Liat Lerner-Geva1,2, Valentina Boyko1, Shelley Ehrlich3, Shlomo Mashiach2,4, Ariel Hourvitz2,5, Jigal Haas2,5, Ehud Margalioth6, David Levran2,7, Ilan Calderon8, Raoul Orvieto2,5,9, Adrian Ellenbogen10, Joseph Meyerovitch2,11, Raphael Ron-El2,12, Adel Farhi1. 1. Women and Children's Health Research Unit, Gertner Institute for Epidemiology & Health Policy Research Ltd., Tel Hashomer, Israel. 2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Division of Biostatistics and Epidemiology, Department of Environmental Health, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio. 4. Assuta Medical Center, IVF Unit, Tel Aviv, Israel. 5. Sheba Medical Center, IVF Unit, Tel Aviv, Israel. 6. Shaarei-Zedek Medical Center, IVF Unit, Tel Aviv, Israel. 7. Wolfson Medical Center, IVF Unit, Tel Aviv, Israel. 8. Bnai-Zion Medical Center, IVF Unit, Tel Aviv, Israel. 9. Barzilai Medical Center, IVF Unit, Tel Aviv, Israel. 10. Hillel-Yafe Medical Center, IVF Unit, Tel Aviv, Israel. 11. Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center, Petah Tikva, Israel. 12. Assaf-Harofeh Medical Center, IVF Unit, Tel Aviv, Israel.
Abstract
BACKGROUND: Among children conceived by assisted reproductive technology (ART), increased risk of adverse birth outcomes has been observed, including multiple births, preterm births, and congenital malformations. Regarding cancer among ART-conceived children, findings are discrepant. METHODS: This is a historical cohort of 9,042 ART-conceived children and 211,763 spontaneously conceived (SC) children born from 1997 through 2004. The median duration of follow-up was 10.6 years (interquartile range 9.0-12.3) in the ART group and 9.3 years (interquartile range 8.0-10.6) in the SC group. The cohort database was linked with the Israel National Cancer Registry updated until December 31, 2011 using each child's personal identification number. RESULTS: Twenty-one cases of cancer were identified in the ART group (2.2 per 10,000 person-years), as compared to 361 cancer cases in the SC group (1.8 per 10,000 person-years). The relative risk (RR) for overall cancer in the ART group compared to the SC group adjusted for maternal characteristics was 1.18 (95% confidence interval [CI] 0.80-1.75). ART children had a significantly increased risk for specific cancers, although based on small number of cases, including two cases of retinoblastoma (RR 6.18, 95% CI 1.22-31.2), as well as four cases of renal tumors (RR 3.25, 95% CI 1.67-6.32). CONCLUSION: A statistically significant increased risk for two pediatric cancers was found. However, for overall types of cancer the risk estimate was elevated but not statistically significant. Further studies with larger sample size and longer follow-up time are warranted in order to either confirm or refute these findings.
BACKGROUND: Among children conceived by assisted reproductive technology (ART), increased risk of adverse birth outcomes has been observed, including multiple births, preterm births, and congenital malformations. Regarding cancer among ART-conceived children, findings are discrepant. METHODS: This is a historical cohort of 9,042 ART-conceived children and 211,763 spontaneously conceived (SC) children born from 1997 through 2004. The median duration of follow-up was 10.6 years (interquartile range 9.0-12.3) in the ART group and 9.3 years (interquartile range 8.0-10.6) in the SC group. The cohort database was linked with the Israel National Cancer Registry updated until December 31, 2011 using each child's personal identification number. RESULTS: Twenty-one cases of cancer were identified in the ART group (2.2 per 10,000 person-years), as compared to 361 cancer cases in the SC group (1.8 per 10,000 person-years). The relative risk (RR) for overall cancer in the ART group compared to the SC group adjusted for maternal characteristics was 1.18 (95% confidence interval [CI] 0.80-1.75). ART children had a significantly increased risk for specific cancers, although based on small number of cases, including two cases of retinoblastoma (RR 6.18, 95% CI 1.22-31.2), as well as four cases of renal tumors (RR 3.25, 95% CI 1.67-6.32). CONCLUSION: A statistically significant increased risk for two pediatric cancers was found. However, for overall types of cancer the risk estimate was elevated but not statistically significant. Further studies with larger sample size and longer follow-up time are warranted in order to either confirm or refute these findings.
Authors: Mandy Spaan; Alexandra W van den Belt-Dusebout; Marry M van den Heuvel-Eibrink; Michael Hauptmann; Cornelis B Lambalk; Curt W Burger; Flora E van Leeuwen Journal: Hum Reprod Date: 2019-04-01 Impact factor: 6.918