Long-term health effects of assisted reproductive technology on cancer risk in women and children
OMEGA women’s cohort
Since endogenous and exogenous gonadal hormones play a key role in the development of hormone-related cancers (i.e. breast, endometrial, ovarian, and colorectal cancer and melanoma), concerns have been raised that subfertility and its treatment may be associated with increased risk of cancer. However, published studies showed inconsistent results and were unable to address the long-term effects of ovarian stimulation and specific subfertility diagnoses on cancer risk. To investigate the long-term risk of hormone-related cancers after assisted reproductive technology (ART) treatment the nationwide OMEGA cohort has been established in 1996 and was expanded in 2010. In total, the study comprises 30,625 women who received ovarian stimulation for ART in 1983-2000 and 9,988 subfertile women not treated with ART. Incident invasive and borderline tumors were ascertained through linkage with the Netherlands Cancer Registry and the Dutch Pathology Registry until July 2018. Cancer risk in ART-treated women is compared with risks in the general population and the subfertile non-ART group.
OMEGA offspring cohort
There is growing evidence that assisted reproductive technology (ART) procedures could perturb epigenetic processes during the pre-implantation period. The aim of OMEGA offspring study is to assess cancer risk in ART-conceived children compared with the general population and with non-ART conceived offspring from subfertile women (conceived naturally with or without ovarian hyperstimulation). Offspring of women who were treated in one of the 13 IVF clinics or two regional fertility centers between 1983-2012 are included. In total, the cohort comprises of over 90,000 live-born children, including more than 50,000 ART-conceived and 40,000 non-ART children. Data on fertility treatments and maternal risk factors are available from the mother’s medical record and the Dutch Perinatal registry. Cancer incidence is ascertained through linkage with the Netherlands Cancer Registry. Cancer risk in ART-conceived children is compared with risk in children not conceived by ART from subfertile women and with children from the general population.
Scientific and clinical relevance
Results of the two nationwide cohorts importantly contribute to knowledge about long-term health of ART-treated women and their offspring. This information is important for women who received ART, couples considering to start or continue ART and gynecologists who advice couples considering ART.