ART poses no risk of neurodevelopmental problems in offspring

Children conceived via assisted reproductive techniques (ART) do not appear to be at increased risk of attention-deficit/hyperactivity disorder (ADHD) or poor school performance, as suggested in a study.

The study tracked >2.4 million children born in Sweden in 1986–2012 through linkage of national registers. ART data were drawn from fertility clinics, medical records, and maternal self-report. ADHD was defined by a specialist diagnosis and/or use of medication. On the other hand, school performance was assessed using records of ninth year final grade averages (0–20) and eligibility for upper secondary school.

Infertility and ART use soared throughout the study period. Couples with infertility vs no known infertility were generally more likely older and married or cohabitating. In the infertile group, couples that conceived with ART tended to be of higher age, with the women being less likely to smoke. ART use was related to a higher frequency of multiple gestations, as expected.

Compared with all other children, those conceived with ART had reduced risk of ADHD (hazard ratio [HR], 0.83, 95 percent confidence interval [CI], 0.80–0.87) and performed better in school (grade mean difference [MD], 1.15, 95 percent CI, 1.09–1.21; secondary school eligibility: odds ratio [OR], 1.53, 95 percent CI, 1.45–1.63).

Compared with nonuse, ART use showed no association with the neurodevelopmental outcomes in an analysis restricted to children born to couples with infertility (ADHD: adjusted HR, 0.95, 95 percent CI, 0.90–1.00; final grade average: adjusted MD, 0.05, 95 percent CI, −0.01 to 0.11; secondary school eligibility: adjusted OR, 1.03, 95 percent CI, 0.96–1.10).

Moreover, neither intracytoplasmic sperm injection nor frozen embryo transfer had a negative effect on ADHD risk and school performance relative to standard in vitro fertilization and fresh embryo transfer, respectively.