Fertility Treatment and Childhood Cancer Risk
Summary
The advent and expansion of assisted reproductive technologies (ART) over recent decades have enabled countless families to conceive where natural fertility was impaired. As the number of children born through in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI) and other ART modalities continues to rise, long-term safety has become a pressing concern. Epidemiological studies to date have yielded largely reassuring results, indicating that the overall risk of malignancy in ART-conceived offspring is low and broadly comparable to that of naturally conceived peers. However, subtle variations in risk have been observed in relation to specific procedures such as frozen-thawed embryo transfer (FET) and to parental subfertility itself. Age- and sex-specific analyses suggest that certain cancer subtypes may display modestly elevated incidence among ART-exposed children, particularly in early school age. Disentangling the influence of treatment protocols from underlying parental factors remains a major challenge, requiring large registry cohorts, robust statistical adjustment and collaborative research across regions. Understanding these nuances is essential for informed clinical counselling, policy on embryo handling strategies and the optimisation of reproductive care pathways worldwide.
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Fertility Treatment and Childhood Cancer Risk publication trend
The graph below shows the total number of articles in fertility treatment and childhood cancer risk across all publications each year (not limited to Nature Index journals).
Technical terms
Assisted reproductive technology (ART): A group of medical procedures, including IVF and ICSI, designed to achieve pregnancy by handling eggs, sperm or embryos in vitro.
In vitro fertilisation (IVF): A procedure in which eggs are retrieved from the ovaries, fertilised with sperm in the laboratory and then transferred to the uterus.
Intracytoplasmic sperm injection (ICSI): A micromanipulation technique in which a single sperm is injected directly into an egg to facilitate fertilisation.
Frozen-thawed embryo transfer (FET): The process of transferring embryos that were cryopreserved after fertilisation and later thawed for uterine implantation.
Hazard ratio (HR): A measure of the relative risk of an event (such as cancer) occurring in one group compared with another over time, derived from survival analysis.
Cox proportional hazards model: A statistical method used to estimate the hazard ratio while adjusting for multiple covariates in time-to-event data.
References
- Sex differences in childhood cancer risk following ART conception: a registry-based study. Human Reproduction (2024).
- Cancer in children born after frozen-thawed embryo transfer: A cohort study. PLOS Medicine (2022).
- Assessment of Birth Defects and Cancer Risk in Children Conceived via In Vitro Fertilization in the US. JAMA Network Open (2020).
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