title: Infertility and its treatments in association with autism spectrum disorders: a review and results from the CHARGE study.
abstract: Previous findings on relationships between infertility, infertility therapies, and autism spectrum disorders (ASD) have been inconsistent. The goals of this study are first, to briefly review this evidence and second, to examine infertility and its treatments in association with having a child with ASD in newly analyzed data. In review, we identified 14 studies published as of May 2013 investigating infertility and/or its treatments and ASD. Overall, prior results showed little support for a strong association, though some increases in risk with specific treatments were found; many limitations were noted. In new analyses of the CHildhood Autism Risk from Genetics and the Environment (CHARGE) population-based study, cases with autism spectrum disorder (ASD, n = 513) and controls confirmed to have typical development (n = 388) were compared with regard to frequencies of infertility diagnoses and treatments overall and by type. Infertility diagnoses and treatments were also grouped to explore potential underlying pathways. Logistic regression was used to obtain crude and adjusted odds ratios overall and, in secondary analyses, stratified by maternal age (≥35 years) and diagnostic subgroups. No differences in infertility, infertility treatments, or hypothesized underlying pathways were found between cases and controls in crude or adjusted analyses. Numbers were small for rarer therapies and in subgroup analyses; thus the potential for modest associations in specific subsets cannot be ruled out. However, converging evidence from this and other studies suggests that assisted reproductive technology is not a strong independent risk factor for ASD. Recommendations for future studies of this topic are provided.
authors: Department of Public Health Sciences, University of California Davis, One Shields Ave, Med-Sci 1C, Davis, CA 95616, USA. kdodge@ucdavis.edu
authors: Kristen
authors: K
authors: Lyall
authors: Alice
authors: A
authors: Baker
authors: Irva
authors: I
authors: Hertz-Picciotto
authors: Cheryl K
authors: CK
authors: Walker
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000209:etiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D027724:Reproductive Techniques, Assisted; D012307:Risk Factors; D055815:Young Adult
references: Arch Pediatr Adolesc Med. 2009 Jan;163(1):72-83
references: 19124707
references: Placenta. 2008 Oct;29 Suppl  B:135-40
references: 18790325
references: Epidemiology. 2002 Jul;13(4):417-23
references: 12094096
references: Environ Health Perspect. 2006 Jul;114(7):1119-25
references: 16835068
references: Hum Reprod. 2002 Apr;17(4):929-32
references: 11925384
references: Stat Med. 1997 Jul 15;16(13):1515-27
references: 9249922
references: NCHS Data Brief. 2009 Aug;(21):1-8
references: 19674536
references: J Am Acad Child Adolesc Psychiatry. 2010 Aug;49(8):794-809
references: 20643313
references: Hum Reprod. 2007 Dec;22(12):3098-107
references: 17905745
references: Curr Opin Neurol. 2010 Apr;23(2):111-7
references: 20160651
references: Epidemiol Rev. 2002;24(2):137-53
references: 12762089
references: Epidemiology. 2009 Jan;20(1):18-26
references: 19234398
references: J Epidemiol Community Health. 2011 Jun;65(6):497-502
references: 20584728
references: Fertil Contracept. 1986 Sep;46(3):365-7
references: 12340953
references: Hum Reprod. 2003 Jun;18(6):1234-43
references: 12773452
references: BMJ. 2004 Aug 7;329(7461):311
references: 15256418
references: Compr Psychiatry. 2006 Jan-Feb;47(1):69-75
references: 16324905
references: Hum Reprod. 2005 Apr;20(4):950-4
references: 15665017
references: N Engl J Med. 2012 May 10;366(19):1803-13
references: 22559061
references: Pediatrics. 2006 Nov;118(5):1819-27
references: 17079550
references: Autism Res. 2012 Feb;5(1):21-30
references: 21972225
references: Arch Pediatr Adolesc Med. 2007 Apr;161(4):326-33
references: 17404128
references: J Autism Dev Disord. 1983 Sep;13(3):325-32
references: 6643376
references: MMWR Surveill Summ. 2012 Mar 30;61(3):1-19
references: 22456193
references: Int J Obes Relat Metab Disord. 1997 Jun;21(6):432-8
references: 9192225
references: Arch Gen Psychiatry. 2011 Nov;68(11):1095-102
references: 21727249
references: Lancet. 2002 Feb 9;359(9305):461-5
references: 11853790
references: Dev Med Child Neurol. 2005 Aug;47(8):551-5
references: 16108456
references: J Pediatr. 1978 Oct;93(4):699-703
references: 702254
references: Hum Reprod. 2007 Jul;22(7):1841-3
references: 17456530
references: J Autism Dev Disord. 2011 May;41(5):618-27
references: 20700638
references: J Autism Dev Disord. 2013 Mar;43(3):663-72
references: 22777105
references: ISRN Obstet Gynecol. 2012;2012:405382
references: 22778982
references: Epidemiology. 2006 May;17(3):276-84
references: 16617276
references: Popul Health Metr. 2012 Aug 31;10(1):17
references: 22938182
references: Dev Med Child Neurol. 1994 Apr;36(4):351-6
references: 8157157
references: Paediatr Perinat Epidemiol. 2012 Jul;26(4):361-72
references: 22686388
references: Vital Health Stat 23. 2005 Dec;(25):1-160
references: 16532609