The Future of Assisted Reproductive Technology Live Births in the United States

Abstract

As postponement of first births continues in the United States, women and couples will likely continue to turn to assisted reproductive technologies (ART) to overcome biological barriers to childbearing. This paper uses stochastic projections to estimate the potential impacts of ART on the US total fertility rate (TFR) overall and across sociodemographic groups using publicly available data. Assuming the trends in ART continue and the TFR remains at the mean estimate, the projection shows the ART TFR will rise from 0.023 accounting for 1.29% of the mean projected TFR in 2020 to 0.048 or 2.64% of the TFR by 2040. However, for the TFR of women over 30, this percentage is estimated at 2.68% in 2020 and 5.60% by 2040. Group-level projections quantify stratification by parity, race, and education assuming trends across these groups continue. Overall, the results show that if current trends continue, growth in demand for ART will likely increase, especially at older maternal ages, even as inequalities by race and social class remain. These projections provide a picture of ART births if inequality in access and outcomes is not addressed and highlight the need for attention to policies that address these disparities.

Self-Perceived Infertility is Not Always Associated with Having Fewer Children: Evidence from German Panel Data

“…Most studies of the relationship between infertility and number of children have focused on the use of ART and the question of whether the use of ART is associated with increased fertility rates (Lazzari et al, 2023 ; Leridon, 2017 ; Tierney, 2022 ). The relevance of ART to the question of the association of infertility and fertility rates is based on the assumption that people who have used reproductive technology are infertile and would likely have not conceived without ART.…”

Causes of ART‐related outcomes in the COVID‐19 era

“…Demographers forecast rising demand for assisted reproductive technologies (ART) in high‐income countries owing to the increased postponement of childbearing to older ages 1,2 . Whereas live births arising from ART in the US accounted for 1.3 percent of live births in 2019, this figure represents almost a doubling relative to that of 2015 3 .…”

Projecting the Contribution of Assisted Reproductive Technology to Completed Cohort Fertility

“…Previous research in Europe and the United States has mostly focused on the impact of ART on overall fertility by adopting either a period (Habbema et al, 2009;Hoorens et al, 2007;Tierney, 2022) or cohort (Leridon, 2017;Leridon & Slama, 2008;Sobotka et al, 2008) approach, with most studies showing a rather modest contribution of 2-5%. Studies that have looked at age-specific ART fertility have found that the absolute contribution of ART to the TFR often peaks in the mid-30s, while the relative share of ART births increases with age (Burcin et al, 2020;Lazzari et al, 2021;Tierney, 2022). For example, Lazzari et al, (2021) found that increases in period fertility rates at late (40 +) reproductive ages in Australia were largely driven by the increasing use of ART.…”