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

Marie-Caroline Compans1,2, Ester Lazzari3, Eva Beaujouan3

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Medically assisted reproduction (MAR) use is increasing, but it doesn't fully compensate for age-related fertility decline. High confidence in MAR success influences childbearing decisions for women aged 35+, but its overall impact on fertility intentions is limited.

Keywords:
Fertility intentionsFertility postponementMedically assisted reproductionUS

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Area of Science:

  • Reproductive Health
  • Sociology of Reproduction
  • Health Economics

Background:

  • Rising use of medically assisted reproduction (MAR) in high-income countries.
  • Delayed childbearing is a significant driver of MAR utilization.
  • Concerns exist that MAR availability may foster misconceptions about extending reproductive lifespan.

Purpose of the Study:

  • To test the hypothesis that perceptions of MAR influence fertility intentions.
  • To examine if confidence in MAR success encourages fertility postponement.
  • To understand the role of MAR in reproductive decision-making.

Main Methods:

  • Analysis of panel survey data from the National Survey of Fertility Barriers (US, 2004-2010).
  • Examination of how MAR perceptions affect fertility intentions across different age groups.
  • Statistical analysis to compare the influence of MAR perceptions versus socio-demographic factors.

Main Results:

  • Perceptions of MAR influence fertility intentions primarily at ages where conception difficulties are more likely (e.g., 35+).
  • Women aged 35+ with high confidence in late 30s MAR are less likely to forgo childbearing.
  • Socio-demographic characteristics remain stronger predictors of fertility decisions than MAR perceptions.

Conclusions:

  • MAR perceptions play a limited but notable role in reproductive decision-making, particularly for older women.
  • The technological salience hypothesis is supported in the context of MAR.
  • Further data collection is needed on MAR's impact in countries with delayed childbearing and increased availability.