{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:34:00Z","timestamp":1769729640965,"version":"3.49.0"},"reference-count":41,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2013,8,19]],"date-time":"2013-08-19T00:00:00Z","timestamp":1376870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>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 (\u226535 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.<\/jats:p>","DOI":"10.3390\/ijerph10083715","type":"journal-article","created":{"date-parts":[[2013,8,19]],"date-time":"2013-08-19T12:27:44Z","timestamp":1376915264000},"page":"3715-3734","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Infertility and Its Treatments in Association with  Autism Spectrum Disorders: A Review and Results from the CHARGE Study"],"prefix":"10.3390","volume":"10","author":[{"given":"Kristen","family":"Lyall","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, University of California Davis, One Shields Ave,  Med-Sci 1C, Davis, CA 95616, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Baker","sequence":"additional","affiliation":[{"name":"University of California Davis MIND Institute, 2825 50th Street, Sacramento, CA 95817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irva","family":"Hertz-Picciotto","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of California Davis, One Shields Ave,  Med-Sci 1C, Davis, CA 95616, USA"},{"name":"University of California Davis MIND Institute, 2825 50th Street, Sacramento, CA 95817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheryl","family":"Walker","sequence":"additional","affiliation":[{"name":"University of California Davis MIND Institute, 2825 50th Street, Sacramento, CA 95817, USA"},{"name":"Department of Obstetrics and Gynecology, University of California Davis Health System,  4860 Y St., Suite 2500, Sacramento, CA 95817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2013,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1001\/archgenpsychiatry.2011.76","article-title":"Genetic heritability and shared environmental factors among twin pairs with autism","volume":"68","author":"Hallmayer","year":"2011","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1093\/epirev\/mxf010","article-title":"Heritable and nonheritable risk factors for autism spectrum disorders","volume":"24","author":"Newschaffer","year":"2002","journal-title":"Epidemiol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/S0022-3476(78)80921-4","article-title":"Behavioral consequences of congenital rubella","volume":"93","author":"Chess","year":"1978","journal-title":"J. Pediatr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1111\/j.1469-8749.1994.tb11856.x","article-title":"Autism in thalidomide embryopathy: A population study","volume":"36","author":"Stromland","year":"1994","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1017\/S0012162205001076","article-title":"Characteristics of fetal anticonvulsant syndrome associated autistic disorder","volume":"47","author":"Rasalam","year":"2005","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1001\/archpedi.161.4.326","article-title":"Prenatal and perinatal risk factors for autism: A review and integration of findings","volume":"161","author":"Kolevzon","year":"2007","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1002\/aur.228","article-title":"Pregnancy complications and obstetric suboptimality in association with autism spectrum disorders in children of the Nurses\u2019 Health Study II","volume":"5","author":"Lyall","year":"2012","journal-title":"Autism Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1478-7954-10-17","article-title":"Measuring infertility in populations: Constructing a standard definition for use with demographic and reproductive health surveys","volume":"10","author":"Mascarenhas","year":"2012","journal-title":"Popul. Health Metr."},{"key":"ref_9","first-page":"1","article-title":"Prevalence of autism spectrum disorders\u2014Autism and developmental disabilities monitoring network, 14 sites, United States, 2008","volume":"61","author":"Wingate","year":"2012","journal-title":"MMWR Surveill. Summ."},{"key":"ref_10","first-page":"1","article-title":"Fertility, family planning, and reproductive health: Data from the 2002 National Survey of Family Growth","volume":"23","author":"Chandra","year":"2005","journal-title":"Vital Health Stat."},{"key":"ref_11","unstructured":"Mathews, T.J., and Hamilton, B.E. (2009). NCHS Data Brief, National Center for Health Statistics."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.placenta.2008.08.013","article-title":"Follow-up of children born after ART","volume":"29","author":"Basatemur","year":"2008","journal-title":"Placenta"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1056\/NEJMoa1008095","article-title":"Reproductive technologies and the risk of birth defects","volume":"366","author":"Davies","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"405382:1","DOI":"10.5402\/2012\/405382","article-title":"A review of outcome data concerning children born following assisted reproductive technologies","volume":"2012","author":"Dupont","year":"2012","journal-title":"ISRN Obstet. Gynecol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1001\/archpediatrics.2008.507","article-title":"Cerebral palsy, autism spectrum disorders, and developmental delay in children born after assisted conception: A systematic review and meta-analysis","volume":"163","author":"Schieve","year":"2009","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/BF01531570","article-title":"Parental reproductive problems and gestational hormonal exposure in autistic and schizophrenic children","volume":"13","author":"Funderburk","year":"1983","journal-title":"J. Autism Dev. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1136\/jech.2009.093823","article-title":"Risk of autism spectrum disorders in children born after assisted conception: A population-based follow-up study","volume":"65","author":"Grove","year":"2011","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1365-3016.2012.01294.x","article-title":"Fertility therapies, infertility and autism spectrum disorders in the nurses\u2019 health study II","volume":"26","author":"Lyall","year":"2012","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1542\/peds.2006-0735","article-title":"Health of children born as a result of in vitro fertilization","volume":"118","author":"Klemetti","year":"2006","journal-title":"Pediatrics"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3098","DOI":"10.1093\/humrep\/dem261","article-title":"Matched follow-up study of 5\u20138-year-old ICSI singletons: Child behaviour, parenting stress and child (health-related) quality of life","volume":"22","author":"Knoester","year":"2007","journal-title":"Hum. Reprod."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.comppsych.2005.01.001","article-title":"Obstetric complications in individuals diagnosed with autism and in healthy controls","volume":"47","author":"Stein","year":"2006","journal-title":"Compr. Psychiatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/S0140-6736(02)07674-2","article-title":"Neurological sequelae in children born after in vitro fertilisation: A population-based study","volume":"359","author":"Dahlquist","year":"2002","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1093\/humrep\/dem082","article-title":"Do children born after assisted conception have less risk of developing infantile autism?","volume":"22","author":"Maimburg","year":"2007","journal-title":"Hum. Reprod."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1093\/humrep\/17.4.929","article-title":"Hospital care utilization of infants born after IVF","volume":"17","author":"Ericson","year":"2002","journal-title":"Hum. Reprod."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1093\/humrep\/deh714","article-title":"Imprinting diseases and IVF: Danish National IVF cohort study","volume":"20","author":"Lidegaard","year":"2005","journal-title":"Hum. Reprod."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1093\/humrep\/deg257","article-title":"Morbidity in a Danish national cohort of 472 IVF\/ICSI twins, 1132 non-IVF\/ICSI twins and 634 IVF\/ICSI singletons: Health-related and social implications for the children and their families","volume":"18","author":"Pinborg","year":"2003","journal-title":"Hum. Reprod."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1136\/bmj.38156.715694.3A","article-title":"Neurological sequelae in twins born after assisted conception: Controlled national cohort study","volume":"329","author":"Pinborg","year":"2004","journal-title":"BMJ"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s10803-012-1598-5","article-title":"Is infertility associated with childhood autism?","volume":"43","author":"Grether","year":"2013","journal-title":"J. Autism Dev. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Baron-Cohen, S., Lutchmaya, S., and Knickmeyer, R. (2004). Prenatal Testosterone in Mind, The MIT Press.","DOI":"10.7551\/mitpress\/5522.001.0001"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1007\/s10803-010-1079-7","article-title":"Maternal early life factors associated with hormone levels and the risk of having a child with an autism spectrum disorder in the nurses health study II","volume":"41","author":"Lyall","year":"2011","journal-title":"J. Autism Dev. Disord."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1097\/WCO.0b013e3283373514","article-title":"The immune system\u2019s role in the biology of autism","volume":"23","author":"Goines","year":"2010","journal-title":"Curr. Opin. Neurol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1289\/ehp.8483","article-title":"The CHARGE study: An epidemiologic investigation of genetic and environmental factors contributing to autism","volume":"114","author":"Croen","year":"2006","journal-title":"Environ. Health Perspect."},{"key":"ref_33","unstructured":"(2008). Assisted Reproductive Technology Success Rates: National Summary and Fertility Clinics Report, Center for Disease Control and Prevention."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1097\/00001648-200207000-00009","article-title":"Perinatal risk factors for infantile autism","volume":"13","author":"Hultman","year":"2002","journal-title":"Epidemiology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1038\/sj.ijo.0800424","article-title":"Women\u2019s reproductive health: the role of body mass index in early and adult life","volume":"21","author":"Lake","year":"1997","journal-title":"Int. J. Obes. Relat. Metab. Disord."},{"key":"ref_36","first-page":"365","article-title":"Cigarette smoking and infertility","volume":"46","author":"Wentz","year":"1986","journal-title":"Fertil. Contracept."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1097\/01.ede.0000208475.99429.2d","article-title":"Estimation of direct causal effects","volume":"17","author":"Peterson","year":"2006","journal-title":"Epidemiology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/EDE.0b013e31818f69ce","article-title":"Marginal structural models for the estimation of direct and indirect effects","volume":"20","year":"2009","journal-title":"Epidemiology"},{"key":"ref_39","unstructured":"Hertzmark, E., Pazaris, M., and Spiegelman, D. (2009). The SAS Mediate Macro, Channing Laboratory, Brigham and Women\u2019s Hospital."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1002\/(SICI)1097-0258(19970715)16:13<1515::AID-SIM572>3.0.CO;2-1","article-title":"Estimating the proportion of treatment effect explained by a surrogate marker","volume":"16","author":"Lin","year":"1997","journal-title":"Stat. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.jaac.2010.05.005","article-title":"Autism spectrum disorders and epigenetics","volume":"49","author":"Grafodatskaya","year":"2010","journal-title":"J. Am. Acad. Child Adolesc. Psychiatr."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/10\/8\/3715\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T21:48:43Z","timestamp":1760219323000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/10\/8\/3715"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,8,19]]},"references-count":41,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2013,8]]}},"alternative-id":["ijerph10083715"],"URL":"https:\/\/doi.org\/10.3390\/ijerph10083715","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,8,19]]}}}