Cycles of Infertility: Intergenerational Transmission and the Role of Assisted Reproduction

This study examines the persistence of fertility-related health problems across generations within the same family, and the utilization of assisted reproductive technologies (ART). Using comprehensive Swedish registry data, we document significant intergenerational transmission of fertility difficulties for both daughters and sons, independent of parental socioeconomic status. Daughters whose parents reported such problems are 2.6 percentage points, or 19.4 percent, more likely to experience fertility problems themselves. Sons whose parents reported fertility difficulties experience a 1.7 percentage point, or 13.5 percent, increase. These associations persist across alternative measures and samples. Comparing biological and adopted children raised in the same households, we find that this phenomenon is unlikely to be driven by family awareness of fertility issues, pointing to biological and other factors that biological children share with their parents but adopted children do not. Medical technology works equally well for those who use it, and we find no significant association between the success of advanced fertility treatments and parental backgrounds. However, past generations’ fertility difficulties are associated both with higher medical expenses and with social costs such as increased likelihood of divorce.