Assisted reproductive technology and risk of malignancy among offspring: a meta-analysis.
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BACKGROUND: With the popularization of assisted reproductive technology (ART), the question of whether ART increases the risk of malignancy in offspring has received increasing attention. Although many studies have explored the relationship between ART use and malignancy in offspring, the results remain controversial. MATERIALS AND METHODS: Two authors used the Embase, Web of Science, PubMed, and the Cochrane Library databases to conduct a systematic search of published studies on the effects of ART on the risk of malignancy in offspring. Odds ratios (OR) and 95% confidence intervals were used for the analysis. RESULTS: Twenty cohort and four case-control studies were included in this review. ART did not increase the risk of overall malignancy in the offspring (OR, 1.04) compared with natural pregnancy (NP). However, the subgroup analysis showed that the offspring in the ART group had a higher risk of leukemia (OR, 1.24), soft tissue tumors (OR, 1.35), hepatic tumors (OR, 2.10), and epithelial tumors and melanoma (OR, 1.50). The risks of lymphoma, retinoblastoma, central nervous system tumors, neuroblastoma, renal tumors, germ cell and gonad tumors, and embryonic tumors did not differ between the ART and NP groups. Subgroup analysis based on ART type showed that in vitro fertilization, intracytoplasmic sperm injection, frozen embryo transfer, and intrauterine insemination or ovulation did not increase the risk of overall malignancy compared to the NP group. CONCLUSIONS: ART may not be associated with the risk of overall malignancy in offspring. However, we found that ART may be associated with an increased risk of leukemia, soft tissue tumors, hepatic tumors, epithelial tumors, and melanoma.