Fertility Treatments And Breast Cancer: Dr Singhal Examines Potential Risks For Women

As more women turn to fertility treatments to conceive, concerns about whether the hormonal medicines used during infertility treatment could increase the long-term risk of breast cancer remain common. The question is particularly relevant during Breast Cancer Awareness Month, when attention is focused on understanding established and potential risk factors. Current medical evidence is broadly reassuring: major reviews and guidelines do not find a consistent overall increase in breast cancer risk among women who undergo assisted reproductive technology (ART) or fertility treatment. Fertility treatment can involve medicines that stimulate the ovaries and temporarily raise levels of reproductive hormones, including oestrogen.

Treatments may include drugs such as clomiphene and gonadotropins, while IVF involves controlled ovarian stimulation followed by egg retrieval and fertilisation outside the body. Because hormonal exposure is one of several factors involved in breast cancer biology, researchers have examined whether these temporary increases associated with fertility treatment translate into a higher long-term cancer risk. However, separating the effect of treatment from the underlying causes of infertility can be difficult. The American Society for Reproductive Medicine (ASRM), in its 2024 guideline on fertility drugs and cancer, concluded that there does not appear to be an increased risk of breast cancer associated with ART.

Its review included multiple observational studies and systematic reviews, most of which found either no significant increase or, in some cases, a lower risk after fertility treatment. A large meta-analysis involving 25 studies and more than 617,000 participants similarly found no significant association between fertility treatment and breast cancer, including among women who underwent six or more IVF cycles. The evidence is not completely uniform, however, and researchers continue to examine specific groups and treatment exposures. Some studies have reported modest increases in breast cancer risk in particular subgroups, but these findings can be influenced by factors such as age, infertility itself, whether a woman has had children, family history and other reproductive characteristics.

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A 2026 review noted that current evidence does not demonstrate a consistent overall increase in breast cancer after ART, while also highlighting that possible differences among specific subgroups and repeated or high-dose treatment cycles require continued study. One important consideration is clomiphene exposure. The ASRM guideline found that prolonged use of clomiphene, particularly for more than 10 cycles, has been associated with a possible increase in breast cancer risk in some evidence and recommends avoiding prolonged exposure. This does not mean that standard fertility treatment causes breast cancer, but it highlights why fertility medicines should be prescribed and monitored according to an individual's medical circumstances rather than used beyond recommended treatment limits.

Researchers also caution against interpreting an apparent association between fertility treatment and cancer as proof that the treatment itself caused the cancer. Women seeking fertility care can differ from the general population in ways that independently affect cancer risk. Infertility, nulliparity, age at first pregnancy and conditions such as endometriosis can complicate comparisons between women who receive fertility treatment and those who do not. Long-term follow-up is also important because breast cancer may develop many years after reproductive treatment. The National Cancer Institute similarly states that the bulk of available evidence is consistent with no increased breast cancer risk associated with fertility drugs or IVF. At the same time, individual risk is not determined by fertility treatment alone.

Family history, inherited genetic mutations, reproductive history, age and other established factors can influence breast cancer risk and should be considered when discussing fertility treatment. For women considering IVF or other infertility treatments, the available evidence therefore offers reassurance that fertility treatment does not appear to create a significant overall increase in breast cancer risk. However, treatment decisions should still be individualised, particularly for women with a personal or strong family history of breast cancer or other relevant risk factors. Discussing the planned medicines, number of treatment cycles and individual cancer-risk profile with a fertility specialist and, when appropriate, a breast or oncology specialist can help women make informed decisions.

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