Characteristics of ovarian and uterine cancers in a cohort of in vitro fertilization patients

Objective. The aim of this study was to describe the features of cancers of the uterus, ovary, and other uterine adnexae in a large cohort of in vitro fertilization (IVF) patients and to thereby assist gynecologic oncologists in counseling patients with a history of infertility. Methods. Record-linkage to population-based cancer registries was used to d etermine the incidence of invasive cancer in a cohort of 29,700 IVF patient s. Pathology reports were made available by the cancer registries and revie wed blind to IVF treatment status. Patient information was abstracted from IVF clinic records. Results. Twelve cancers of the uterus and 13 cancers of the ovary and other uterine adnexae were identified and pathology reports were reviewed for al l but I. Patients ranged in age at diagnosis from 28 to 48 years. Five canc ers were diagnosed within 8 months of referral for IVF or IVF treatment; th e others were diagnosed between I and 12 years later. The ovarian cancers w ere of the following histologic types: serous (4), mucinous (1), seromucino us (1), endometrioid (3), clear cell (2), and unknown type (1). A choriocar cinoma of the fallopian tube was diagnosed in a woman with a history of tub al infertility. Cancers of the uterus included endometrial adenocarcinomas (8), stromal sarcomas (2), and leiomyosarcomas (2). Ovarian cancer was diag nosed in a woman with Bloom's syndrome, a rare autosomal recessive disorder associated with increased cancer risk. Conclusion. Cancer cases in this large, well-defined cohort of IVF patients show a broad range of patient and tumor characteristics. We found an incre ased incidence of uterine sarcoma in women with a history of infertility. i ncreased ascertainment of preexisting cancers in the course of infertility investigations and management is to be expected, (C) 2001 Academic Press.