Perceptions of Medically Assisted Reproduction and Fertility Postponement: Limited Evidence, Critical Questions

The number of women using medically assisted reproduction (MAR) is rising in high-income countries. This trend is partly driven by the tendency to delay childbearing, yet infertility treatments cannot compensate for the decrease in reproductive capacity with age. Scholars are currently concerned that the increasing availability of MAR is fuelling the misconception that it can extend reproductive life. High confidence in the success of MAR later in life would then encourage fertility postponement. However, this assumption remains untested, likely due to limited data availability. We examine this using panel survey data from the National Survey of Fertility Barriers, conducted in the United States in 2004-2007 and 2007-2010. Our findings support the technological salience hypothesis, which states that perceptions of MAR would only influence fertility intentions at ages when women are more likely to experience difficulties conceiving. Specifically, women aged 35 or over who have high confidence in the success of MAR when used in the late 30s are less likely to forego childbearing than those with low confidence. Overall, however, perceptions of MAR play a limited role in explaining fertility decisions compared to other socio-demographic characteristics. Nonetheless, taking them into account improves our understanding of how technologies enter the realm of reproductive decision-making, particularly at less fertile ages. In conclusion, we highlight the need for further data collection on this issue, covering more recent periods and countries where births are delayed and MAR availability is increasing.