Cancer-Related Morbidity Among Patients Conceiving Through Oocyte Donation: A Healthcare Registry Cohort Study

<b><i>Background:</i></b> Ovarian aging, often leads to increased use of a donor oocyte, which is associated with greater risk for age-related diseases. <b><i>Objective</i></b>: To evaluate the association between women conceiving through oocyte donation (OD) and future cancer-related morbidity, as compared with women conceiving through IVF (<i>in vitro</i> fertilization) with autologous oocytes (AO), spontaneous conceptions (SC), and nulliparas. <b><i>Methods:</i></b> This retrospective, cohort study was based on the electronic health records of a very large health maintenance organization. The cohort included mothers who delivered before age 45, during 2000-2019. The index date for surveillance was the delivery date of the relevant pregnancy. Each woman from the OD group was matched to a woman the same age at delivery and with the same number of children. Cancer diagnosis was the main outcome. <b><i>Results:</i></b> Matching: 664 OD cases to 664 AO, 700 OD cases to 700 SC, and 700 OD cases to 700 nulliparas. Mean follow-up times were 8.9 ± 3.8 OD, 10 ± 4.1 AO, and 6.4 ± 4.1 years SC. Cancer-related morbidity rates were comparable between OD and the other groups, but compared with nulliparas, a trend was noted (1.6% and 3.1%, respectively, <i>p</i> = 0.07). Survival analysis curves were not significantly different, although a trend was shown in the curve comparing to nulliparity (<i>p</i> = 0.07). In a Cox regression model corrected for BMI, smoking and hormone replacement therapy exposure, cancer in the OD group did not differ compared to the other groups. <b><i>Conclusion:</i></b> Women conceiving through OD do not have increased risk for cancer-related morbidity in the decade following delivery.