International Meeting for Autism Research: Association Between Assisted Reproductive Technology and Autism Spectrum Disorders

Association Between Assisted Reproductive Technology and Autism Spectrum Disorders

Saturday, May 22, 2010
Franklin Hall B Level 4 (Philadelphia Marriott Downtown)
11:00 AM
P. A. Davis , Lurie Center/LADDERS, MassGeneral Hosptial for Children/Harvard Medical School, Lexington, MA
K. Hollenbach , University of California, San Diego, San Diego, CA
K. Schmidt , Lurie Center/LADDERS, MassGeneral Hosptial for Children/Harvard Medical School, Lexington, MA
C. Ferrone , Lurie Center/LADDERS, MassGeneral Hosptial for Children/Harvard Medical School, Lexington, MA
M. L. Bauman , Lurie Center/LADDERS; Anatomy and Neurobiology, MassGeneral Hosptial for Children/Harvard Medical School; Boston University School of Medicine, Lexington, MA
Background:
There has been a dramatic upswing in the number of autism diagnoses among children beginning in the early 1990’s.  A recent prevalence report indicates that 1 in 91 children ages 3 to 17 have such a disorder.  The increasing incidence in Autism Spectrum Disorders (ASD) is potentially associated with the increasing use of Assisted Reproductive Technology (ART) to achieve pregnancy.  In the United States, 1.2% of the 2005 U.S. birth cohort was born following ART treatment (CDC, 2008).  Despite the lack of a systemic surveillance effort on the safety of ART, convincing evidence that ART treatment increases the risk of adverse outcomes, including developmental disabilities, among conceived children has begun to emerge.

Objectives:
To examine the relationship between ART and the occurrence of ASD.

Methods:
Reproductive history information was analyzed from all subjects enrolled in the Autism Treatment Network (ATN) Clinical Research Registry. The ATN is a group of 15 hospitals and medical centers dedicated to improving medical care for children and adolescents with autism spectrum disorder through treatment research.  Participating institutions administer standardized protocols and assessments and contribute this data to a national database.  Those enrolled in the registry are between the ages of 2 and 17.6 years and have met ASD criteria on both the DSM-IV and the Autism Diagnostic Observation Scale at an established ATN site.

Results: Of the 1491 autism spectrum disorder patients enrolled in the ATN, 94% (n= 1401) provided information on whether their pregnancy was conceived naturally or through use of assisted reproductive technology (ART) and were used as the basis for analysis.  One hundred sixty-six subjects (11.8%) conceived through use of ART.  This rate was significantly higher than the 1.2% of US births conceived using ART in 2005 (z =  36.4; p < 0.0001).  ASD was further defined as Autism, Asperger Syndrome or PDD/NOS, and percentage of pregnancies conceived using ART among each group was 12.5%, 12.1% and 10.2%, respectively.  Women in the study who conceived using ART had a mean age of 32.1 ± 6.6 as compared to women who conceived naturally (29.6 ± 5.9 years)(t=4.9; p < 0.001).  Similarly, mean paternal age was higher among those whose pregnancies were conceived using ART (34.2 ± 7.0 years) as compared to those whose were not (32.1 ± 6.6 years)( t = 3.7; p = 0.0002).   Among the ATN registry, there was no gender difference between those conceived naturally or through use of  ART, with 15.6% and 14.5% female registrants, respectively (z = 0.37; p = 0.71). 

Conclusions:
This study demonstrates a strong association between ASD and ART.  Further studies on ART-conceived children with ASD are warranted.

See more of: Epidemiology
See more of: Clinical & Genetic Studies