Adolescents conceived with assisted reproductive techniques (ARTs) are not at a higher old for poor psychiatric health compared with the general population, according to a Swedish study published in JAMA Psychiatry.

Researchers conducted a long-term follow-up with children born in Sweden between 1994 and 2006 whose data were included in the Swedish Medical Birth Register. They collected data on mood disorders and anxiety disorders, along with parental infertility and potential use of ARTs, which was based on information from in vitro fertilization (IVF) clinics, maternal self-reports, and the National Patient Register. They also collected potential confounding factors that could be common causes of infertility or ART use.

They identified 127,123 children who were born to couples with infertility and 31,565 who were conceived with help from ARTs out of a cohort of 1,221,812 children.

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Mothers in couples that experienced infertility tended to be older (5.0% vs 2.4% older than 40 years), more likely to be primiparous (55.5% vs 40.7%), be overweight or obese (30.2% vs 26.4%), and have polycystic ovary syndrome (1.6% vs 0.1%) or endometriosis (1.8% vs 0.3%), compared with mothers in couples who did not experience infertility.

Mothers in couples with infertility who used ARTs tended to have polycystic ovary syndrome (2.3% vs 1.3%), not smoke (6.1% vs 11.3% smokers), and have postsecondary education (53.7% vs 46.6%). The individuals who underwent standard IVF had a closer association with endometriosis (2.6% vs 4.9%).

At adulthood, children born to couples without infertility tended to have higher or equivalent cumulative incidence as children conceived with ARTs. Children of couples who experienced fertility but who were not conceived through ARTs tended to have a slightly higher risk for anxiety (6.2% vs 5.6% for the other groups) and mood disorders (4.7% vs 4.4% for the other groups).

Children conceived with ARTs tended to have a slightly higher rate of anxiety (Hazard Ratio [HR] 1.07), specifically obsessive-compulsive disorder (OCD HR 1.35). When the researchers adjusted for parental characteristics, they found that the association between ARTs conception and OCD decreased (adjusted hazard ratio [aHR] 1.10).

When parents utilized fresh, not frozen, embryo transfer to conceive their child, the child’s risk for mood disorders was lower compared with children of couples with infertility who conceived without ARTs (aHR 0.90). Frozen embryo transfer was associated with a higher risk for mood disorders (aHR 1.25) and antidepressant use (aHR 1.16).

Limitations of the study include the age of analysis for depression and anxiety, missing data, and generalizability outside of Sweden.

“These findings suggest that adolescents conceived with ARTs around the millennium are not at risk of poor psychiatric health compared with the general population, except for an elevated risk of OCD that may be explained by differences in parental characteristics,” the researchers noted.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Wang C, Johansson ALV, Rodriguez-Wallberg KA, et al. Long-term follow-up of psychiatric disorders in children and adolescents conceived by assisted reproductive techniques in Sweden. JAMA Psychiatry. 2022;79(2):133–142. doi:10.1001/jamapsychiatry.2021.3647