Risk for autism increased for children born to those with infertility

Children born to individuals with infertility have a slightly higher risk for autism spectrum disorder (ASD), according to a study published online Nov. 20 in JAMA Network Open.

Maria P. Velez, M.D., Ph.D., from Queen's University in Kingston, Ontario, Canada, and colleagues examined the association between infertility and its treatments on the risk for ASD in a population-based cohort study in Ontario.

The exposure was mode of conception: unassisted conception; infertility without fertility treatment (subfertility); ovulation induction (OI) or intrauterine insemination (IUI); or in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Diagnosis of ASD at age 18 months or older was assessed as the study outcome.

Data were included for 1,370,152 children: 86.5, 10.3, 1.5, and 1.7 percent with unassisted conception, parental subfertility, OI or IUI, and IVF or ICSI, respectively. The researchers found that among children in the unassisted conception group, the incidence rate of ASD was 1.93 per 1,000 person-years.

Relative to the unassisted conception group, the adjusted hazard ratios for ASD were 1.20, 1.21, and 1.16 in the subfertility group, the OI or IUI group, and the IVF or ICSI group, respectively. A sizeable proportion of the association between mode of conception and ASD risk was mediated by obstetrical and neonatal factors.

"Efforts to decrease multifetal pregnancy following OI or IUI and IVF should continue to be reinforced, alongside the development of focused care pregnancy plans both for individuals with subfertility and those receiving fertility treatment," the authors write.