In a large, population-based sample we failed to find evidence suggesting an excess of brothers among children with autism while controlling for several threats to validity. This test cannot rule out a role of any given exposure, including prenatal testosterone, in either risk of autism or offspring sex ratio, but suggests against a common cause of both.

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This study sheds light on when parents suspect autism. We find that parents’ fertility behavior changes relative to matched controls very early after the birth of a child who will later be diagnosed with autism.

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