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

Viktoria Falk, Andreas Madestam and Emilia Simeonova

No 21476, CEPR Discussion Papers from Centre for Economic Policy Research

Abstract: This study examines intergenerational correlations in fertility problems and the utilization of infertility treatments and assisted reproductive technologies (ART) using comprehensive Swedish registry data. We document significant intergenerational transmission of subfertility, defined as diminished but not absent reproductive capacity, for both daughters and sons. The intergenerational correlation is independent of parental socioeconomic status. Daughters whose parents reported fertility difficulties are 2.6 percentage points (19.4 percent) more likely to experience fertility problems themselves, while sons whose parents reported fertility difficulties experience a 1.7 percentage point (13.5 percent) increase. Parental fertility issues predict gender-specific treatments in the next generation: subfertility on the male side raises the probability of male-specific treatments (ICSI, donor insemination), while female-side subfertility raises the probability of ovulation stimulation. We find no evidence of assortative mating by parental subfertility background. Couples where at least one partner has a family history of infertility face an 18 percent higher divorce risk. Our findings highlight the substantial personal and social costs of fertility problems and show that they are not solely consequences of lifestyle choices or delayed childbearing but reflect factors that persist across generations.

Date: 2026-05
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