Abstract
Many studies have investigated the relationship between medically assisted reproduction (MAR) and health outcomes, particularly cancer, in the offspring. This meta-analysis investigated the association between MAR and childhood cancer. Data sources were PubMed, Scopus, and Web of Science up until June 2018. From the selected studies, we extracted the cancer risk estimates of the exposure of interest (MAR, assisted reproductive technology—ART, and in fitro fertilization—IVF). We conducted the meta-analysis using a random effects model. The outcomes of interest were childhood cancers, classified according to the international classification of childhood cancer (ICCC-3). In our meta-analysis (18 cohort and 15 case-control studies) the overall cancer risk was significantly increased in children conceived by MAR, ART, or IVF. MAR and ART significantly increased the risk for hematological tumors, hepatic tumors, and sarcomas (odds ratio (OR) 1.54; 95% CI 1.18–2.02 and OR 1.92; 95% CI 1.34–2.74, respectively). MAR increased acute myeloid leukemia risk (OR 1.41; 95% CI 1.02–1.95) and ART increased neural cancer risk (OR 1.21; 95% CI 1.01–1.46). Our results suggest an increased risk of cancer in children conceived by MAR. Further studies are needed to investigate the impact of fertility treatments, parental subfertility status, and their association on health outcomes in the offspring.
Highlights
Since the first child born after in vitro fertilization (IVF) in the United Kingdom in 1978, assisted reproductive technologies (ART) for treatment of fertility problems have been increasing
In this meta-analysis, we investigated the possible association of fertility treatments and childhood cancer, and we found an increased risk of all cancers in children conceived by medically assisted reproduction (MAR), ART, and IVF
The heterogeneity in the high range observed for hematological cancers and leukemias is probably due to the variability of the fertility treatments included in MAR, as suggested by the stratified analysis for ART, which showed a significant heterogeneity in the moderate range
Summary
Since the first child born after in vitro fertilization (IVF) in the United Kingdom in 1978, assisted reproductive technologies (ART) for treatment of fertility problems have been increasing. ART are defined as all interventions that include the in vitro handling of both human oocytes and sperm, or of embryos. In Europe, about 3% of all births are a result of ART, accounting for an estimated 170,000 births each year [1,2,3]. In this context, it is important to consider that in addition to ART, other types of fertility treatments have been used.
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