When patients see headlines about childhood cancer rates for babies born as a result of in vitro fertilization or other assisted reproductive technology (ART) procedures, they understandably become concerned about the link between fertility treatment and cancer.
Does using ART cause childhood cancer? A growing body of research says the answer is no. It is important for reproductive endocrinologists to sensitively address their patients' concerns while also explaining that the risk of children conceived with ART developing childhood cancer is extremely low. The best way to do this is with facts, data and a listening ear.
Highlight Overall IVF Safety
Physicians should explain to patients undergoing IVF that they are in good company — not only in the U.S., but also around the world. According to the American Society for Reproductive Medicine (ASRM), more than 77,000 IVF babies were born in the U.S. in 2019, representing an increase of more than 3 percent from the previous year.
IVF has long been considered a safe procedure for both patient and baby. In fact, the Centers for Disease Control (CDC) expects IVF births to increase to as many as 200 million by the end of the century.
ASRM regularly releases and updates ethics committee opinions and practice committee documents that encourage reproductive specialists to hold themselves to the highest standards. For example, ASRM recently updated its clinical standards for practices offering ART, which provide a framework for IVF labs to meet or exceed the certification requirements suggested by the CDC. Patients may be more willing to trust safety of the IVF process overall if they are aware of these guidelines.
In Europe, the European Society of Human Reproduction and Embryology publishes its own set of rigorous guidelines for reproductive specialists, such as a set of benchmark values for ART lab performance indicators based on the Vienna Consensus. Other international ART leaders, such as the Japan Association of Obstetricians and Gynecologists, maintain their own regional sets of practice parameters.
Explain Study Results
Your patients may have read articles on popular news sites about the potential connections between IVF and childhood cancer, but few seek out the full-length scientific studies. Summarize relevant academic research in a way your patients can understand, and offer to provide them with links or copies of journal articles if you feel it would benefit them.
For example, a retrospective, population-based cohort study published in JAMA Pediatrics of 275,686 IVF babies born in the U.S. found that only 321 developed childhood cancer. The researchers deemed only a "small association" between fertility treatment and cancer.
Another retrospective cohort study published in JAMA of 1,085,172 children born in Denmark following frozen embryo transfers found a 0.044 percent chance of developing childhood cancer, compared to 0.0175 percent among fertile women. The risk was deemed small but significant by the researchers, and there was no increased risk at all between other types of fertility treatment and cancer.
Practice Empathy and Open Communication
Reproductive endocrinologists should tap their emotional intelligence to prepare for difficult conversations with patients, especially patients who need emotional support during the IVF process. The ability to recognize and understand your patient's emotional responses or apprehension — while measuring your own emotions — can be instrumental in developing an empathetic patient-physician relationship.
Physicians should provide reassuring information about fertility treatment in a variety of formats — such as printed handouts, videos or text on the fertility clinic's website — to accommodate different patient learning styles.
Above all, remember that empathy and compassion go a long way, as do personal and anecdotal examples of successful outcomes.
