STUDY QUESTION Does the probability of a live birth after fresh IVF/ICSI cycles with autologous oocytes differ in early onset female cancer survivors compared to their siblings? SUMMARY ANSWER The probability of a live birth was similar in female cancer survivors and siblings after four fresh IVF/ICSI cycles. WHAT IS KNOWN ALREADY Fertility preservation strategies are rapidly being developed to help female cancer patients who wish to have children later. However, there are only a few studies available on fertility treatments and following live births in female cancer survivors before fertility preservation strategies became available. In one of them, the probability of a live birth was reduced after assisted reproductive technology with autologous oocytes in cancer survivors compared to siblings. STUDY DESIGN, SIZE, DURATION In this retrospective, register-based study, data from Finnish registers on cancer, birth and prescribed medications were merged to identify 8944 female cancer survivors (diagnosed with cancer between 1953 and 2012 at the age of 0–40 years) and 9848 female siblings of survivors eligible for IVF/ICSI treatments between January 1993 and December 2012. PARTICIPANTS/MATERIALS, SETTING, METHODS Fresh IVF/ICSI cycles and following live birth rates (LBRs) within 22–48 weeks in cancer survivors and siblings at the age of 20–41 years were identified. A binomial regression model with log-link function was used to calculate risk ratio (RR) for live births after fresh IVF/ICSI cycles in survivors compared to siblings, adjusting for attained age and calendar time. A Poisson regression model was used to estimate incidence rate ratios (IRRs) for an IVF/ICSI treatment, as well as overall live births, including both pregnancies after fertility treatments and spontaneous pregnancies, in survivors compared to siblings. MAIN RESULTS AND THE ROLE OF CHANCE We observed an overall decreased LBR, irrespective of IVF/ICSI treatments, in cancer survivors compared to siblings (IRR 0.68, 95% CI 0.64–0.71). All in all, 179 (2.0%) survivors and 230 (2.3%) siblings were prescribed fertility drugs for IVF/ICSI treatments (IRR 0.72, 95% CI 0.62–0.84). For the first fresh IVF/ICSI cycle, the LBR was 17.2% among survivors and 15.7% among siblings (RR 1.13, 95% CI 0.72–1.87). The mean LBR after four fresh IVF/ICSI cycles was not statistically different in survivors compared to siblings. LIMITATIONS, REASONS FOR CAUTION In this study, only IVF/ICSI treatments with autologous oocytes were included. The probability of a live birth after a frozen embryo transfer or oocyte donation could not be evaluated in this study. Information on miscarriages, extrauterine pregnancies or termination of pregnancies was not available. WIDER IMPLICATIONS OF THE FINDINGS For those early onset cancer survivors, who received IVF/ICSI treatments, the probability of live birth was not different from siblings who received IVF/ICSI treatments. However, an overall decreased LBR, irrespective of IVF/ICSI treatments, was observed in cancer survivors compared to siblings, indicating that cancer survivors receiving IVF/ICSI treatments in our study consisted of a selected group with at least a moderate ovarian reserve. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by a grant from the Cancer Foundation (Finland) (grant number 130079) and by a grant from LähiTapiola. The authors have no potential conflicts of interest. TRIAL REGISTRATION NUMBER N/A.

中文翻译：

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女性早发性癌症幸存者 IVF/ICSI 治疗后活产的概率：芬兰基于人群的登记研究

研究问题 与她们的兄弟姐妹相比，早期发病的女性癌症幸存者在使用自体卵母细胞的新鲜 IVF/ICSI 周期后活产的概率是否不同？总结答案 在四个新的 IVF/ICSI 周期后，女性癌症幸存者和兄弟姐妹的活产概率相似。已知情况 生育力保存策略正在迅速发展，以帮助希望以后生育的女性癌症患者。然而，在生育力保存策略可用之前，只有少数关于生育治疗和女性癌症幸存者活产后的研究可用。在其中一个案例中，与兄弟姐妹相比，在癌症幸存者中使用自体卵母细胞进行辅助生殖技术后，活产的可能性降低了。研究设计、规模、持续时间在这次回顾展中，基于登记的研究，合并了来自芬兰癌症、出生和处方药登记的数据，以确定 8944 名女性癌症幸存者（在 1953 年至 2012 年间被诊断出患有癌症，年龄在 0-40 岁之间）和 9848 名符合体外受精条件的幸存者的女性兄弟姐妹/ICSI 治疗于 1993 年 1 月至 2012 年 12 月之间。参与者/材料、环境、方法确定了 20-41 岁癌症幸存者和兄弟姐妹在 22-48 周内的新鲜 IVF/ICSI 周期和活产率 (LBR) . 使用具有对数链接函数的二项式回归模型来计算幸存者与兄弟姐妹相比，在新的 IVF/ICSI 周期后活产的风险比 (RR)，并根据达到的年龄和日历时间进行调整。泊松回归模型用于估计 IVF/ICSI 治疗的发病率比 (IRR)，以及与兄弟姐妹相比，幸存者的整体活产，包括生育治疗后的怀孕和自然怀孕。主要结果和机会的作用 我们观察到，与兄弟姐妹相比，癌症幸存者的 LBR 总体下降，无论 IVF/ICSI 治疗如何（IRR 0.68, 95% CI 0.64–0.71）。总而言之，179 名 (2.0%) 幸存者和 230 名 (2.3%) 兄弟姐妹接受了 IVF/ICSI 治疗的生育药物治疗 (IRR 0.72, 95% CI 0.62–0.84)。对于第一个新的 IVF/ICSI 周期，幸存者的 LBR 为 17.2%，兄弟姐妹中的 LBR 为 15.7%（RR 1.13，95% CI 0.72-1.87）。与兄弟姐妹相比，幸存者在四个新的 IVF/ICSI 周期后的平均 LBR 没有统计学差异。限制，谨慎的原因 在这项研究中，仅包括使用自体卵母细胞的 IVF/ICSI 治疗。本研究无法评估冷冻胚胎移植或卵母细胞捐赠后活产的可能性。没有关于流产、宫外妊娠或终止妊娠的信息。研究结果的更广泛意义 对于那些接受 IVF/ICSI 治疗的早发癌症幸存者，活产的概率与接受 IVF/ICSI 治疗的兄弟姐妹没有区别。然而，与兄弟姐妹相比，无论 IVF/ICSI 治疗如何，在癌症幸存者中观察到 LBR 总体下降，这表明在我们的研究中接受 IVF/ICSI 治疗的癌症幸存者由至少具有中等卵巢储备的选定组组成。研究资助/竞争兴趣 本研究得到了癌症基金会（芬兰）的资助（资助号 130079）和 LähiTapiola 的资助。作者没有潜在的利益冲突。试用注册号 不适用。