Children conceived via ART at increased risk of atopic disease

New research shows that children born via assisted reproductive technology (ART) are prone to developing asthma, allergic rhinitis, or atopic dermatitis.

Compared with naturally conceived children, those who were conceived after ART had a 13-percent greater risk of asthma (adjusted hazard ratio [AHR], 1.13, 95 percent confidence interval [CI], 1.09–1.18; p<0.001), 15-percent greater risk of allergic rhinitis (AHR, 1.15, 95 percent CI, 1.12–1.18; p<0.001), and 8-percent greater risk of atopic dermatitis (AHR, 1.08, 95 percent CI, 1.05–1.12; p<0.001). [JAMA Netw Open 2025;8:e2551690]

In subgroup analyses, children conceived using fresh embryos were more likely to develop allergic rhinitis compared with those conceived with frozen embryos (AHR, 1.12, 95 percent CI, 1.06–1.19; p<0.001), whereas no between-group difference was noted for asthma (p=0.37) or atopic dermatitis (p=0.79). The use of intracytoplasmic sperm injection did not influence the risk of asthma (p=0.18), allergic rhinitis (p=0.68), or atopic dermatitis (p=0.17).

“In the literature, it remains controversial as to whether ART is associated with atopic disease development among offspring… [But] the developmental origins of health and disease (DOHAD) theory may help explain our study findings suggesting that the use of ART technology may contribute to the development of atopic disease in children,” the authors noted.

According to the DOHAD theory, various factors influencing early human development, including the foetal stage, can contribute to permanent changes in the structure and function of organs and tissues and, in turn, influence the onset and progression of chronic diseases. [J Pediatr (Rio J) 2007;83:494-504]

Moreover, there is evidence suggesting that ART technology has potential effects on the immune system. In a mice study, those conceived via ART exhibited a weaker response to the Bacillus Calmette-Guérin vaccine and increased Th2 immune responses. [Reprod Toxicol 2017;69:196-203; J Reprod Immunol. 2020;139:103117] 

Another study indicated that children conceived using ART had a higher immune tolerance to tumour antigens, making them susceptible to cancer development. [JAMA 2019;322:2203-2210]

The mechanisms by which ART may contribute to atopic disease development remain unclear, but the findings underscore the importance of long-term follow-up for offspring conceived via ART, the authors said.

For the study, the authors used data from the Taiwan’s National Health Insurance Research Database, Assisted Reproduction Database, and Maternal and Child Health Database. They identified 69,785 children (52.5 percent male), of which 13,957 were conceived after ART and 55,828 were conceived spontaneously (control).

In the ART and control groups, the mean follow-up duration was 7.99 and 8.41 years for asthma, 5.79 and 6.34 years for allergic rhinitis, and 7.34 and 7.62 years for atopic dermatitis, respectively. Follow-ups began at birth.