Exploring the Link Between Infertility and Prostate Cancer

Men with infertility who undergo assisted reproduction are at increased risk of being diagnosed with prostate cancer and are more likely to be diagnosed at a younger age, according to new research published in the British Medical Journal.

Results were pulled from a study conducted in Sweden between 1994 and 2014. Researchers included data from more than 1.1 million fathers, who were grouped according to their fertility status by mode of conception — 20,618 by in vitro fertilization (IVF), 14,882 by intra-cytoplasmic sperm injection (ICSI) and 1,145,990 by natural conception.

Fathers who used ICSI had a 60% higher risk and those who used IVF had a 30% higher risk of being diagnosed with prostate cancer than men who conceived naturally. Their increased risk was most pronounced before the age of 55.

Despite the fact that men who underwent assisted reproduction saw an increased risk, it is important to note that overall prostate cancer risk remained below half of one percent across the study’s three groups. While men who conceived naturally were diagnosed at a rate of 0.28%, men who conceived by ICSI were diagnosed at a rate of 0.42%, and 0.37% of men who conceived through IVF received diagnoses.

It’s also important to note that this is not the first study to investigate a link between prostate cancer and infertility. Three American studies have reported an increased risk of prostate cancer in men with impaired semen quality, corroborating evidence found in this study in the BMJ.

However, three Scandinavian studies and one American study indicated a lower risk of prostate cancer in childless men, and these findings were confirmed in a follow up meta-analysis that summarized evidence from 10 relevant studies. Still other research found no discernible relation between fatherhood and the risk of prostate cancer.

Still, evidence from this study in the BMJ is noteworthy because of its large sample size, which contains virtually all men who fathered a child in Sweden over the course of 20 years.

“For many people having children is an important aspect of life. Yet as many as 15 to 20% of all couples struggle to conceive naturally,” wrote Yahia Al-Jebari, the study’s lead author, in an accompanying editorial statement. “One of the solutions available for couples is to go through assisted reproduction. It is understandable that healthcare providers and patients only focus on what they consider to be the main aim — to have a baby. However, the struggle to conceive has been shown to be associated with a multitude of future morbidities among men, ranging from metabolic syndrome to autoimmune disease.”

Because of the strength of their findings, the authors wrote that they believe that the risk of prostate cancer is “inherent to male fertility itself, regardless of the fertility treatment type.” As a result, preventative measures should be extended from only men who are undergoing assisted reproduction to all men who are experiencing infertility.