Men who undergo treatment for infertility issues may have an increased risk for early onset prostate cancer, according to recent findings.
Prostate cancer and infertility in men is fairly common, affecting about 10% and 8%, respectively, of the male population. Common infertility treatments include in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).
“The objective of this study was to use compulsory national registries containing information on prostate cancer diagnoses and infertility treatments to investigate whether the risk of prostate cancer in men who became fathers through IVF or ICSI, reflecting the grade of hampered spermatogenesis, differed in terms of incidence, age at onset, and, where applicable, severity from men who achieved fatherhood naturally,” the researchers wrote. “Such information could be important for defining clinical routines for follow-up of men undergoing fertility treatment.”
The study, published in The BMJ, included 1,181,490 fathers in Sweden whose children were born between 1994 and 2014. Fathers were stratified into tree groups based on mode of conception: IVF (n = 20,618, ICSI (n = 14,882), and natural conception (n = 1,145,990). The primary outcomes were prostate cancer diagnosis, age at diagnosis, and androgen deprivation therapy.
Total follow-up time was 14,389,198 person-years. The mean age at childbirth of fathers who received IVF or ICSI treatments was 37 years, while the mean age for fathers who conceived naturally was 33 years.
Among men who conceived naturally, 0.28% (n = 3,244) received a prostate cancer diagnosis, compared to 0.37% (n = 77) and 0.42% (n = 63) in the IVF and ICSI groups, respectively. When excluding men who were diagnosed prior to conception, the rates were 0.28% (n = 3,216), 0.37% (n = 76), and 0.36 (n = 54) for natural conception, IVF, and ICSI groups, respectively.
“In the entire cohort, men who had undergone ICSI treatment had a statistically significantly increased risk of prostate cancer (hazard ratio 1.64, 95% confidence interval 1.25 to 2.15; P<0.001) compared with natural conception,” the study authors wrote. “IVF fathers also had a statistically significantly increased risk, but of a lesser magnitude (hazard ratio 1.33, 1.06 to 1.66; P=0.02) compared with natural conception.”
The authors concluded that, compared to men who fathered children through natural conception, men who underwent ICSI treatment had a 60% increased risk for prostate cancer, and those who used IVF had a 30% greater risk.
“We would, therefore, welcome studies in other cohorts investigating the risk of prostate cancer in men being treated for infertility and studies on the efficacy and benefits of screening for this risk group, similarly to what is currently offered for other high risk groups,” they concluded.