Charité-Universitätsmedizin Berlin Germany, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Paediatric Oncology, Haematology and Stem Cell Transplantation, 13353 Berlin, Germany.
Department of Paediatric Oncology, Masaryk University, University Hospital Brno, 61137 Brno, Czech Republic.
Curr Oncol. 2022 Aug 15;29(8):5748-5762. doi: 10.3390/curroncol29080453.
CCS often wish to have biological children yet harbour concerns about fertility impairment, pregnancy risks and the general health risks of prospective offspring. To clarify these concerns, health outcomes in survivor offspring born following ART (n = 74, 4.5%) or after spontaneous conception (n = 1585) were assessed in our European offspring study by descriptive and bivariate analysis. Outcomes were compared to a sibling offspring cohort (n = 387) in a 4:1 matched-pair analysis (n = 1681). (i) Survivors were more likely to employ ART than their siblings (4.5% vs. 3.7%, p = 0.501). Successful pregnancies were achieved after a median of one cycle with, most commonly, intracytoplasmic sperm injection (ICSI) using non-cryopreserved oocytes/sperm. (ii) Multiple-sibling births (p < 0.001, 29.7% vs. 2.5%), low birth weight (p < 0.001; OR = 3.035, 95%-CI = 1.615−5.706), and preterm birth (p < 0.001; OR = 2.499, 95%-CI = 1.401−4.459) occurred significantly more often in survivor offspring following ART utilisation than in spontaneously conceived children. ART did not increase the prevalence of childhood cancer, congenital malformations or heart defects. (iii) These outcomes had similar prevalences in the sibling population. In our explorative study, we could not detect an influence on health outcomes when known confounders, such as multiple births, were taken into account.
CCS 通常希望拥有自己的亲生子女，但同时又担心生育能力受损、妊娠风险以及未来子女的一般健康风险。为了澄清这些担忧，我们在欧洲后代研究中通过描述性和双变量分析，评估了接受 ART（n = 74，4.5%）或自然受孕（n = 1585）后出生的存活后代的健康结局。通过 4:1 配对分析（n = 1681），将这些结果与同胞后代队列（n = 387）进行了比较。（i）幸存者使用 ART 的可能性高于其兄弟姐妹（4.5% vs. 3.7%，p = 0.501）。成功怀孕是在一个中位数周期后实现的，最常见的是使用非冷冻卵/精子进行胞浆内单精子注射（ICSI）。（ii）多胎分娩（p < 0.001，29.7% vs. 2.5%）、低出生体重（p < 0.001；OR = 3.035，95%-CI = 1.615−5.706）和早产（p < 0.001；OR = 2.499，95%-CI = 1.401−4.459）在接受 ART 治疗的幸存者后代中比自然受孕的儿童更为常见。ART 并未增加儿童癌症、先天性畸形或心脏缺陷的患病率。（iii）这些结果在同胞群体中也具有相似的患病率。在我们的探索性研究中，当考虑到多胎分娩等已知混杂因素时，我们并未发现对健康结局的影响。
