Analyzing the Association Between ART and Neurodevelopmental Disorders

Assisted reproductive technology (ART) has proven to be a critical tool for those unable to conceive via biological mechanisms. However, considering the relatively new nature of these tools, little is understood about the potential risks to patients and their offspring. In a study published by JAMA Network Open, researchers analyzed the association between ART and neurodevelopmental disorders in offspring conceived through ART.

The study looked at two widely used ART methods. The first, in vitro fertilization (IVF), is often utilized for patients suffering from female infertility issues. The second, intracytoplasmic sperm injection (ICSI), is for patients struggling with male infertility.

This study, conducted in Taiwan, used data from the national population registry, national birth data, and national ART data sets from January 2008 to December 2016. The researchers excluded any multiple births which can be associated with other neurodevelopmental disorders. ART offspring were followed from birth until diagnosis or December 2018, depending on which came first.

Researchers looked for the incidence of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and developmental delays. The study, which included data from 1,575,971 births, found that ASD was nearly 2.5 times more likely in patients conceived via ICSI than those conceived via natural conception. Additional data found that developmental delays were 61% more likely in patients conceived via ICSI.

This data presents serious public health concerns as ICSI has been widely used since it was first developed in the early 1990s. While used in some cases of female infertility, it is more common for male infertility.

A review published earlier this year in Human Reproductive Update found that the average global sperm count has decreased by 51.6% between 1973 and 2018. While the average sperm count is still within the fertile window, it indicates declining male fertility. With male fertility declining, the popularity of ICSI, among other ARTs, is increasing. According to the JAMA publication, ICSI’s popularity in ART is approximately 70%, a remarkable increase from the 20% popularity in 2011.

Researchers in the publication concluded, “Considering the fear of fertilization and pregnancy failure with ART, the popularity of ICSI is increasing worldwide. However, we reported the association of ICSI with offspring health, which may affect the established benefits of ART with ICSI. These results suggest the importance of establishing the indications of ICSI use in couples experiencing infertility.”