News from ASRM 2017: Subfertility May be Harbinger of Disease Later in Life

The American Society for Reproductive Medicine (ASRM) 2017 Scientific Congress kicked of today morning by an opening keynote address from President Richard J. Paulson, M.D. at San Antonio, TX. The agenda ranges from the latest molecular and genetic technologies to advocacy for the patients with a focus on access to care.

Researchers from the University of Pennsylvania today presented research showing that women seeking infertility treatment have a shorter life span as compared to their parous counterparts. They have a higher risk of dying from endocrine related disorders such as diabetes and breast cancer than other women.

This retrospective cohort study examined  records of nearly 80,000 women and followed them for nearly 13 years, with an aim to determine the association of a history of infertility with all-cause mortality.

These women were enrolled in the Prostate Lung, Colorectal, and Ovarian (PLCO) Cancer screening trial from 1992-2001. Nearly 76,000 women had data on infertility.

It was seen that 14.5% (n=11,006) of women did not have any children. The average age at death for each cohort was similar (74 years) but women in infertile cohort had 10% greater chances of dying as compared to fertile cohort.  (HR1.10, 95%CI 1.03, 1.17, p=0.005).

Infertile women also face 69% increased chances of dying due to diabetes, 49% more chances of death due to breast cancer.

Ovarian cancer and Endometrial cancer did not increase the risk of death, although infertile women had marginally high risk of ovarian cancer.

This large retrospective study does show an association between endocrine related diseases and infertility but does not prove causation.It stresses the need of prospective studies and more research  in this area.

But, infertility can present an early opportunity to screen these women for chronic diseases and interventions.

Richard J. Paulson, MD, President of ASRM said in a News Release, “This is an intriguing and potentially very important study. More work is clearly needed to help us understand if, in some patients, there might be an underlying medical problem that presents as infertility during the reproductive years and then contributes to endocrine-related disease later in life. We also need to investigate if infertility treatments can counter some of this increased risk.”

The study is also published in Fertility and Sterility September supplement.