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New Study Reveals Slight Increase in Autism Risk for Children Born to Individuals with Infertility

The Link Between Infertility, Treatment, and Autism Explored in Ontario Cohort Study

In a groundbreaking cohort study conducted in Ontario, Canada, researchers have delved into the association between infertility, its treatments, and the risk of Autism Spectrum Disorder (ASD) in children. The study, involving 1.3 million children born between 2006 and 2018, sheds light on the nuanced relationship between infertility and child neurodevelopment.

Key Findings: Infertility and ASD Risk

The study categorized children based on the mode of conception: unassisted conception, subfertility (infertility without treatment), ovulation induction (OI) or intrauterine insemination (IUI), and in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). The incidence rate of ASD per 1000 person-years was 1.9 in unassisted conception, 2.5 in subfertility, and 2.7 after fertility treatment. Notably, there was a slightly higher risk of ASD in children born to individuals with infertility, a risk that was partially mediated by obstetrical and neonatal factors.

Implications and Recommendations

The findings suggest the need for broader strategies to address adverse pregnancy outcomes in individuals with infertility, irrespective of whether they undergo fertility treatment. Efforts to optimize child neurodevelopment should consider the impact of infertility itself, alongside associated obstetrical and neonatal factors.

Study Details and Methodology

The population-based cohort study considered all singleton and multifetal live births at 24 or more weeks’ gestation. Data analysis took place from October 2022 to October 2023. The exposure categories included unassisted conception, subfertility, OI or IUI, and IVF or ICSI. The main outcome measured was the diagnosis of ASD at age 18 months or older.

Mediation Analysis: Unraveling the Complex Web

Causal mediation analysis was employed to dissect the mediating effect of adverse pregnancy outcomes, including preeclampsia, cesarean birth, multifetal pregnancy, preterm birth, and severe neonatal morbidity. Results indicated varying degrees of mediation, with factors like multiple pregnancies playing a substantial role, especially after IVF or ICSI.

Conclusion: Navigating the Complex Landscape

In summary, the study suggests a nuanced connection between infertility, its treatments, and the risk of ASD in children. While the risk is slightly elevated, efforts should focus on minimizing adverse pregnancy outcomes and optimizing neurodevelopment in children born to individuals with infertility. This research adds valuable insights to the ongoing dialogue surrounding fertility treatments and their impact on child health.

Credit: JAMA Network Open