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Cancer Epidemiol. 2019 Oct 10;63:101613. doi: 10.1016/j.canep.2019.101613. [Epub ahead of print]

Assisted reproductive technology and the risk of pediatric cancer: A population based study and a systematic review and meta analysis.

Author information

1
Maccabi-Kahn Research Institute, Tel Aviv, Israel; IVF Unit, Assuta Medical Center, Tel Aviv, Israel. Electronic address: daniella.gilboa@gmail.com.
2
Maccabi-Kahn Research Institute, Tel Aviv, Israel; The Faculty of Medicine, Ariel University, Israel. Electronic address: gidiup_2000@yahoo.com.
3
Maccabi-Kahn Research Institute, Tel Aviv, Israel. Electronic address: barer_y@mac.org.il.
4
Maccabi-Kahn Research Institute, Tel Aviv, Israel. Electronic address: Katz_rach@mac.org.il.
5
Maccabi-Kahn Research Institute, Tel Aviv, Israel. Electronic address: ran.rotem@mail.harvard.edu.
6
Dep. of Obstetrics and Gynecology, Soroka Medical Center and the Faculty of Health Sciences Ben Gurion University of the Negev, Beer Sheva, Israel. Electronic address: lunenfeld@bgu.ac.il.
7
Maccabi-Kahn Research Institute, Tel Aviv, Israel; Tel Aviv University, Israel.

Abstract

BACKGROUND:

There is controversy whether exposure to assisted reproductive technology (ART) is associated with increased risk of pediatric cancer. We aimed at calculating the overall risk of pediatric cancers after ART in a large cohort of exposed women; and to conduct a systematic review and meta- analysis of cohort studies examining overall risk of pediatric cancers after ART.

METHODS:

All children born in Israel who were members of Maccabi Health Services (MHS) between 1999 and 2016 after ART, were linked to the Israeli Registry of Childhood Cancer (IGS) to identify those with cancer diagnosed before 16 years of age. In parallel we conducted a systematic review and meta-analysis of observational cohort studies with more than 5000 ART- exposed cases that measured pediatric cancer after ART.

RESULTS:

In the cohort study, the risk ratio for pediatric cancer after ART in general was 0.95 (95% CI, 0.76-1.19). The RR was 1.09 (95% CI, 0.79-1.48) for IVF treatments. Meta- analysis of 13 cohort studies with a total of 750,138 women exposed to ART (with 1152 pediatric cancers) and 214,008,000 unexposed controls (with 30,458 pediatric cancers) did not reveal increased risk for pediatric cancers (RR 0.99; 95% CI, 0.85-1.15).

CONCLUSIONS:

Based on very large numbers, ART in general, and IVF in particular, are not associated with overall increased risk of pediatric cancer.

KEYWORDS:

Assisted reproductive technology; Children; In vitro fertilization; Pediatric cancer; Pregnancy

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