Objective To compare the risk and severity of prostate cancer between men achieving fatherhood by assisted reproduction and men conceiving naturally.
Design National register based cohort study.
Setting Sweden from January 1994 to December 2014.
Participants 1 181 490 children born alive in Sweden during 1994-2014 to the same number of fathers. Fathers were grouped according to fertility status by mode of conception: 20 618 by in vitro fertilisation (IVF), 14 882 by intra-cytoplasmic sperm injection (ICSI), and 1 145 990 by natural conception.
Main outcome measures Prostate cancer diagnosis, age of onset, and androgen deprivation therapy (serving as proxy for advanced or metastatic malignancy).
Results Among men achieving fatherhood by IVF, by ICSI, and by non-assisted means, 77 (0.37%), 63 (0.42%), and 3244 (0.28%), respectively, were diagnosed as having prostate cancer. Mean age at onset was 55.9, 55.1, and 57.1 years, respectively. Men who became fathers through assisted reproduction had a statistically significantly increased risk of prostate cancer compared with men who conceived naturally (hazard ratio 1.64, 95% confidence interval 1.25 to 2.15, for ICSI; 1.33, 1.06 to 1.66, for IVF). They also had an increased risk of early onset disease (that is, diagnosis before age 55 years) (hazard ratio 1.86, 1.25 to 2.77, for ICSI; 1.51, 1.09 to 2.08, for IVF). Fathers who conceived through ICSI and developed prostate cancer received androgen deprivation therapy to at least the same extent as the reference group (odds ratio 1.91; P=0.07).
Conclusions Men who achieved fatherhood through assisted reproduction techniques, particularly through ICSI, are at increased risk for early onset prostate cancer and thus constitute a risk group in which testing and careful long term follow-up for prostate cancer may be beneficial.

目的比较男性通过辅助生殖和自然受孕而获得父亲身份的男性患前列腺癌的风险和严重程度。
设计基于国家注册的队列研究。
设置瑞典从1994年1月至2014年12月
参加1个181 490在1994至2014年出生的活在瑞典相同数量的父亲的孩子。父亲按照受孕状况按受孕方式分组：通过体外受精（IVF）接受20 618次；通过胞浆内精子注射（ICSI）接受14 882次；通过自然受孕1 145 990次。
主要结局指标前列腺癌的诊断，发病年龄和雄激素剥夺治疗（作为晚期或转移性恶性肿瘤的代理）。
结果在通过IVF，ICSI和非辅助手段获得父亲身份的男性中，分别被诊断出患有前列腺癌的比例为77（0.37％），63（0.42％）和3244（0.28％）。发病的平均年龄分别为55.9岁，55.1岁和57.1岁。与自然受孕的男性相比，通过辅助生殖成为父亲的男性患前列腺癌的风险有统计学上的显着增加（危险比率1.64，95％置信区间1.25至2.15，ICSI； 1.33，1.06至1.66，IVF）。他们的早期发病风险也更高（也就是说，在55岁之前进行诊断）（ICSI的风险比为1.86，1.25至2.77； IVF的风险比为1.51，1.09至2.08）。通过ICSI受孕并发展为前列腺癌的父亲接受雄激素剥夺治疗的程度至少与参考组相同（比值比为1.91； P = 0.07）。
结论通过辅助生殖技术，特别是通过ICSI获得父亲身份的男性，罹患早期前列腺癌的风险增加，因此构成了一个风险人群，在该人群中进行检测和长期认真的前列腺癌随访可能有益。