Socioeconomic differences in access to and use of Medically Assisted Reproduction (MAR) in a context of increasing childlessness

The WHO estimates that around 186 million individuals live with infertility. Although the drivers of infertility are varied and complex, it is linked to the postponement of childbearing in Western countries, and unsafe abortions and deficits in maternal health in less affluent societies. The development of Medically Assisted Reproduction (MAR) has attracted increased attention of both researchers and the wider public. This report summarizes research on MAR and examines the main drivers behind its development, as well as the different contexts in which it takes place, and the main socioeconomic variables underlying variations in access and usage. We focus more specifically on Europe, where MAR is more extensively regulated, but also more widespread compared to other regions. The first section contextualises the emergence and increasing use of MAR from a sociodemographic perspective and describes the major fertility-related transformations and the socioeconomic correlates behind these trends. The second section engages with the phenomenon of infertility, providing evidence of its prevalence and underlying drivers from a biological and an environmental perspective. The third section provides an overview of MAR treatments offered and their regulation and use across countries, as well as the role of macro- and micro-level factors in explaining these variations. Lastly, the report discusses the implications and challenges posed by the development of MAR in contemporary societies.