Sex differences in infant health following ART-treated, subfertile, and fertile deliveries

Sunah S. Hwang, Dmitry Dukhovny, Daksha Gopal, Howard Cabral, Leslie V. Farland, Judy E. Stern

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose: Among infants following ART-treated, subfertile, and fertile deliveries to determine (1) the presence and magnitude of sex differences in health outcomes and (2) whether the presence of sex differences varied among maternal fertility groups. Methods: Retrospective cohort analysis of infants born in Massachusetts (MA) in 2004–2013 who were conceived by ART. The Society for Assisted Reproductive Technology Clinic Outcome Reporting System was linked to the Pregnancy to Early Life Longitudinal data system, which links birth certificates to hospital discharge records for MA mothers and infants. Included were singletons born via ART-treated, subfertile, and fertile deliveries. Multivariable logistic regression was used to model the association between infant sex and health outcomes, controlling for maternal demographic and health characteristics. Results: A total of 16,034 ART-treated, 13,277 subfertile, and 620,375 fertile singleton live births were included. For all three groups, males had greater odds of being preterm (AOR range 1.15–1.2), having birth defects (AOR range 1.31–1.71), experiencing respiratory (AOR range 1.33–1.35) and neurologic (AOR range 1.24–1.3) conditions, and prolonged hospital stay (AOR range 1.19–1.25) compared to females. The interaction between maternal fertility group and infant sex for all infant outcomes was nonsignificant, denoting that the presence of sex differences among fertile, subfertile, and ART groups did not vary. Conclusion: Sex differences in birth outcomes of infants following ART-treated, subfertile, and fertile deliveries exist but the magnitude of these differences does not vary among these maternal fertility groups.

Original languageEnglish (US)
Pages (from-to)211-218
Number of pages8
JournalJournal of Assisted Reproduction and Genetics
Issue number1
StatePublished - Jan 2021


  • Assisted reproductive technology
  • Infant health
  • Sex differences

ASJC Scopus subject areas

  • Reproductive Medicine
  • Genetics
  • Obstetrics and Gynecology
  • Developmental Biology
  • Genetics(clinical)


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