Difficulty conceiving a pregnancy may be associated with small differences in children’s learning and behavior, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health (NIH).
Neurodevelopmental differences in childhood, including behavioral concerns and conditions such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), can affect long-term health and well-being. As more families use fertility treatments, researchers are working to understand whether these treatments—or the underlying fertility challenges that preceded them—may be linked to children’s development. Previous studies have often been small or unable to separate the effects of infertility from the effects of treatment.
To address these gaps, researchers analyzed data from the ECHO Cohort, examining how fertility history and fertility treatments were related to children’s neurodevelopment. The study included 15,382 mother–child pairs from 44 study sites across the U.S., including Puerto Rico. Researchers combined survey data and medical records to categorize pregnancies by fertility history, including infertility diagnoses, fertility treatments, multiple miscarriages, and extended time trying to conceive. Children’s development between ages 2 and 10 was assessed using parent-completed questionnaires and reports of clinician diagnoses of ASD and ADHD.
In this study, children of parents with fertility challenges showed slightly higher behavior-problem scores, slightly more autism-like traits, and higher odds of an ASD diagnosis, even when conceived without fertility treatment. The study also found an association between children conceived using non–in vitro fertilization (IVF) fertility treatments had higher odds of ADHD compared with those conceived naturally. However, researchers did not find clear evidence that IVF itself was associated with neurodevelopmental outcomes.
Key takeaways include:
- Parental fertility challenges were associated with small differences in children’s behavioral and developmental outcomes.
- Conception using non-IVF fertility treatments was associated with higher odds of ADHD.
- IVF was not clearly associated with neurodevelopmental outcomes in this study.
“This study contributes to the growing body of evidence indicating that infertility treatment itself is not independently associated with child neurodevelopment outcomes,” said ECHO researcher Linda Kahn, PhD, of NYU Langone Health. “Rather, it appears that the parents’ underlying fertility problems—whether stemming from genetic, environmental, or other influences—are likely driving these associations.”
This collaborative research, titled “Associations of subfecundity and infertility treatment with child neurodevelopment in ECHO,” is published in JAMA Network Open.
About ECHO
The ECHO Cohort Consortium is a research program supported by the National Institutes of Health (NIH) with the mission to enhance the health of children for generations to come. ECHO Cohort investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.
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