April 26, 2017

Babies conceived through fertility treatments are at triple the risk of developing pediatric cancers and abnormal growths (neoplasms), according to a new study by Ben-Gurion University of the Negev (BGU) researchers.

The study,  published in the March issue of the American Journal of Obstetrics & Gynecology, was a population-based cohort analysis of babies born between 1991 and 2013 at Soroka University Medical Center in Beersheva, Israel, with follow-up to age 18.

More than 200,000 babies were monitored for the study.

Prof. Eyal Sheiner — vice dean of the BGU Faculty of Health Sciences and a physician at Soroka — says Israel was the right place to conduct the study because in vitro fertilization (IVF) is covered by the country’s public health system. As such, the database comprises a broad range of socioeconomic groups.

“In Israel, all fertility interventions, which include in-vitro fertilization and ovulation induction (OI), are fully covered by insurance, enabling citizens of all backgrounds access to these treatments,” says Sheiner, lead author of the study.

In fact, Israel has a reputation as a world leader in IVF treatment. In 2012, a Health Ministry report showed that some 25 percent of IVF treatments in Israel resulted in pregnancy, with 20% of the attempts resulting in a live birth.

Many scientists have questioned the long-term health effects of offspring conceived with the aid of fertility treatments. The BGU study set out to find answers, and indeed discovered an increased risk as compared to spontaneously conceived children.

According to the American Cancer Society, the most common pediatric neoplasms are leukemia, brain and spinal cord tumors, neuroblastomas, Wilms tumors, and lymphoma, including both Hodgkin and non-Hodgkin.

Importance of health follow-ups

Of the 242,187 newborn infants in the study, 237,863 (98.3 percent) were conceived spontaneously; 2,603 (1.1 percent) were conceived after in-vitro fertilization, and 1,721 (0.7 percent) were conceived after ovulation induction.

The researchers found that during the follow-up period of approximately 10.6 years, 1,498 neoplasms (0.6 percent) were diagnosed.

The incidence rate for neoplasms was highest among children conceived through IVF (1.5/1000) and OI (1.0/1000) as compared to that of naturally conceived children (.59/1000).

Other researchers who participated in the study include Prof. Tamar Weinstock, Prof. Ilana Shoham-Vardi and Ruslan Sergienko, BGU Department of Public Health; Dr. Daniella Landau, BGU Department of Pediatrics; Drs. Ari Harlev and Asnat Walfisch, BGU Department of Obstetrics and Gynecology; and Dr. Idit Segal, Israel Ministry of Health.

Lead author Sheiner noted that the data does not include reasons for infertility and that the researchers did not look at environmental exposures.

But he says the association between in-vitro fertilization and total pediatric neoplasms and the association between any fertility treatments and malignancies remained noteworthy.

“The research concludes that the association between IVF and total pediatric neoplasms and malignancies is significant,” says Sheiner. “With increasing numbers of offspring conceived after fertility treatments, it is important to follow up on their health.”

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