Children born to women who took fertility drugs are more than twice as likely to develop leukemia, French scientists announced in April.
Researchers from the Center for Research in Epidemiology and Population Health (INSERM), based in a southern suburb of Paris, linked the use of ovarian-stimulating drugs to a 2.6-fold increase in acute lymphoblastic leukemia (ALL), the most common type.
The risk of developing the rarer acute myeloid leukemia was increased 2.3-fold by the drugs, according to research presented Dr. Jeremie Rudant at the Childhood Cancer 2012 conference in London, hosted by the charity Children with Cancer UK.. Children whose mothers struggled to conceive for more than a year were 50 percent more likely to develop ALL, the study found.
Acute Lymphoblastic Leukemia (ALL)
Acute lymphoblastic leukemia (ALL) is a fast-growing cancer of the white blood cells. Lymphocytes are a type of white blood cell that the body uses to fight infections.
In ALL, the bone marrow makes lots of unformed cells called blasts that normally would develop into lymphocytes (white blood cells). However, the blasts are abnormal. They do not develop and cannot fight infections. The number of abnormal cells (or leukemia cells) grows quickly. They crowd out the normal red blood cells, white blood cells and platelets the body needs.
ALL can affect children of any age but is most common between the ages of one and four. It is also more likely to affect boys than girls. There are about 4,000 new cases of ALL in the United States each year. ALL is the most common leukemia in children.
Signs and symptoms
The symptoms a person with ALL has depend on how many normal blood cells he or she has. Symptoms also depend on how many leukemia cells there are and where they collect in the body.- Red blood cells carry oxygen throughout the body. Low numbers of red blood cells can lead to anemia -- feeling tired or weak, being short of breath and looking pale.
- White blood cells fight infections. Low numbers of white blood cells can lead to fever and frequent infections that are hard to treat.
- Platelets control bleeding. Low numbers of platelets can lead to cuts that heal slowly, easy bruising or bleeding and tiny red spots under the skin (petechiae).
- High numbers of leukemia cells can cause pain in the bones or joints, lack of appetite, headache or vomiting. These symptoms are less common.
The Study
A total of 2,445 French children and their mothers took part in the study, comprising 764 children who had been diagnosed with leukaemia and 1,681 who were free of the disease. Mothers were asked if they had taken more than a year to conceive a child, and questioned about the treatments they had received. The research did not find an increased risk with in vitro fertilization (IVF) or artificial insemination.
Study leader Dr. Jeremie Rudant from the Centre for Research in Epidemiology and Population Health said, "It has always been hypothesized that assisted reproductive technologies may be involved in the onset of childhood cancer as they involve repeated treatment at the time of conception and/or manipulation of the sperm and egg. And it is now established that a majority of acute leukemia have a prenatal origin."
He added, "Previous studies have suggested a link between infertility treatments and acute childhood leukemia, but there haven't been many studies. Most of them have been small, and they focused either on IVF or hormonal treatment. Our study was much larger, and it's the first time that a specific increased risk linked to fertility drugs has been found."
Rudant said that the findings, which were not yet published in a scientific journal, "indicate that more research is now needed to investigate more closely the link between specific types of fertility drugs and what role the underlying causes of infertility may play in the potential development of childhood leukemia."
Fertility Technology on the Rise
The Total Fertility Rate (TFR) in the U.S. is predicted to fall to 1.89 children per woman in 2012, from a recent high of 2.12 per children per woman in 2007. In fact, statistics indicate that infertility affects one in six couples worldwide, with an estimated 250,000 babies born every year as a result of fertility drugs.
Use of fertility technology is increasing worldwide. In the UK, 1.8% of all live births in 2007 followed fertility treatment, compared with just 0.5% in 1992. Here in the US, currently 6% of all live births followed fertility treatments.
How Much of a Risk Is There?
According to the book 100 Questions & Answers About Infertility over 70,000 cycles of fertility treatments are performed each year in the US and the website for the National Marrow Donor Program states there are approximately 4,000 new cases of ALL each year in the US. In Britain, where about 44,000 cycles of fertility treatment are carried out each year, there are just 400 cases of childhood leukemia each year.
Despite a significant increase in risk, the actual number of children developing leukemia after their mothers undergo fertility treatment remains very small.
More research is needed to understand the connection between fertility treatments and leukemia. Researchers have sounded an alarm but have little more than that right now. For prospective parents suffering with infertility this adds to the difficult choices about which treatments they should undertake and until further research is completed no recommendations will be made about the use of fertility drugs. It's up to parents to consult with their doctor and weigh the risks.
http://english.inserm.fr/
http://www.foxnews.com/health/2012/04/24/fertility-drugs-more-than-double-childhood-cancer-risk-scientists-say/#ixzz1szGiwfqk
http://www.huffingtonpost.co.uk/2012/04/23/fertility-drugs-link-childhood-leukaemia_n_1446326.html
http://marrow.org/Patient/Disease_and_Treatment/About_Your_Disease/ALL/Acute_Lymphoblastic_Leukemia_(ALL).aspx
http://www.cdc.gov/Features/dsFertilityDrugs/
http://www.sciencedaily.com/releases/2010/01/100120104002.htm
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