Health outcomes in offspring born to survivors of childhood cancers following assisted reproductive technologies

Greta Sommerhäuser,Kathy Astrahantseff,Katja Baust,Gabriele Calaminus,Magdalena Balcerek,Ralf Dittrich,Charlotte J König,Heike Hölling,Anja Borgmann-Staudt,Marta J Fernández-González,Laura Lotz,Ralph Schilling,Theresa Schuster

doi:10.1007/s11764-020-00929-0

Abstract

PurposeAn increasing number of childhood cancer survivors are using assisted reproductive technologies (ART) to overcome treatment-related fertility impairment. We report perinatal and health outcomes of offspring born to survivors following ART.MethodsThe FeCt Multicenter Offspring Study surveyed the health of offspring of childhood cancer survivors. Health outcomes in offspring born to survivors following ART (n = 57, 4.6%) or after spontaneous conception (n = 1182) were assessed in the German cohort (n = 1239) using bivariate analysis. Findings were put into the context of the general German population by health outcome assessment in 1:1 matched-pair analysis (n = 2478).ResultsNearly twice the survivors used ART compared with numbers reported for the German general population (4.6% vs. 2.6%). Successful pregnancies were achieved after a median of two cycles, mainly using non-cryopreserved oocytes/sperm. Multiple sibling births (p < 0.001, 28.1% vs. 3.0%) and low birth weight (p = 0.008; OR = 2.659, 95% CI = 1.258–5.621) occurred significantly more often in offspring born to survivors who utilized ART than spontaneously conceived children, whereas similar percentages were born preterm or too small for their gestational age. ART did not increase the prevalence of childhood cancer or congenital malformations in offspring born to survivors.ConclusionART use by childhood cancer survivors was successful with both fresh and cryopreserved oocytes/sperm, and did not influence perinatal health or health outcomes when known confounders were taken into account.Implications for Cancer SurvivorsOncofertility is an important component of patient care. Our study implicates that the utilization of ART by adult survivors of childhood cancer does not put offspring at additional risk for adverse perinatal or health outcomes.

Highlights

Worldwide, > 5,000,000 live births have been reported following assisted reproductive technologies (ART), mostly in vitro fertilization and intracytoplasmic sperm injection [1], with annual numbers rising [2]
Even though the number of offspring born to childhood cancer survivors following ART (n = 57) was small, post hoc calculation of statistical power revealed that the given sample size provided 80% power to detect group differences at the 5% significance level and an odds ratio (OR) of 2.8 by logistic regression
Survivors who utilized ART were older at cancer diagnosis, but parental cancer diagnoses were distributed between children born after ART or spontaneously conceived children (Table 1)

Summary

Introduction

Worldwide, > 5,000,000 live births have been reported following assisted reproductive technologies (ART), mostly in vitro fertilization and intracytoplasmic sperm injection [1], with annual numbers rising [2]. While the majority of children conceived by ART are born healthy, ART has been associated with a higher risk of adverse birth outcomes than spontaneous conception [4]. These include increased occurrences of adverse perinatal events [5], childhood cancer [6], congenital malformations [7] (including heart defects [8]), hypertension [9, 10], and asthma [11]. Whether ART affects offspring health when used by childhood cancer survivors has not been addressed

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