Assisted reproductive technology increases childhood cancer risk

According to a recent study, childbirth through assisted reproductive technology (ART) is more likely to lead to childhood cancer than both natural and infertile deliveries without ART.

Over time, more and more babies are born through ART, with approximately 1 in 20 babies born with the help of ART in Taiwan in 2018. However, children born to parents with epigenetic alterations have an increased risk of cancer or are undergoing infertility treatment.

The researchers conducted a population-based cohort study, retrieving data from the Maternal and Child Health Database for the period January 1, 2004, to December 31, 2017. The data contains 99.78% of the parent-child triads in Taiwan, and comes from 6 national administrative databases.

Children born through sperm or oocyte donation; children with parents younger than 20 years of age; parents with documented drug, alcohol or smoking addiction; parents without medical records prior to coming to stage; Excluded.

Children were divided into 3 groups based on conception: naturally conceived, subfertile and non-ART and ART. For ART classification, children must meet 3 criteria: a parent with a diagnosis of infertility, a documented clinical pregnancy after ART, and a date of birth within 290 days of transfer. Infertility diagnoses in parents with no history of ART classified their child as infertile but not on ART.

All 3 groups were followed from birth to cancer development, death, end of follow-up period or until they met any exclusion criteria. Cancer cases were taken from the Taiwan Cancer Registry, which has been shown to have high accuracy and completeness.

More than 2 million parent-child triads were included in the study. About 52% of children were boys, about 48% were girls, about 97% were singletons, about 8% were premature, and about 7% were low birth weight infants. ART has the highest rates of multiple pregnancy, low birth weight, and preterm birth. The parents of these children are often older, live in urbanized areas, and have higher household incomes.

Of the children examined, 1,880 were determined to have childhood cancer. The ART group had the highest rates of childhood cancer, while the natural conception group had the lowest rates of cancer, leukemia, and liver tumors. Retinoblastoma is also more common in children born on ART.

Childhood cancers, leukemia and liver tumors were all at increased risk in children receiving ART, showing a significant increase compared to the non-significant difference between non-ART infertility and natural conception. Other types of cancer did not change based on the method of conception.

The source of infertility and the sex of the child did not affect the incidence of childhood cancer, but fresh embryos were associated with cancer risk compared with frozen embryos. Preterm birth and low birth weight were considered potential mediators because of their association with ART and non-ART conception, as well as increased risk of childhood cancer and liver tumors. However, no mediators were observed among these factors.

The results of this study suggest that ART use is associated with childhood cancer, whereas subfertility is not associated with childhood cancer. ART use is associated with an increased risk of cancer compared with natural and subfertile non-ART births.

refer to

Weng S, Huang Y, Huang Y, Li Y, Chien L. Assisted reproductive technology and childhood cancer risk. JAMA Network Open. 2022;5(8):e2230157. doi:10.1001/jamanetworkopen.2022.30157

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