Infertility Linked With Certain Cancers
A paper published in early December in the Journal of Clinical Oncology has created a bit of a sensation. It seems that Dr. Kutluk Oktay, M.D., a professor of obstetrics and gynecology at the New York Medical College has found a possible link between the presence of breast cancer genes and infertility. Dr. Oktay's specialty is preserving or restoring the fertility of female cancer patients.
As the lead author of this study, Oktay found that those mutations of the BRCA1 gene that have a known association to early onset breast cancer, also have an apparent link to the early loss of a woman's egg reserves. This observation may serve to answer the question of why women with mutations of the BRCA1 gene have a higher rate for infertility, as well as an increased risk for ovarian and breast cancers.
Oktay's research team attempted to preserve the fertility of 126 breast cancer patients by performing ovarian stimulation that would be followed by oocyte or embryo cryopreservation. Out of this number, 82 women were found to meet the criteria for inclusion in this preservation treatment plan. Of this number, 47 women, or 57% had been tested for the presence of BRCA, with 14 of them found to have BRCA gene mutations. In those patients who tested positive for BRCA mutations, there was a significant increase in the number of women who had low ovarian response as compared to those women who did not have the BRCA gene mutations, or compared to those who had not undergone any gene testing.
Dr. Oktay realized at this point that if the fertility drugs used to stimulate egg production are not as effective in women who show the BRCA1 mutations, then a firm link has been established between a known risk for the development of breast or ovarian cancer and infertility.
An estimated one in every one thousand women tests positive for BRCA mutations. However specific ethnic groups, for instance Ashkenazi Jews, have a much higher incidence for this mutation where the rate can climb as high as 2.5%. Experts have already identified hundreds of these mutations in the BRCA1 gene and many of them are known to be linked to a high risk for cancer. According to Oktay's observations, these mutations affect a woman's egg reserves, and therefore, the fertility of a large number of women in the United States.