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BRCA Mutations Affect Age at Menopause But Do Not Increase the Incidence of Infertility

March 22 , 2013
by: ASRM Office of Public Affairs
Published in ASRM Press Release

US and Canadian researchers from the Hereditary Breast Cancer Study Group have found that although women carrying the BRCA 1 or BRCA 2 mutations reach menopause at an earlier average age than women who do not carry one of the mutations,  BRCA carriers do not experience an increased incidence of infertility.

Participants from 43 centers in the United States and Canada were recruited from an ongoing study for risk factors for hereditary breast and ovarian cancer.  Recruited between 1995 and 2012, they were tested for BRCA1 and BRCA2 and provided detailed reproductive and health histories at the time of recruitment with updates every two years thereafter.   Reproductive health history included questions about  age at first period, use of  oral contraceptives, fertility problems, age at first birth and last birth, and age at natural menopause.

Nine hundred and eight case subjects were included. They tested positive for BRCA 1 or 2, but had not had breast or ovarian cancer, hysterectomy or bilateral salpingoopherectomy, and did not report any other form of non-naturally induced menopause.  They were matched with 908 control subjects with similar characteristics, whose family members carried BRCA mutations, but who, themselves, tested negative for the mutations. Matching was one-to-one, with case and control subjects born within a year of one another and entering the study at the same age, within a year.

Age at menopause was lower on average for women carrying the BRCA mutation.  By age 40, 4.7% of BRCA carriers had gone through menopause compared to 1.4% of non-carriers.  By 45, 22.1% of BRCA carriers had reached menopause, while 14.3% of non-carriers were menopausal.

There was no difference in the proportions of BRCA positive and BRCA negative women who reported fertility problems- 12.5% vs. 13.7% -or who reported using fertility medications- 6% vs. 7%.  More BRCA negative controls (2.1%) reported receiving assisted reproductive technology treatment than BRCA positive subjects (0.8%).

Linda Guidice, MD, PhD, President of the American Society for Reproductive Medicine, commented, “Increasing knowledge of genetic mutations and their effects on fertility will enable us to provide better care to our patients.  While it is heartening to know that women who carry a BRCA mutation are not more likely than non-carriers to need fertility treatment, their greatly increased likelihood of developing breast cancer and ovarian cancer still presents challenges to their family planning.  For some BRCA-positive women, fertility preservation techniques such as egg or embryo cryopreservation will be key to having the children they want to have.”   

Finch et al, Frequency of premature menopause in women who carry a BRCA1 or BRCA2 mutation, Fertility and Sterility, in press.

 

The American Society for Reproductive Medicine, founded in 1944, is an organization of more than 7,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.  Affiliated societies include the Society for Assisted Reproductive Technology, the Society for Male Reproduction and Urology, the Society for Reproductive Endocrinology and Infertility, the Society of Reproductive Surgeons and the Society of Reproductive Biologists and Technologists.

The Society for Assisted Reproductive Technology, an ASRM affiliate,  is the primary organization of professionals dedicated to the practice of assisted reproductive technologies (ART) in the United States. The organization includes more than 393 member practices, representing more than 85 percent of the ART clinics in the country. SART’s mission is to set and help maintain the standards for ART in an effort to better serve its members and their patients. 


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