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Fertility Treatment, Female-Factor Infertility, and Autism Spectrum Disorder: Study to Explore Early Development.
Michelle Delahanty1, Julie Daniels1, Stephanie Engel1
1The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
Paediatric and Perinatal Epidemiology
|November 27, 2025
Summary
Fertility treatments, including ovulation-inducing medications and assisted reproductive technology (ART), were not associated with autism spectrum disorder (ASD) in this study. Further research is needed to clarify potential links in specific populations.
Area of Science:
- Reproductive Medicine and Developmental Neurobiology
- Autism Spectrum Disorder Etiology
- Epidemiology of Fertility Treatments
Background:
- Previous studies suggest a weak link between fertility treatments and autism spectrum disorder (ASD).
- Confounding by indication, where the reason for fertility treatment influences outcomes, complicates previous findings.
- Focusing on female-factor infertility populations is crucial for accurate ASD risk assessment.
Purpose of the Study:
- To investigate the association between ovulation-inducing medications, assisted reproductive technology (ART), and ASD.
- To reduce confounding by indication by analyzing a subsample with confirmed female-factor infertility.
Main Methods:
- Utilized data from the Study to Explore Early Development (SEED), a U.S. population-based case-control study (2007-2020).
- Included children aged 2.5-5 years with and without ASD, assessed in-person.
- Identified fertility treatments (ovulation-inducing medications, ART, or both) via interviews, analyzing a subsample with difficulties conceiving.
Main Results:
- No significant association was found between ovulation-inducing medications and ASD in either the full sample or the female-factor infertility subsample.
- Assisted reproductive technology (ART) and combination treatments showed a potential increased likelihood of ASD in the full sample, but this association diminished in the subsample.
- Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated using logistic regression, controlling for multiple covariates.
Conclusions:
- The study found no association between fertility treatments and autism spectrum disorder (ASD) in the analyzed data.
- Observed associations in prior studies may be influenced by confounding factors related to the indication for treatment.
- Future research should focus on specific populations with similar indications to disentangle treatment effects from underlying factors.
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