Difficulties conceiving may be associated with small differences in children’s learning and behavior, according to a new study funded by the National Institutes of Health’s (NIH) Environmental Effects on Child Health Outcomes (ECHO) program.
Differences in childhood neurodevelopment, including behavioral concerns and conditions such as autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD), can impact long-term health and well-being. As more families turn to infertility treatments, researchers are working to understand whether these treatments, or underlying fertility problems that preceded them, may be related to child development. Previous studies have often been small or unable to distinguish between the effects of infertility and the effects of treatment.
To address these gaps, researchers analyzed data from the ECHO cohort to examine how reproductive history and infertility treatments are associated with children’s neurodevelopment. The study involved 15,382 mother-infant pairs from 44 research sites across the United States, including Puerto Rico. Using a combination of survey data and medical records, the researchers categorized pregnancies by history of infertility treatment, including infertility diagnosis, infertility treatment, multiple miscarriages, and extended time spent trying to conceive. Children’s development from 2 to 10 years of age was assessed using parent-completed questionnaires and clinician-reported diagnoses of ASD and ADHD.
The study showed that even when pregnant without fertility treatment, children of parents with fertility problems had slightly higher behavior problem scores, slightly higher autism-like traits, and higher odds of an ASD diagnosis. The study also found that children conceived through non-in vitro fertilization (IVF) fertility treatment were associated with higher rates of ADHD than children conceived naturally. However, the researchers found no clear evidence that IVF itself was associated with neurodevelopmental outcomes.
The main takeaways are:
- Parental fertility challenges were associated with small differences in children’s behavioral and developmental outcomes.
- Pregnancies resulting from non-IVF infertility treatment were associated with higher odds of ADHD.
- In this study, IVF was not clearly associated with neurodevelopmental outcomes.
This study contributes to a growing body of evidence showing that infertility treatment itself is not independently associated with children’s neurodevelopmental outcomes. Rather, it seems more likely that underlying fertility issues in the parents are driving these associations, whether due to genetic, environmental, or other influences. ”
Dr. Linda Kahn, NYU Langone Health, ECHO Investigator
The collaborative study is titled “The association between low fertility and infertility treatment and pediatric neurodevelopment in ECHO” and is published in the journal ECHO. JAMA network open.
sauce:
Environmental influences on children’s health outcomes
Reference magazines:
Khan, L.G. Others. (2026) Subfertility, infertility, and pediatric neurodevelopment. JAMA network open. DOI: 10.1001/jamanetworkopen.2026.17324. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2849956
