The Inserm team, Epidemiology of Childhood and Adolescent Cancers (EPICEA – UMR Inserm 1153) and the scientific interest group EPI-PHARE (ANSM/Cnam), together with experts in assisted reproductive technology (ART), have published in the journal JAMA Network Open. the results of a large study aimed at comparing the cancer risk of children conceived through ART to that of children conceived naturally. Covering more than 8.5 million children born in France between 2010 and 2021, it is one of the largest studies conducted to date on the cancer risk in children conceived through ART.
The study does not show an increase in the overall risk of cancer in children conceived through ART, but it suggests a very slight increase in the risk of leukaemia in these children.
ART accounts for about 1 in 30 births in France (see the box). Limited and heterogeneous data have suggested increases in the risk of certain health disorders, including cancers, among children conceived through ART. Large-scale evaluation of cancer risk is essential and constitutes a priority research objective, as recently emphasized in a report by the National Academy of Medicine.
Scientists from Inserm and EPI-PHARE, together with specialists in ART, have assessed this cancer risk in one of the largest cohorts worldwide of children born after ART.
They utilized data from the National Health Data System (SNDS) to identify children conceived through ART (artificial insemination, conventional in vitro fertilization (IVF), or with intracytoplasmic sperm injection (ICSI)) and to detect the occurrence of cancer in children conceived with and without ART.
In total, the study included 8,526,306 children born in France between 2010 and 2021, of whom 260,236 (3%) were conceived through ART, and followed them up to a median age of 6.7 years.
During this follow-up, 9,256 children, including 292 children conceived through ART, developed cancer. The risk of cancer, of all types combined, was not higher in children conceived after ART than in children conceived naturally.
However, a slight increase in the risk of leukemia was observed in children conceived through IVF or ICSI. This increase is very small, on the order of one additional case for every 5,000 newborns conceived through IVF or ICSI who have reached the age of 10 years. It requires confirmation.
The absence of an overall increase in cancer risk is reassuring. Epidemiological monitoring will nonetheless continue to better evaluate the long-term cancer risk. It is also necessary to continue research efforts to understand which mechanisms related to ART techniques or parental fertility disorders could lead to the increased risk of leukemia, if confirmed.
Assisted reproductive technology (ART) facilitates the conception of a child for couples facing difficulties or the inability to conceive naturally. The most commonly used techniques are artificial insemination and in vitro fertilization (IVF), either conventional or with intracytoplasmic sperm injection (ICSI), with transfer of fresh or frozen embryos.
In this cohort, 60,106 of these children were born after artificial insemination, 133,965 after fresh embryo transfer, and 66,165 after frozen embryo transfer following conventional IVF or ICSI.
For more information on these techniques, visit the Inserm website or the website of the French Biomedicine Agency (Agence de la biomédecine).
This study received funding from the French National Agency for Medicines and Health Products Safety (ANSM).
[1] The team is integrated into the Research Center in Epidemiology and Statistics (CRESS) (Inserm/University of Paris).
[2] Jouannet P, Claris O, Le Bouc Y. Report 23-07. Long-term health of children conceived through in vitro fertilization (IVF). Bull Acad Ntle Med 2023; 207: 695-705.
[3] The SNDS integrates the main existing public health databases. The SNDS aims to improve knowledge about medical care and broaden the scope of research, studies, and evaluations in the field of health.