HMN 2026: How Difficulty conceiving is tied to small neurodevelopmental differences in children

Difficulty conceiving a pregnancy may be associated with small differences in children’s learning and behavior, according to a new study, published in the journal JAMA Network Open, titled “Associations of subfecundity and infertility treatment with child neurodevelopment in ECHO.”

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-IVF fertility treatments and higher odds of ADHD compared with those conceived naturally. However, researchers did not find clear evidence that IVF itself was associated with neurodevelopmental outcomes.

“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, Ph.D., 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.”

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