Alice Goisis, Center Longitudinal Studies, University College London.

Abstract

The number and proportion of children conceived through medically assisted reproduction (MAR) is steadily increasing across Europe, underlining the importance of better understanding the association between infertility treatment and offspring outcomes. The evidence on the longer-term well-being of MAR children remains inconclusive and we lack a comprehensive view on how MAR-conceived children are doing and developing compared to naturally conceived children. Using administrative register data on all children born in 1995–2000 in Finland, we examine several social and mental health outcomes in late adolescence (ages 16–18 in 2011–2017) for MAR and naturally conceived children. First, we estimate differences by mode of conception in the overall population, before and after adjustment for observed child and parental socio-demographic characteristics (e.g. birth order, education, income). Second, we used fixed effects models to compare MAR to their naturally conceived siblings within families accounting for all (observed and unobserved) factors shared between siblings. In the baseline models, no differences were observed in care episodes due to mental disorders and high-risk health behaviours. In contrast, the results showed that school drop-out, not being in education or employment, early home-leaving were less common and school performance better among MAR-conceived adolescents. Adjustment for observed sociodemographic characteristics on one side attenuated the differentials in social outcomes whilst on the other amplified the risk of internalizing and developmental mental disorders among MAR adolescents. Internalizing mental health disorders were more common also when comparing MAR adolescents to their naturally conceived siblings. For a variety of social and mental health outcomes, MAR adolescents showed similar or better outcomes than naturally conceived children, but mental disorders might represent a cause of concern.