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Infertility and Its Treatments in Association with Autism Spectrum Disorders: A Review and Results from the CHARGE Study
Department of Public Health Sciences, University of California Davis, One Shields Ave, Med-Sci 1C, Davis, CA 95616, USA
University of California Davis MIND Institute, 2825 50th Street, Sacramento, CA 95817, USA
Department of Obstetrics and Gynecology, University of California Davis Health System, 4860 Y St., Suite 2500, Sacramento, CA 95817, USA
* Author to whom correspondence should be addressed.
Received: 28 June 2013; in revised form: 31 July 2013 / Accepted: 9 August 2013 / Published: 19 August 2013
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.
Keywords: infertility; autism; ASD; assisted reproductive technology; infertility therapies
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Lyall, K.; Baker, A.; Hertz-Picciotto, I.; Walker, C.K. Infertility and Its Treatments in Association with Autism Spectrum Disorders: A Review and Results from the CHARGE Study. Int. J. Environ. Res. Public Health 2013, 10, 3715-3734.
Lyall K, Baker A, Hertz-Picciotto I, Walker CK. Infertility and Its Treatments in Association with Autism Spectrum Disorders: A Review and Results from the CHARGE Study. International Journal of Environmental Research and Public Health. 2013; 10(8):3715-3734.
Lyall, Kristen; Baker, Alice; Hertz-Picciotto, Irva; Walker, Cheryl K. 2013. "Infertility and Its Treatments in Association with Autism Spectrum Disorders: A Review and Results from the CHARGE Study." Int. J. Environ. Res. Public Health 10, no. 8: 3715-3734.