TY - JOUR

T1 - Risk of ovarian cancer in women who give birth after assisted reproductive technology (ART)—a registry-based Nordic cohort study with follow-up from first pregnancy

AU - Sandvei, Marie Søfteland

AU - Pinborg, Anja

AU - Gissler, Mika

AU - Bergh, Christina

AU - Romundstad, Liv Bente

AU - van Leeuwen, Flora E.

AU - Spaan, Mandy

AU - Tiitinen, Aila

AU - Wennerholm, Ulla Britt

AU - Henningsen, Anna Karina

AU - Opdahl, Signe

N1 - Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer Nature Limited.

PY - 2023

Y1 - 2023

N2 - Background: There is concern that assisted reproductive technology (ART) may increase ovarian cancer risk, but previous studies are inconclusive. We compared ovarian cancer risk for women who gave birth after ART vs natural conception. Methods: Through linkage of nationwide registry data, we followed 3,303,880 initially nulliparous women in Denmark (1994–2014), Finland (1990–2014), Norway (1984–2015) and Sweden (1985–2015) from first pregnancy ≥22 weeks to ovarian cancer, emigration, death or end of follow-up (2014/2015). We estimated hazard ratios (HRs), adjusting for age, parity, maternal birth year and country, and for body mass index and smoking in subsamples. Results: Mean age at first birth was 27.7 years. During a mean follow-up of 14.4 person-years, 2683 participants (0.08%) developed ovarian cancer; 135 after ART and 2548 after natural conception only (incidence rates 11.6 and 5.5 per 100,000 person-years, respectively). The risk was higher for women who ever gave birth after ART (HR 1.70, 95% confidence interval 1.42–2.03) compared to natural conception. Associations were stronger for conventional in vitro fertilisation than for intracytoplasmic sperm injection. Conclusions: Among parous women, ART-conception was associated with a higher risk of ovarian cancer than natural conception. Further studies should decipher whether this is causal or confounded by infertility or other factors.

AB - Background: There is concern that assisted reproductive technology (ART) may increase ovarian cancer risk, but previous studies are inconclusive. We compared ovarian cancer risk for women who gave birth after ART vs natural conception. Methods: Through linkage of nationwide registry data, we followed 3,303,880 initially nulliparous women in Denmark (1994–2014), Finland (1990–2014), Norway (1984–2015) and Sweden (1985–2015) from first pregnancy ≥22 weeks to ovarian cancer, emigration, death or end of follow-up (2014/2015). We estimated hazard ratios (HRs), adjusting for age, parity, maternal birth year and country, and for body mass index and smoking in subsamples. Results: Mean age at first birth was 27.7 years. During a mean follow-up of 14.4 person-years, 2683 participants (0.08%) developed ovarian cancer; 135 after ART and 2548 after natural conception only (incidence rates 11.6 and 5.5 per 100,000 person-years, respectively). The risk was higher for women who ever gave birth after ART (HR 1.70, 95% confidence interval 1.42–2.03) compared to natural conception. Associations were stronger for conventional in vitro fertilisation than for intracytoplasmic sperm injection. Conclusions: Among parous women, ART-conception was associated with a higher risk of ovarian cancer than natural conception. Further studies should decipher whether this is causal or confounded by infertility or other factors.

U2 - 10.1038/s41416-022-02097-7

DO - 10.1038/s41416-022-02097-7

M3 - Journal article

C2 - 36550209

AN - SCOPUS:85144533763

VL - 128

SP - 825

EP - 832

JO - The British journal of cancer. Supplement

JF - The British journal of cancer. Supplement

SN - 0007-0920

IS - 5

ER -