Hepatocellular Adenoma and IVF

One to three percent of live births in the US and Europe are currently brought about with assisted reproductive technologies such as in vitro fertilization (IVF) [1]. IVF primarily utilizes fertility hormones, such as LH, FSH and Estrogen to promote ovulation and thus fertility. The effect of estrogen on hepatocellular adenoma (HA) growth is well established through many studies analyzing the relationship between oral contraceptives (OCPs) and hepatocellular adenoma since the 1970s [2-4]. Although they are largely benign, hepatocellular adenomas can have severe consequences such as malignant transformation, rupture, and spontaneous haemorrhage [5]. These neoplasms are associated most commonly with prolonged oral contraceptive use, glycogen storage diseases, and anabolic androgens [6]. However, they can arise in other high-estrogen states, such as pregnancy [7]. Given this association, should women desiring IVF be screened for HA prior to starting IVF treatment?