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Association of IVF with Childhood Cancer in the United States

A recent study published in the Journal of the American Medical Association Pediatrics considered the incidence of childhood cancers among children conceived in IVF relative to children conceived naturally. Dr. Logan Spector of the Division of Epidemiology/Clinical Research, Department of Pediatrics, University of Minnesota, was the lead author of the multicenter investigation.

The analysis was a retrospective, population-based cohort study linking cycles reported to the Society for Assisted Reproductive Technology (SART) Clinical Outcomes Reporting System from January 1, 2004, to December 31, 2012, that resulted in live births from September 1, 2004, to December 31, 2013, to the birth and cancer registries of 14 states, comprising 66% of United States births and 75% of IVF-conceived births, with follow-up from September 1, 2004, to December 31, 2014. The study included 275,686 children conceived via IVF and a cohort of 2,266,847 children, in which 10 births were randomly selected for each IVF birth.

A total of 321 cancers were detected among the children conceived via IVF (49.1% girls and 50.9% boys; mean age, 4.6 years for singleton births and 5.9 years for multiple births), and a total of 2042 cancers were detected among the children not conceived via IVF (49.2% girls and 50.8% boys; mean age, 6.1 years for singleton births and 4.7 years for multiple births). The overall cancer rate per 1,000,000 person-years was 251.9 for the IVF group and 192.7 for the non-IVF group. The rate of hepatic tumors was higher among the IVF group than the non-IVF group (hepatic tumor rate: 18.1 vs 5.7); the rates of other cancers did not differ between the 2 groups. There were no associations with specific IVF treatment modalities or indication for IVF.

This study found the rate of hepatic tumors was significantly higher among children conceived via IVF than among children conceived naturally (hepatic tumor rate, 18.1 vs 5.7); the rates of other cancers did not differ between the two groups. The study suggests an association between IVF and childhood cancer and does not determine whether the increased risk of liver tumors was due to IVF-related procedures or to the infertility population who underwent IVF to conceive.

 Although the association of conception by IVF with childhood cancer is small and limited to rare tumors, further surveillance of cancer occurrence among children conceived via IVF is certainly warranted.

Reference: JAMA Pediatr. 2019;173(6):e190392. doi:10.1001/jamapediatrics.2019.0392

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