November 02, 2017
Links between male infertility and higher rates of cancer have been known for some time now, but how these reproductive struggles affect women's health outcomes are not as well-established.
New research from the Perelman School of Medicine suggests women with a history of infertility are at a higher risk of both overall mortality and cancer-related deaths, a finding that raises questions about whether these issues are the result of underlying conditions.
“Though we can’t yet explain the association between infertility and mortality, it is possible that the condition may be an early indicator of either endocrine or inflammatory disruption that over time, leads to long-term health issues such as malignancy or diabetes," said Natalie Stentz, a fellow in Reproductive Endocrinology and Infertility at Perelman and lead author of the study presented this week at the annual American Society of Reproductive Medicine Scientific Congress & Expo.
The study examined data from 78,214 women enrolled in the National Cancer Institute’s Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer screening trial between 1992 and 2001. Among them, 14.5 percent had reported infertility at some point in their lifetime.
With an emphasis on all causes of mortality and primary cause of death, the Penn team looked at outcomes for women in the study who self-reported infertility, defined as an inability to conceive for one year or greater.
Women in the infertile group were 10 percent more likely to be deceased at the end of the 13-year study than women who didn't encounter problems with pregnancy. Women in both groups did, however, die at a similar age.
A closer look at the data found that women with infertility have 20 percent higher risk of cancer-related death than women in the other group, including a 44 percent higher risk of death from breast cancer. The risk of developing other reproductive cancers, including ovarian and endometrial cancers, was not associated with infertility.
The authors caution that because infertility is diagnosed during a woman's reproductive years, typically long before her death, establishing a correlation between fertility and health poses challenges:
“There is certainly much left to be studied – including how pregnancy and fertility treatments may affect mortality later in life – but our results highlight the fact that a history of infertility is indeed related to a woman’s lifelong health, and opens a potential opportunity for screening and/or preventative management for infertile women for both women’s health care providers and the general practitioner.”