Fertility treatments and pediatric neoplasms of the offspring: results of a population-based cohort with a median follow-up of 10 years

Tamar Wainstock, Asnat Walfisch, Ilana Shoham-Vardi, Idit Segal, Avi Harlev, Ruslan Sergienko, Daniella Landau, Eyal Sheiner

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Objective Studies have questioned the long-term health effects of offspring conceived after fertility treatments. Methods We aimed to evaluate whether an association exists between mode of conception (in vitro fertilization, ovulation induction, or spontaneous pregnancy) and neoplasm risk (both benign and malignant tumors) among the offspring; we observed the offspring for up to 18 years. Study Design A population-based cohort analysis was performed that compared the risk for neoplasms among children (up to the age of 18 years) based on mode of conception. Neoplasm diagnoses were based on hospital records of the same single tertiary center in the region. All singletons born during from 1991–2013 and discharged alive were included in the study. Offspring with congenital malformations were excluded from the analysis. Kaplan-Meier survival curves were constructed to compare cumulative neoplasms incidence; multivariable survival analyses were used to control for confounders that included gestational age, pregnancy complications, and maternal factors. Results During the study period, 242,187 newborn infants met the inclusion criteria: 2603 (1.1%) were conceived after in vitro fertilization; 1721 (0.7%) were conceived after ovulation induction treatments, and 237,863 (98.3%) were conceived spontaneously. During the follow-up period (median, 10.55 years), 1498 neoplasms(0.6%) were diagnosed. Incidence density rate for neoplasms was higher among children conceived either after in vitro fertilization (1.5/1000 person years) or ovulation induction treatments (1.0/1000 person years), as compared with naturally conceived children (0.59/1000 person years; Kaplan-Meier log rank, P<.001). The association between in vitro fertilization and total pediatric neoplasms and the association between any fertility treatments and malignancies remained significant; we controlled for confounders such as gestational diabetes mellitus, hypertensive disorders, preterm birth, and maternal age (adjusted hazard ratio, 2.48; 95% confidence interval, 1.71–3.50; and adjusted hazard ratio, 1.96; 95% confidence interval, 1.14–3.36, for all neoplasms and all malignancies, respectively). Conclusion Children conceived after fertility treatments are at an increased risk for pediatric neoplasms.

Original languageEnglish
Pages (from-to)314.e1-314.e14
JournalAmerican Journal of Obstetrics and Gynecology
Issue number3
StatePublished - 1 Mar 2017


  • assisted reproduction technology
  • childhood cancer
  • fertility treatment
  • in vitro fertilization
  • ovulation induction

ASJC Scopus subject areas

  • Obstetrics and Gynecology


Dive into the research topics of 'Fertility treatments and pediatric neoplasms of the offspring: results of a population-based cohort with a median follow-up of 10 years'. Together they form a unique fingerprint.

Cite this