Canadian Study on Fertility Treatments and ASD Risk

A recent Canadian study found the intricate relationship between fertility treatments, infertility, and the risk of Autism Spectrum Disorder (ASD) in children. The outcomes of the study were published in the Journal of the American Medical Association.

The study spanned from 2006 to 2018 and challenged previous research that overlooked the impact of infertility itself and the potential mediating role of obstetrical and neonatal factors. The research examined data from over 1.3 million children born through various conception methods:

• Unassisted conception
• Infertility without fertility treatment (subfertility)
• Ovulation induction (OI) or intrauterine insemination (IUI)
• In vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI)

Children born to parents with subfertility or those who underwent fertility treatments exhibited a slightly higher risk of ASD compared to those conceived naturally. The study found that the adjusted hazard ratios for ASD were:

• 1.20 for the subfertility group
• 1.21 following OI or IUI
• 1.16 after IVF or ICSI, relative to unassisted conception

The research also explored the mediating effect of various obstetrical and neonatal factors. Cesarean birth, multifetal pregnancy, preterm birth, and severe neonatal morbidity were identified as some factors that contribute to the observed associations. For instance, after IVF or ICSI, nearly:

• 30% of the increased ASD risk was mediated by cesarean birth
• 78% by multifetal pregnancy
• 50% by preterm birth
• 25% by severe neonatal morbidity

While shedding light on the nuanced connection between fertility treatments, infertility, and ASD, the study emphasizes the need for a comprehensive understanding of the impact of various factors on child neurodevelopment. This suggests that strategies to optimize child neurodevelopment should go beyond fertility treatments to include important consideration of obstetrical and neonatal factors, even for individuals who are not undergoing fertility treatment.

Source

Velez, M. P., Dayan, N., Shellenberger, J., Pudwell, J., Kapoor, D., Vigod, S. N., & Ray, J. G. (2023). Infertility and risk of autism spectrum disorder in children. JAMA Network Open, 6(11), e2343954. https://doi.org/10.1001/jamanetworkopen.2023.43954