IVF may be safe after borderline ovarian tumors

NEW YORK (Reuters Health) - Infertility drugs may be safely used in women who have been treated for borderline ovarian tumors, researchers in France report.

In vitro fertilization (IVF) is still an option for infertile women who have undergone conservative treatment of borderline ovarian tumors, Dr. Philippe Morice from Institut Gustave Roussy, Villejuif, told Reuters Health.

Borderline ovarian tumors are unlikely to become malignant. Only about 15 percent of this type of tumor, which is usually diagnosed at an early stage, will develop into ovarian cancer, according to the National Cancer Institute.

Morice and associates investigated the outcomes of 30 women, with a history of a borderline ovarian tumor, who underwent infertility therapy.

Three women underwent simple ovarian stimulation with the drug clomiphene and 27 underwent an IVF procedure with hyperstimulation of the ovaries, an average of 16 months after tumor treatment, the authors report.

Four patients had an ovarian tumor recurrence after infertility treatment, the investigators report in the medical journal Fertility and Sterility, and all four women were disease-free again 12 to 84 months after treatment of the recurrence.

Three of the four recurrences were in women initially treated with surgical removal of the ovarian tumor, as opposed to removal of most or all of the affected ovary, the investigators report. They suggest that the recurrences could be more associated with the surgery than the IVF procedure.

Nearly half the patients (13 women) became pregnant, resulting in 11 normal pregnancies, 1 miscarriage, and 1 premature delivery (with normal development of the newborn).

“Results from this study are important and a message of hope for physicians and patients,” Morice said. “In patients with borderline tumors,” he added, “the number of cycles of IVF should be reasonable, and should not exceed four.”

SOURCE: Fertility and Sterility, March 2007.