Health outcomes in offspring born to survivors of childhood cancers following assisted reproductive technologies
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Health outcomes in offspring born to survivors of childhood cancers following assisted reproductive technologies Greta Sommerhäuser 1 & Anja Borgmann-Staudt 1 & Kathy Astrahantseff 1 & Katja Baust 2 & Gabriele Calaminus 2 & Ralf Dittrich 3 & Marta J. Fernández-González 1 & Heike Hölling 4 & Charlotte J. König 1 & Ralph Schilling 1,5 & Theresa Schuster 1 & Laura Lotz 3 & Magdalena Balcerek 1,6 Received: 29 May 2020 / Accepted: 15 August 2020 # The Author(s) 2020
Abstract Purpose An increasing number of childhood cancer survivors are using assisted reproductive technologies (ART) to overcome treatment-related fertility impairment. We report perinatal and health outcomes of offspring born to survivors following ART. Methods The FeCt Multicenter Offspring Study surveyed the health of offspring of childhood cancer survivors. Health outcomes in offspring born to survivors following ART (n = 57, 4.6%) or after spontaneous conception (n = 1182) were assessed in the German cohort (n = 1239) using bivariate analysis. Findings were put into the context of the general German population by health outcome assessment in 1:1 matched-pair analysis (n = 2478). Results Nearly twice the survivors used ART compared with numbers reported for the German general population (4.6% vs. 2.6%). Successful pregnancies were achieved after a median of two cycles, mainly using non-cryopreserved oocytes/sperm. Multiple sibling births (p < 0.001, 28.1% vs. 3.0%) and low birth weight (p = 0.008; OR = 2.659, 95% CI = 1.258–5.621) occurred significantly more often in offspring born to survivors who utilized ART than spontaneously conceived children, whereas similar percentages were born preterm or too small for their gestational age. ART did not increase the prevalence of childhood cancer or congenital malformations in offspring born to survivors. Conclusion ART use by childhood cancer survivors was successful with both fresh and cryopreserved oocytes/sperm, and did not influence perinatal health or health outcomes when known confounders were taken into account. Implications for Cancer Survivors Oncofertility is an important component of patient care. Our study implicates that the utilization of ART by adult survivors of childhood cancer does not put offspring at additional risk for adverse perinatal or health outcomes. Keywords Assisted reproductive technologies . Childhood cancer survivor . Pediatric cancer . Infertility . Offspring
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11764-020-00929-0) contains supplementary material, which is available to authorized users. * Anja Borgmann-Staudt [email protected] 1
2
Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany University Hospital Bonn (UKB), Venusberg-Campus 1, 53127 Bonn, Germany
3
Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexande
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