The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Birth Defects and Related of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China; West China School of Medicine, Sichuan University, Chengdu 610041, China.
Eur J Cancer. 2020 Oct;138:133-148. doi: 10.1016/j.ejca.2020.08.001. Epub 2020 Sep 1.
It is important to explore the association between different fertility treatments and the incidence of paediatric cancer, as this will provide crucial guidance for clinical decision-making. Previous studies have explored the relationship between fertility treatments and different types of cancer in offspring, but the results are controversial.
Two authors searched PubMed, Embase, Web of Science and Cochrane databases independently to acquire qualified studies. Then, the same authors extracted data from these studies and analysed these data using RevMan 5.3.
Eleven case-control studies and 16 cohort studies were included in this review and meta-analysis. The relative risk of association between in vitro fertilisation (IVF) and paediatric cancer incidence was 1.01 (95% confidence interval [CI]: 0.80-1.28) in cohort studies and 1.09 (95% CI: 0.74-1.58) in case-control studies. The relative risk of association between intracytoplasmic sperm injection (ICSI) and paediatric cancer incidence was 0.97 (95% CI: 0.80-1.17) in cohort studies. The relative risk of association between fertility drugs and paediatric cancer incidence was 1.07 (95% CI: 0.68-1.69) in cohort studies and 1.12 (95% CI: 0.90-1.41) in case-control studies. The relative risk of association between frozen embryo transfer and paediatric cancer incidence was 1.37 (95% CI: 1.04-1.81) in natural pregnancy controls and 1.28 (95% CI: 0.96-1.69) in fresh embryo transfer controls.
There is no evidence that IVF, ICSI and fertility drugs are associated with an increase in paediatric cancer incidence in offspring; however, frozen embryo transfer is associated with an increase in paediatric cancer incidence in the offspring, but this finding needs further research and attention.
探讨不同生育治疗方法与儿科癌症发病率之间的关联非常重要，因为这将为临床决策提供重要指导。先前的研究已经探讨了生育治疗方法与后代不同类型癌症之间的关系，但结果存在争议。
两位作者分别独立检索了 PubMed、Embase、Web of Science 和 Cochrane 数据库，以获取合格的研究。然后，两位作者从这些研究中提取数据，并使用 RevMan 5.3 对这些数据进行分析。
本综述和荟萃分析纳入了 11 项病例对照研究和 16 项队列研究。队列研究中，体外受精（IVF）与儿科癌症发病率之间的关联相对风险为 1.01（95%置信区间 [CI]：0.80-1.28），病例对照研究中为 1.09（95% CI：0.74-1.58）。队列研究中，卵胞浆内单精子注射（ICSI）与儿科癌症发病率之间的关联相对风险为 0.97（95% CI：0.80-1.17）。队列研究中，生育药物与儿科癌症发病率之间的关联相对风险为 1.07（95% CI：0.68-1.69），病例对照研究中为 1.12（95% CI：0.90-1.41）。自然妊娠对照组中，冷冻胚胎移植与儿科癌症发病率之间的关联相对风险为 1.37（95% CI：1.04-1.81），新鲜胚胎移植对照组中为 1.28（95% CI：0.96-1.69）。
目前尚无证据表明 IVF、ICSI 和生育药物会增加后代儿科癌症的发病率；然而，冷冻胚胎移植与后代儿科癌症发病率的增加有关，但这一发现需要进一步研究和关注。
