#5-08E. Unmasking the True Culprit: Subfecundity vs. Infertility Treatments in Child Neurodevelopment (JAMANetworkOpen, 2026)

Are the neurodevelopmental risks seen in children conceived via infertility treatments caused by the medical procedures themselves, or by the parents' underlying fertility struggles? In this large-scale US cohort study involving over 15,000 mother-child dyads, researchers evaluated the associations between infertility treatments, underlying subfecundity, and child neurodevelopmental outcomes such as ASD, ADHD, and behavioral problems. The study reveals a pivotal finding: subfecundity itself is independently associated with an increased risk of behavioral issues and autism spectrum disorder, even among children conceived naturally. However, when critically appraising this study, physicians must be cautious of potential confounding by indication, particularly regarding the association between non-IVF treatments and ADHD, which might be driven by underlying maternal conditions like polycystic ovary syndrome (PCOS) rather than the treatment itself. For clinical practitioners, this paper is highly significant as it provides crucial evidence to reassure patients that assisted reproductive technologies are not the primary drivers of neurodevelopmental risks; instead, it guides physicians to focus on assessing parental underlying subfecundity and specific maternal conditions when counseling couples and monitoring long-term pediatric health outcomes.

Citation: Kahn LG. Subfecundity, Infertility Treatment, and Child Neurodevelopment. JAMA Network Open. 2026. DOI: 10.1001/jamanetworkopen.2026.17324

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