Klip H, Burger C W, de Kraker J, van Leeuwen F E
Department of Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
Hum Reprod. 2001 Nov;16(11):2451-8. doi: 10.1093/humrep/16.11.2451.
Over the past decade attention has been increasingly focused on the long-term health effects of assisted reproductive technologies (ART), such as IVF, in both women and their offspring. To determine the risk of cancer in children conceived by IVF we used a large population-based historical cohort that was initially designed to examine the risk of gynaecological disorders in women who underwent IVF.
Children were included in the exposed group if they were conceived by IVF or other related fertility techniques (n=9484). The unexposed group consisted of 7532 children whose mothers were diagnosed with subfertility disorders but who were conceived naturally. All cohort members were asked to complete a mailed questionnaire that inquired about reproductive variables and cancer in the offspring (response rate 66.9%).
During an average follow-up period of 6.0 years, 16 cancers were observed in the exposed and unexposed group combined, whereas 15.5 were expected [standardized incidence ratio (SIR) = 1.0; 95% confidence interval (95% CI) 0.6-1.7]. A direct comparison between children conceived after ART and naturally conceived children revealed no increased risk for childhood malignancies [risk ratio (RR) = 0.8; 95% CI 0.3-2.3].
Despite the small numbers of observed cancer cases, these findings demonstrate that children conceived by ART have no greatly increased risk of cancer during childhood compared with the general population and the internal reference group.
在过去十年中,辅助生殖技术(如体外受精)对女性及其后代长期健康影响的关注度日益增加。为了确定体外受精受孕儿童患癌症的风险,我们使用了一个基于人群的大型历史队列,该队列最初旨在研究接受体外受精的女性患妇科疾病的风险。
如果儿童通过体外受精或其他相关生育技术受孕,则将其纳入暴露组(n = 9484)。未暴露组由7532名儿童组成,其母亲被诊断患有不育症,但她们是自然受孕的。所有队列成员都被要求填写一份邮寄问卷,询问生殖变量和后代癌症情况(回复率66.9%)。
在平均6.0年的随访期内,暴露组和未暴露组共观察到16例癌症,而预期为15.5例[标准化发病率(SIR)= 1.0;95%置信区间(95%CI)0.6 - 1.7]。对辅助生殖技术受孕儿童和自然受孕儿童进行直接比较发现,儿童患恶性肿瘤的风险没有增加[风险比(RR)= 0.8;95%CI 0.3 - 2.3]。
尽管观察到的癌症病例数量较少,但这些发现表明,与一般人群和内部参照组相比,辅助生殖技术受孕儿童在童年期患癌症的风险没有大幅增加。