Thursday, February 5, 2009

Malignant Conditions In Children Born After Assisted Reproductive Technology

A recent article article reviews the risks of childhood malignancies and imprinting disorders in children born as a result of assisted reproductive technology (ART) (Bibliography at the end of this post). Since the birth of Louise Brown, there have been 3 million babies born by IVF. Factors which have been implicated in potentially increasing the risk of malignancies in these offspring include:

1. gonadotropins for superovulation,
2. intracytoplasmic sperm injection,
3. blastocyst culture,
4. assisted hatching,
5. and preimplantation genetic diagnosis.

For example, whereas, a significant risk of neuroblastoma, retinoblastomas, acute lymphatic leukemia and non-Hodgkin lymphoma has been reported after ART, others have failed to replicate these findings.

Epigentic alterations leading to DNA modifications and imprinting disorders have also been implicated as a result of assisted reproductive techniques. Two genetic imprinting disorders that are known to cause birth defects and childhood malignancies, Beckwith-Wiedmann syndrome and Angelman syndrome. Each of these have been associated with ART.

The current paper provides a literature review that was unable to identify the precise risks of imprinting disorders and childhood cancers in children conceived with ART.

Although, most studies have not shown an increase in the incidence of childhood cancers after ART, patients should be advised about the known and unknown associated risks.

Neelanjana M, Sabaratnam A
Obstet Gynecol Surv. 2008 Oct;63(10):669-76