Abstract:Objective To systematiclly evaluate the relationship between assisted reproductive technology（ART） and autism spectrum disorders（ASD） in their offspring. Methods Systematic searches of PubMed, Web of Science, CBM, VIP, and CNKI databases were conducted to collect the cohort studies on ASD in ART progeny published from database establishment to April 1, 2022. After four independent reviewers screened the literature, extracted the data and assessed their quality with Newcastle-Ottawa scale（NOS）, a Meta-analysis was performed using Stata 15.1 software. Results Finally, 8 articles were included to assess the risk of ASD in 335507 offspring after ART（ART group） and 14233258 offspring of natural conception（NC group）. After excluding one study with greater heterogeneity by sensitivity analysis,the incidence of child with ASD in ART group was significantly higher than that in NC group（RR=1.06, 95%CI1.01-1.11, P<0.05）. The stratified analysis showed that the risk of ASD in ART offspring was higher than that in NC offspring based on the subgroup analysis on the data from Europe and the United States（RR=1.06, 95%CI 1.01-1.11, P=0.014）, Newcastle Ottawa scale（NOS） score 7-9（RR=1.06, 95%CI 1.01-1.11, P=0.022）, ART sample size of more than 10000 participants（RR=1.06, 95%CI 1.01-1.11, P=0.016）, correction factors of more than 5（RR=1.06, 95%CI 1.01-1.11, P=0.014） and corrected maternal psychiatric morbidity（RR=1.06, 95%CI 1.01-1.11, P=0.022）. ConclusionsCurrent evidence suggests that ART may increase the risk of autism in offspring, but more rigorous cohort studies need to be designed to increase the strength of the evidence.