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#Grand Rounds

Children Conceived by ART and Cancer Risk: Results from the OMEGA Offspring Cohort

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BACKGROUND AND PURPOSE:

  • Previous studies have suggested a possible link between children conceived with assisted reproductive technology (ART) and cancer risk
  • Limitations include
    • Confounding due to underlying subfertility | Relatively short follow-up and/or small ‘n’
  • Spaan et al. (Human Reproduction, 2019) evaluated cancer risk in ART-conceived children and young adults using Dutch OMEGA-offspring cohort

METHODS:

  • Nationwide historical cohort study with prospective follow-up (1980-2001)
  • Participants
    • All live-born offspring from women treated with subfertility treatments and followed in the OMEGA study
  • Data sources
    • Medical records and questionnaires
    • Includes information on conception method of each child and potential confounders
    • Cancer incidence was ascertained through linkage with The Netherlands Cancer Registry
  • Data analysis
    • Cancer risk in ART-conceived children was compared with risks in
      • Naturally conceived children from subfertile women (using hazard ratio [HRs])
      • The general population (standardized incidence ratio [SIRs])

RESULTS:

  • 47,690 live-born children included
    • ART-conceived: 24,269
    • naturally conceived: 13,761
    • 9660 were conceived naturally or through fertility drugs (not ART)
  • Follow-up
    • Median follow-up: 21 years (interquartile range (IQR): 17–25)
    • Follow-up was shorter in ART-conceived children (20 years) vs naturally conceived children (24 years)
  • Overall cancer risk was not increased in ART-conceived children compared to
    • Naturally conceived children from subfertile women: HR 1.00 (95% CI, 0.72–1.38)
    • General population: SIR 1.11 (95% CI, 0.90–1.36)
    • Still not significant when analyzing data from from 18 years of age onwards
      • Cancer in ART-conceived vs naturally conceived individuals: HR 1.25 (95% CI, 0.73–2.13)
  • Risks likewise not significant in children conceived by
    • ICSI: HR 1.52 (95% CI, 0.81–2.85)
    • Cryopreservation: 1.80 (95% CI, 0.65–4.95)
  • Specific cancers in ART-conceived children were not associated with increased risk compared with naturally conceived children
    • Lymphoblastic leukemia: HR 2.44 (95% CI, 0.81–7.37)
    • Melanoma: H 1.86 (95% CI, 0.66–5.27)

CONCLUSION:

  • While this study had a long median follow-up, the authors still suggest even longer follow-up to assess if there is any risk of cancer in adults and in children conceived by ICSI or cryopreserved embryos due to slightly elevated, although non-significant, risk
  • The authors conclude

This large-scale study with 21 years of follow-up shows that overall cancer risk in ART-conceived children is not increased, neither when compared with the general population nor when compared with naturally conceived offspring born to subfertile women.

Learn More – Primary Sources:

Risk of cancer in children and young adults conceived by assisted reproductive technology

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Related ObG Topics:

Does Assisted Reproduction Increase Risk of Breast, Ovarian, Uterine Cancer?
Does ART Increase Risk of Postpartum Hemorrhage?
Are Offspring of IVF/ICSI Pregnancies at Higher Risk for Congenital Heart Defects?

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