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As more families turn to fertility treatments to build their families, researchers continue to investigate whether fertility challenges or the treatments themselves could influence a child's long-term health. A new large-scale study published in JAMA Network Open has added important insights to this discussion, suggesting that underlying fertility difficulties may play a greater role in certain childhood neurodevelopmental outcomes than fertility treatments themselves.
The study analyzed data from more than 15,000 mother-child pairs across the United States and examined whether subfertility, infertility treatments, or both were associated with behavioral and developmental conditions in children.
Subfertility refers to reduced fertility or difficulty becoming pregnant. In this study, researchers defined subfertility as having a history of infertility diagnosis, infertility treatment, repeated miscarriages, or attempting pregnancy for at least 12 months without success.
The research also evaluated two categories of fertility treatment:
The primary goal was to determine whether any observed developmental differences in children were linked to fertility treatments themselves or to the underlying reproductive health conditions that led families to seek treatment.
The study followed children between the ages of 2 and 10 years and evaluated several neurodevelopmental outcomes, including:
Researchers used standardized developmental and behavioral assessment tools commonly employed in pediatric research and clinical settings.
One of the most significant findings was that children born to parents with a history of subfertility showed slightly higher rates of certain developmental and behavioral concerns, regardless of whether fertility treatment was used.
According to the study, children of parents who experienced subfertility demonstrated:
Importantly, these associations were observed even among children conceived naturally after a history of fertility difficulties.
This suggests that the underlying biological or health factors associated with subfertility may contribute more to developmental outcomes than fertility treatments themselves.
A finding likely to reassure many families is that IVF treatment was not significantly associated with increased risks of ADHD, ASD, or other major neurodevelopmental concerns in this study.
Researchers found no statistically significant relationship between IVF conception and the developmental outcomes they measured.
These results align with a growing body of research suggesting that IVF itself may not be responsible for developmental differences observed in some children born to parents with fertility challenges.
Instead, pre-existing medical conditions, genetic factors, or reproductive health issues may be influencing outcomes.
The study did identify one noteworthy association involving non-IVF fertility treatments.
Children conceived using non-IVF fertility treatments showed higher odds of being diagnosed with ADHD compared with children conceived naturally, both among families with and without a history of subfertility.
However, researchers emphasized that this finding does not necessarily mean the treatments directly caused ADHD.
The authors suggested that specific underlying health conditions among patients receiving these treatments could explain part of the increased risk.
One condition highlighted was polycystic ovary syndrome (PCOS), which appeared more frequently among participants who underwent fertility treatment. Previous research has also linked PCOS with certain neurodevelopmental outcomes in offspring.
A major strength of this research was its ability to separate the effects of fertility treatments from the effects of subfertility itself.
Many earlier studies struggled to distinguish between these two factors. As a result, it was often unclear whether developmental outcomes were related to medical treatment or to the reproductive health conditions that prompted treatment.
This new analysis suggests that fertility-related health conditions may play a more important role than previously recognized.
The researchers noted that biological factors associated with infertility could influence pregnancy outcomes, fetal development, and long-term child health.
In addition, subfertility is sometimes associated with conditions such as:
These factors may contribute to developmental differences independently of fertility treatments.
While the findings are important, they should not be interpreted as a reason for concern among individuals considering fertility treatment.
Several key points are worth remembering:
Experts emphasize that fertility treatment remains a valuable and effective option for many families, and the benefits often outweigh potential risks.
The study's authors recommend further investigation into specific causes of subfertility and how they may affect child development.
Future research may focus on:
Understanding these factors could help clinicians better support families before, during, and after fertility treatment.
This large U.S. study contributes to an evolving understanding of fertility, reproductive health, and child development. The findings suggest that underlying fertility challenges may have a stronger association with certain neurodevelopmental outcomes than fertility treatments themselves.
Perhaps the most reassuring takeaway is that IVF was not linked to significant developmental risks in this research. Instead, the results highlight the importance of studying the broader health factors connected to fertility difficulties.
As scientists continue to investigate these relationships, families and healthcare providers will gain a clearer picture of how reproductive health may influence children's long-term development.
Kahn LG, Hipwell AE, Stanford JB, et al. Subfecundity, Infertility Treatment, and Child Neurodevelopment. JAMA Network Open. Published June 8, 2026.
This article is for educational and informational purposes only and should not be considered medical advice. The study discussed identifies statistical associations and does not prove causation. Individuals with questions about fertility, pregnancy, or child development should consult qualified healthcare professionals for personalized guidance.