. The only danger, according to him, is if you already have a specific type of breast cancer whose growth can be accellerated by the all the hormones. But the drugs do not CAUSE cancer or any other morbidity, according to him. It will interesting to see if Ghost agrees.

I have heard same. But your RE is wayyyyy ahead of me. I've never studied this at all, just heard a couple of presentations.

[Kiwi expat]

Ghost, Rotobay - thank you for your replies.

It's reassuring to hear that news - as if this process isn't hard enough on our bodies, without having something else to worry about!!

I don't come from a scientific background (so I may be jumping to needless conclusions here) - But a recent study stated that women who have menstruated for a longer number of years are more susceptible to certain cancers, possibly due to the amount of overall oestrogen released by their bodies over the years. If you started menstruating at an earlier age, you are more likely to cease menstruation at an older age, hence, those women fall into a high risk group. As this is to do with the amount of oestrogen our body produces over the years, it is also (possibly) linked to the controversy over HRT and the associated higher risk of related cancers. Some of these HRT pills (progynova) are prescribed quite liberally by my clinic for ivf treatment.

What I'm trying to establish is the association between the high oestrogen levels we are subjecting ourselves to now through these ivf related procedures and the possibility that we are putting ourselves into this high risk group at a later stage? I know that I've taken very high dosages of progynova tablets (for defective luteal phase support and for FET), and am wondering if this is a reasonable assumption, and if so, are there any conclusive or on going studies to prove or disprove this?

Sorry to be so negative about all of this. - Again appreciate any advice from anyone.
Cheers!

[Rotobay]

The simple answer is no, there is no increased cancer risk for IVF patients. If you read the data on estrogen/cancer correllations, it is not a simple cause and effect, but much more complex. Here is a lay article that explains it...there are tons of them available. If it makes you feel any better I have also been on the max dosages due to poor response--600 of Follistim and 2 amps of Repronex/daily and my RE assured me that I could go thru 30 cycles and my cancer risk would not increase (and he has studied this specifically). Hope that helps.


In-Vitro Fertilization Not Linked To Cancer Risk
Study Suggests In-vitro Fertilization Does Not Increase Cancer Risk

Article date: 2000/01/13
The findings of a 20-year study recently published in the British journal The Lancet (Vol. 354, No. 9,190) confirm that women who undergo in-vitro fertilization (IVF) have no greater risk of developing invasive breast, uterine, or ovarian cancers than women who do not undergo the procedure.
In-vitro fertilization involves removing eggs from the uterus and placing them in a laboratory dish, where they are fertilized by sperm before being returned to the woman's uterus. Women undergoing IVF are given hormones to boost ovulation, and there has been concern over whether the hormones increase the risk of certain cancers.

The study analyzed data on 29,700 women provided by 10 clinics over the course of 22 years, making this the largest research project of its type ever conducted. Of the study group, 20,656 women were exposed to fertility drugs, and 9,044 were not. The exposed group showed no greater rates of breast or ovarian cancer than was expected of the general population. Researchers expected to find 155 cases of breast cancer and found 143. They predicted and found 13 cases of invasive ovarian cancer.

Invasive ovarian cancer is the most common form of ovarian cancer. This study did not determine whether fertility drugs affected the women's risk of developing ovarian tumors of low malignant potential. These tumors, also known as borderline tumors, have been linked to fertility drug use in some, but not all, earlier studies. Borderline tumors tend to spread within the pelvis and abdomen. However, they do not spread through the bloodstream as often as invasive ovarian cancers. Although borderline tumors tend to have a better prognosis than invasive cancers, some cases may be fatal.

The study also suggested there is an increased risk of cancer in very small sub-groups of women. Women with unexplained infertility had significantly more cancers of the ovary and uterus than expected, whether or not they had taken fertility drugs. Also, more cases of breast cancer were diagnosed in the first year after treatment with fertility drugs than researchers predicted: nine were predicted and 17 were detected.

Alison Venn, PhD, an epidemiologist at La Trobe University in Melbourne, Australia, and lead author of the study, speculated that the higher number of breast cancer diagnoses within a year after fertility treatment might be due to increased medical supervision for those women at that time rather than an increase in cancer cases. It might also be that hormonal changes as a result of pregnancy or fertility treatment could stimulate the growth of existing tumors, though they wouldn’t cause the cancer. "You can’t cause breast cancer that quickly," Dr. Venn said.

As for why women with unexplained infertility had higher-than-expected rates of ovarian and uterine cancer, Dr. Venn believes, in some of these women, infertility might have been a symptom when the underlying disease was cancer.

Debbie Saslow, PhD, director of breast and cervical cancer for the American Cancer Society (ACS), agreed with that assessment. "The reason for infertility might be the same as what is causing women to develop ovarian cancer," she said. "A great deal depends on how much estrogen a woman has been exposed to. All of this is clearly related to hormones, but more research is needed to understand the mechanisms involved."

Dr. Venn said the women in the study should be followed as they grow older to try to understand the reasons for increased risk of certain cancers in women with unexplained infertility.



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ACS News Center stories are provided as a source of cancer-related news and are not intended to be used as press releases

[Kiwi expat]

Rotobay - thanks again for your info.
And best of luck for baby #2!