• Bjørn Bay, Erik Lykke Mortensen, Dorte Hvidtjørn, and Ulrik Schiøler Kesmodel.
• School of Public Health, Section for Epidemiology, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark. bjornbay@me.com
• BMJ. 2013 Jul 5; 347: f3978.

ObjectiveTo assess the mental health of children born after fertility treatment by comparing their risk of mental disorders with that of spontaneously conceived children.DesignProspective register based cohort study.SettingNationwide register based information from Danish National Health Registers cross linked by a unique personal identification number assigned to all citizens in Denmark.ParticipantsAll children born in Denmark in 1995-2003 with follow-up in 2012 when the children were aged 8-17; 33,139 children were conceived after fertility treatment and 555,828 children were born after spontaneous conception.Main Outcome MeasuresAbsolute risks and hazard ratios for overall and specific mental disorders estimated with adjustment for potential confounding variables. Estimated association between the risk of mental disorders and subtypes of procedures, hormone treatments, gamete types, and cause of infertility.ResultsThe risk of mental disorders in children born after in vitro fertilisation or intracytoplasmic sperm injection was low, and was no higher than in spontaneously conceived children, except for a borderline significant increased risk of tic disorders (hazard ratio 1.40, 95% confidence interval 1.01 to 1.95; absolute risk 0.3%). In contrast, children born after ovulation induction with or without insemination had low but significantly increased risks of any mental disorder (1.20, 1.11 to 1.31; absolute risk 4.1%), autism spectrum disorders (1.20, 1.05 to 1.37; 1.5%), hyperkinetic disorders (1.23, 1.08 to 1.40; 1.7%), conduct, emotional, or social disorder (1.21, 1.02 to 1.45; 0.8%), and tic disorders (1.51, 1.16 to 1.96; 0.4%). There was no risk systematically related to any specific type of hormone drug treatment.ConclusionsThere was a small increase in the incidence of mental disorders in children born after ovulation induction/intrauterine insemination. Children born after in vitro fertilisation/intracytoplasmic sperm injection were found to have overall risk comparable with children conceived spontaneously.

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