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Subfecundity, Infertility Treatment, and Child Neurodevelopment
Linda G Kahn1, Alison E Hipwell2, Joseph B Stanford3
1New York University Grossman School of Medicine, New York, New York.
JAMA Network Open
|June 8, 2026
Summary
Subfecundity, not infertility treatment, is linked to higher risks of autism spectrum disorder (ASD) and behavioral problems in children. Non-IVF treatments showed an association with attention deficit/hyperactivity disorder (ADHD).
Area of Science:
- Reproductive Health
- Child Neurodevelopment
- Infertility Research
Background:
- An increasing number of children are conceived via infertility treatments.
- Concerns exist regarding potential neurodevelopmental effects on children conceived through these methods.
- Understanding the independent roles of subfecundity and infertility treatments is crucial.
Purpose of the Study:
- To evaluate the association between infertility treatment and child neurodevelopment.
- To determine if underlying subfecundity contributes to any observed associations.
- To differentiate the neurodevelopmental outcomes associated with in vitro fertilization (IVF) versus non-IVF treatments.
Main Methods:
- A large US cohort study analyzed mother-child dyads from the NIH ECHO Cohort (infants conceived 1998-2022).
- Subfecundity and infertility treatments (IVF, non-IVF) were defined based on prior diagnoses, treatments, or conception history.
- Neurodevelopmental outcomes, including autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD), were assessed using validated questionnaires and physician diagnoses.
Main Results:
- Subfecundity was associated with higher scores for externalizing behavioral problems and autism-like symptoms (SRS scores), and increased odds of ASD diagnosis, independent of infertility treatment.
- Non-IVF infertility treatment was associated with higher odds of ADHD diagnosis compared to natural conceptions, both with and without subfecundity.
- No significant associations were found between in vitro fertilization (IVF) treatment and the studied neurodevelopmental outcomes.
Conclusions:
- Subfecundity itself is a significant factor associated with adverse neurodevelopmental outcomes, including behavioral problems and ASD, irrespective of infertility treatment.
- Non-IVF infertility treatments may be linked to an increased risk of ADHD in offspring.
- Further research is warranted to explore specific indications for non-IVF treatments and their potential impact on child neurodevelopment.
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