fertility drugs and autism???

What do you think about this, have you heard this before???

			  **Studies Link Infertility Treatments to Autism**

					 						 						    By 						     						    							     							   [Claudia Wallis](http://www.time.com/time/letters/email_letter.html) 							 	 						  Thursday, May. 20, 2010 						

Every parent of a child with autism wonders what might have caused the disorder. Does it secretly run in the family? Was there a toxic exposure during pregnancy? An infection in early infancy? Was the mother or father too old?

Amy Sawelson Landes of Tarzana, Calif., has asked herself all of these questions, plus one more: Could the fact that she had taken an infertility drug to get pregnant have contributed to her son Ted’s autism? “It was one of the first things I wondered about,” says Landes, who was 37 when Ted was born 18 years ago. (See pictures of summer camp for autistic kids.)](http://www.time.com/time/photogallery/0,29307,1982676,00.html)
](http://www.time.com/time/photogallery/0,29307,1982676,00.html)
A study presented Wednesday at the International Meeting for Autism Research in Philadelphia provides some of strongest evidence to date that Landes might be onto something. The study, conducted by a team at the Harvard School of Public Health, found that autism was nearly twice as common among the children of women who were treated with the ovulation-inducing drug Clomid and other similar drugs than women who did not suffer from infertility, and the link persisted even after researchers accounted for the women’s age.

Moreover, the association between fertility drugs and autism appeared to strengthen with exposure: the longer women reported being treated for infertility, the higher the chances their child had an autism spectrum disorder (ASD). (See pictures of a journey into the world of autism.)](http://www.time.com/time/photogallery/0,29307,1911931,00.html)
](http://www.time.com/time/photogallery/0,29307,1911931,00.html)
A second paper presented at the conference by an Israeli team found an association between autism risk and in vitro fertilization, which also involves the use of drugs that stimulate ovulation. Taken together, the studies add to a growing body of evidence that a history of infertility and treatment for infertility could play a role in causing autism. However, the papers raise more questions than they answer.

The Harvard study was the first to look specifically at Clomid-type drugs and autism. It was a large study involving data from 3,985 women — all of them nurses; 111 reported having a child with autism. However the data was based on questionnaires completed by the women, rather than clinical records, so there was no way to confirm the history or timing of treatment for infertility or autism diagnosis. Nor did researchers have access to information on whether the affected children were born prematurely, whether they were twins or triplets, or whether they had low birth weights. (See how to prevent illness at any age.)](http://www.time.com/time/specials/packages/article/0,28804,1903873_1903802,00.html)
](http://www.time.com/time/specials/packages/article/0,28804,1903873_1903802,00.html)
“Preterm delivery, low birth weight, twinning and maternal age are all associated with infertility treatment and they are all associated with the risk of autism. We need to understand how to tease these factors apart,” observes Lisa Croen, senior research scientist with Kaiser Permanente in Oakland, Calif., and director of its Autism Research Program, who was not associated with the paper. “This study is addressing a really important question but we really need more data.” (Comment on this story.)](http://www.time.com/time/health/article/0,8599,1990567,00.html#comments)
](http://www.time.com/time/health/article/0,8599,1990567,00.html#comments)
The Israeli report on in vitro fertilization (IVF) is also intriguing, but perhaps even more preliminary. The study looked at 564 children with ASD, who had come to an autism center for in-depth evaluation. It found that 10.2% of the children were the product of IVF, much higher than the rate in the general population of Israel, which is 3.5%. Still, it isn’t clear to what degree the greater risk of autism might be traceable to confounding factors such as maternal age, premature birth or multiple birth. (Read “Fragile X: Unraveling Autism’s Secrets.”)](http://www.time.com/time/magazine/article/0,9171,1818268,00.html)
](http://www.time.com/time/magazine/article/0,9171,1818268,00.html)
IVF has been associated in previous studies with a greater risk of birth malformations, certain genetic defects and developmental problems, including autism. There is also some evidence from animal studies that the growth media used to culture embryos outside the body before implantation may play a role in causing genetic or developmental anomalies. But, again, it’s difficult to separate out the intertwined factors of twinning, prematurity and low birth weight that are also associated with autism, and come into play with IVF and other treatments for infertility.

Epidemiologist Kristen Lyall, who led the Harvard study, cautions that even if further research should confirm a link between infertility drugs and autism, any additional treatment-related risk appears to be small: among women whose average age was 35 when they had their first child, there was a 4% risk of having a child with autism for those who had taken fertility drugs, compared with 2% for those with no drug exposure. The increase in risk was even smaller among a younger subset of women.

Still, infertility is a common problem affecting about 10% of American women, many of whom seek drug treatment and interventions such as IVF. “With so many women being exposed, it’s important that we understand the associated risks,” says Geraldine Dawson, chief scientific officer for Autism Speaks.

http://www.time.com/time/health/article/0,8599,1990567,00.html

** Common Fertility Drug Linked to Autism **

                         Bethany Sanders Grotelueschen           ON           May 26, 2010 at  4:46PM         

During my first pregnancy, conceived with the help of six rounds of Clomid, I worried about a lot of things: Would I carry my baby to term? Would he/she be healthy? Was there a secret twin hiding behind the one visible embryo? Would I poop on the table during delivery? Hey, I’m a worrier. It can’t be helped.

It never occurred to me, though, to worry about autism. A recent study out of Harvard School of Public Health found that autism is twice as common in children of women who took Clomid and other similar infertility drugs than in children of women not treated for infertility. That baby of mine is seven now and developing normally, but should I have worried?

Yes and no. The research is not perfect. While the Harvard study was large with nearly 4,000 nurses participating – 111 of whom reported having a child with autism – the data was collected through questionnaires, not clinical research. That leaves room for ambiguity. And while the results were adjusted to account for age, whether or not the women gave birth prematurely or to multiples was not taken into consideration.

From Time:
“Preterm delivery, low birth weight, twinning and maternal age are all associated with infertility treatment and they are all associated with the risk of autism. We need to understand how to tease these factors apart,” observes Lisa Croen, senior research scientist with Kaiser Permanente in Oakland, Calif., and director of its Autism Research Program, who was not associated with the paper. “This study is addressing a really important question but we really need more data.”

But the Harvard study does add to what Time calls a growing body of evidence linking infertility treatments to autism. During the same conference where the Harvard study was presented, Israeli researchers said they found a link between IVF and autism.

Here’s the reassuring part: Even if this research is spot on – and no one is saying that it is at this time – the risk is still relatively low. The average woman under age 35 has a two percent risk of having a child with autism. With fertility treatment, that risk is theoretically raised just four percent.

Re: fertility drugs and autism???

I read this message posted by Dr. Ed Marut of the Fertility Centers of Illinois, in response to the study:

Infertility treatment is sometimes associated with an increase in a variety of abnormalities in the offspring of the treatment, because the infertile couple has an increased risk by virtue of their own infertility. Whether an infertile couple eventually conceives on their own, or uses conventional treatment, or assisted reproductive technology, there is a small increased risk compared to fertile couples. There is probably a genetic reason why many people cannot conceive on their own, and this is magnified by both older women and men. Autism and other diseases seem to be related to the age of the man more so than the woman, whose age is related to chromosomal abnormalities like Down Syndrome. In addition, the recall bias of couples who have children with abnormalities after treatment can exaggerate the reporting. Most large studies show no difference in the frequency of congenital abnormalities or developmental problems once prematurity and parental age are controlled for. However, analyzing small groups for isolated conditions can produce apparent associations, which do not exist in larger populations. Autism is especially difficult to diagnose, and many children with other neurobehavioral disorders now are lumped with autism for non-medical reasons, giving the appearance of an increase in the population. The quoted studies in this article are admittedly questionable and point to the need for continued surveillance of outcomes. As many studies are published with negative findings as positive ones. This should be reassuring to all involved.

Re: fertility drugs and autism???

interesting read. I took clomid for conception for both pregnancies. My younger daughter is on the specturum.

Re: fertility drugs and autism???

I was treated for infertility for my first son who is on the spectrum and always had a feeling that this was somehow related. My 3rd son is also on the spectrum although much less so, at age 6, he no longer meets any diagnostic criteria and fares very well in school and with playmates.

Very interesting read, ME....I think now that the MMR vaccine uproar has been proven false, I have hope that the true cause(s) will be found.

Re: fertility drugs and autism???

On May 20, 2010, researchers from the Harvard School of Public Health presented their findings from a study exploring the possible relationship between the use of fertility drugs and autism spectrum disorder (ASD). The scientists reported to attendees at the International Meeting for Autism Research in Philadelphia that women who used fertility drugs to get pregnant had almost double the risk of having a child with ASD verses nonusers. The drugs studied included Clomid (clomiphene citrate) and Pergonal (gonadotropin).

Some have expressed skepticism about the study. However, although its value cannot be fully assessed until it appears in a peer-reviewed journal, there are several factors that argue in favor of its merits. In an effort to rule out other causes, Dr. Lyall and her colleagues made an “adjustment for pregnancy complications, maternal age, and other possible risk factors,” before making a determination that use of fertility drugs represented a 91% increased risk. This was at a highly significant statistical level – namely, the odds that their data did not occur by chance were 993 out of 1,000 (P=0.007). They also determined that a history of infertility – exclusive of fertility drugs – was not significantly associated with ASD, and that the “odds ratio for autism spectrum disorder increased with the number of reports of use of ovulation inducing drugs” (P=0.008).

This recent study is part of a growing body of research that strengthens the argument that Clomid and other fertility drugs are a cause of ASD via their ability to deny cholesterol to a developing embryo shortly after conception. About 58% of ASD children have low total cholesterol (<160 mg/dL) and about 19% have extremely low total cholesterol (<100 mg/dL). The average level for children is about 165 mg/dL. It has also been observed that a high percentage of children (71-86%) born with Smith-Lemli-Opitz syndrome (SLOS), in addition to a wide array of birth defects are also born with ASD. Infants with SLOS are born with a defective enzyme that impairs the body’s ability to convert a precursor (7-dehydrocholesterol) to cholesterol. Cholesterol is essential for growth of the myelin membranes that cover the brain and abnormalities in the myelin sheath are believed to be a contributing cause of ASD. Many experts thus believe that low cholesterol during early embryonic development is one of the causes of ASD.

Clomid has a long half-life and is present during the embryonic period (first 8 weeks) even when taken before conception. Studies have shown it to be biologically active for up to 54 days after ingestion and that it can accumulate over successive cycles of treatment. As mentioned, in the Harvard study they found that the longer the use of fertility drugs, the higher the risk of developing ASD. A critically important fact – and one not known by most physicians prescribing the drug – is that Clomid is a cholesterol inhibitor and impairs its production by acting upon enzymes in the body similar to Lipitor and other statin drugs. Its chemical structure is also similar to the cholesterol-reducing drug, Triparanol, which was briefly available during the 1960s. Animal studies have shown that Clomid and Triparanol both act on the same enzyme and affect developing organs in a similar way, with Triparanol being slightly more potent.

Pergonal (also known as human menopausal gonadotropin or hMG) likewise reduces cholesterol, but by way of a different mechanism. Namely, it suppresses cholesterol levels in early pregnancy via its ability to elevate estrogen production. Studies have established that following hyperstimulation of the ovaries by Pergonal, the resulting elevated estrogen during the luteal (post-ovulation) phase of the cycle suppresses the level of total cholesterol. In fact, there is an inverse correlation between concentrations of estrogen and the level of total cholesterol – the higher the level of estrogen, the lower the concentration of total cholesterol.

The GOOD NEWS is that many ASD children with low cholesterol, treated with cholesterol supplementation, have shown dramatic improvement. Scientists at Johns Hopkins University Medical Center, led by Dr. Richard Kelley, have shown such treatment resulting in improved mobility, verbalization, growth, behavior, sociability and alertness. Better yet, once we have a full understanding about one of the causes of ASD, some day in the future we might be in a position to eliminate that cause. As I postulated over two years ago, maintaining an optimum level of cholesterol throughout pregnancy could likely eliminate many cases of birth defects and autism spectrum disorder. www.terencemix.com.

Re: fertility drugs and autism???

On May 20, 2010, researchers from the Harvard School of Public Health presented their findings from a study exploring the possible relationship between the use of fertility drugs and autism spectrum disorder (ASD). The scientists reported to attendees at the International Meeting for Autism Research in Philadelphia that women who used fertility drugs to get pregnant had almost double the risk of having a child with ASD verses nonusers. The drugs studied included Clomid (clomiphene citrate) and Pergonal (gonadotropin).

Some have expressed skepticism about the study. However, although its value cannot be fully assessed until it appears in a peer-reviewed journal, there are several factors that argue in favor of its merits. In an effort to rule out other causes, Dr. Lyall and her colleagues made an “adjustment for pregnancy complications, maternal age, and other possible risk factors,” before making a determination that use of fertility drugs represented a 91% increased risk. This was at a highly significant statistical level – namely, the odds that their data did not occur by chance were 993 out of 1,000 (P=0.007). They also determined that a history of infertility – exclusive of fertility drugs – was not significantly associated with ASD, and that the “odds ratio for autism spectrum disorder increased with the number of reports of use of ovulation inducing drugs” (P=0.008).

This recent study is part of a growing body of research that strengthens the argument that Clomid and other fertility drugs are a cause of ASD via their ability to deny cholesterol to a developing embryo shortly after conception. About 58% of ASD children have low total cholesterol (<160 mg/dL) and about 19% have extremely low total cholesterol (<100 mg/dL). The average level for children is about 165 mg/dL. It has also been observed that a high percentage of children (71-86%) born with Smith-Lemli-Opitz syndrome (SLOS), in addition to a wide array of birth defects are also born with ASD. Infants with SLOS are born with a defective enzyme that impairs the body’s ability to convert a precursor (7-dehydrocholesterol) to cholesterol. Cholesterol is essential for growth of the myelin membranes that cover the brain and abnormalities in the myelin sheath are believed to be a contributing cause of ASD. Many experts thus believe that low cholesterol during early embryonic development is one of the causes of ASD.

Clomid has a long half-life and is present during the embryonic period (first 8 weeks) even when taken before conception. Studies have shown it to be biologically active for up to 54 days after ingestion and that it can accumulate over successive cycles of treatment. As mentioned, in the Harvard study they found that the longer the use of fertility drugs, the higher the risk of developing ASD. A critically important fact – and one not known by most physicians prescribing the drug – is that Clomid is a cholesterol inhibitor and impairs its production by acting upon enzymes in the body similar to Lipitor and other statin drugs. Its chemical structure is also similar to the cholesterol-reducing drug, Triparanol, which was briefly available during the 1960s. Animal studies have shown that Clomid and Triparanol both act on the same enzyme and affect developing organs in a similar way, with Triparanol being slightly more potent.

Pergonal (also known as human menopausal gonadotropin or hMG) likewise reduces cholesterol, but by way of a different mechanism. Namely, it suppresses cholesterol levels in early pregnancy via its ability to elevate estrogen production. Studies have established that following hyperstimulation of the ovaries by Pergonal, the resulting elevated estrogen during the luteal (post-ovulation) phase of the cycle suppresses the level of total cholesterol. In fact, there is an inverse correlation between concentrations of estrogen and the level of total cholesterol – the higher the level of estrogen, the lower the concentration of total cholesterol.

The GOOD NEWS is that many ASD children with low cholesterol, treated with cholesterol supplementation, have shown dramatic improvement. Scientists at Johns Hopkins University Medical Center, led by Dr. Richard Kelley, have shown such treatment resulting in improved mobility, verbalization, growth, behavior, sociability and alertness. Better yet, once we have a full understanding about one of the causes of ASD, some day in the future we might be in a position to eliminate that cause. As I postulated over two years ago, maintaining an optimum level of cholesterol throughout pregnancy could likely eliminate many cases of birth defects and autism spectrum disorder. www.terencemix.com.

Re: fertility drugs and autism???

very interesting read but needs further investigation. It's news to me that kids on the spectrum have very low cholestreol

Re: fertility drugs and autism???

what does "on the spectrum" mean?

Re: fertility drugs and autism???

Autism is a spectrum. No two children on it are 100% alike in their symptoms and behaviors. %between%