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Having one child diagnosed with autism spectrum disorder (ASD) can raise a difficult question for parents planning another baby: will our next child have autism too? This concern is completely understandable. In this post, we’ll explore what science says about autism’s causes and family recurrence risk, and how modern genetic tools like whole genome sequencing (WGS) and preimplantation genetic testing (PGT) can help you make informed reproductive decisions. 

Genetic and Environmental Factors in ASD

Autism arises from a combination of genetic and environmental influences. Studies estimate that 30% of autism diagnoses can currently be traced to a specific genetic cause (What causes Autism?). The remaining cases likely result from a multifactorial mix of multiple genes and environmental factors. For example, things like parental age and prenatal environment might play a role alongside genetics. In short, genes matter a lot, but they aren’t the whole story when it comes to autism.

Recurrence Risk in Siblings

Many parents ask if having one child with autism means their other children will have it too. The risk does increase for siblings, but it’s far from certain and can vary. The first step is to determine if there is an underlying genetic cause for the first child’s autism. If a genetic factor is identified, the chances of recurrence in future children will depend on that specific cause. Consulting a medical geneticist and genetic counselor can provide more clarity and guidance.

Whole Genome Sequencing and Individual Risk

Because autism often has a genetic component, new genetic testing technologies can provide valuable insights for families. With whole genome sequencing (WGS), it’s possible to screen for a subset of known single-gene forms of autism  Researchers have identified at least over 200 genes where mutations can directly lead to autism (Genetic Testing for Autism, Intellectual Disability, and other Neurodevelopmental Disorders). These mutations can be inherited from a parent or arise spontaneously (de novo) in the affected child. This explains why autism can appear in a family with no prior history – a child might have a new genetic change that wasn’t present in the parents.

Please note that if a particular genetic cause is found in your child, that knowledge can refine the risk estimate for future children. For example, if your first child’s autism is linked to a specific gene variant, testing can determine if parents carry that variant and assess the chances of it occurring again. 

PGT in IVF: A Tool to Make Informed Choices

For prospective parents considering IVF, Preimplantation Genetic Testing (PGT) is a powerful option to help reduce the risk of a subset of genetic forms of autism. If there is a known genetic cause for autism in your family, targeted testing of embryos may be available through PGT-M to learn which embryos have the same mutation. Even if there isn’t a single known mutation or any family history at all, Orchid’s whole-genome embryo screening (PGT-WGS) offers the unique opportunity to check embryos for a specific set of hundreds of gene variants known to cause autism and other neurodevelopmental disorders (Genetic Testing for Autism, Intellectual Disability, and other Neurodevelopmental Disorders). This means parents can identify embryos that carry known high-risk variants for autism and avoid transferring those. It’s important to note that no test can detect every possible cause of autism. Many cases are due to unknown or complex genetic combinations that current tests can’t fully capture. If you have a family history of autism and genetic testing on the affected individual(s) is negative, risks to future children are likely to remain elevated. However, PGT stacks the odds in your favor by allowing you to screen out other known genetic causes of ASD (What causes Autism?). This proactive step can give parents more peace of mind and control when growing their family.

Empowering Your Family’s Future with Orchid

In summary, having one child with autism does mean a higher risk for future children, but it by no means guarantees the same outcome. Understanding the genetic and environmental factors at play can help you put that risk in perspective. And thanks to modern advances like WGS and PGT, you aren’t left powerless – you have options to assess and actively manage that risk. Orchid is here to support families in this journey. We offer whole genome embryo screening and expert guidance to help you make informed reproductive decisions before pregnancy. If you’re considering IVF or want to learn more about your family’s genetic risk for ASD, explore Orchid’s guides and services or reach out to our team for a consultation. Taking advantage of these resources can empower you to plan your family’s future with greater confidence.

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