Educational Differences in ART: Disentangling Access, Need and Timing

Jenny Chanfreau , University of Sussex
Alice Goisis, University College London
Øystein Kravdal, University of Oslo

Parents of children conceived following assisted reproductive technology (ART) tend to be older, more highly educated and have higher earnings than parents of naturally conceived children. On the one hand, these patterns may reflect inequalities in treatment access. On the other hand, given the educational gradient of fertility postponement and age-related increase in difficulties conceiving, such socio-economic differences among parents may reflect greater need for treatment among more socially advantaged socio-economic groups. However, it is unclear to what extent this is the case because research on socio-economic differences in ART births generally lack information on need for ART. This paper aims to address this gap by using primary care diagnosis information as an indicator of need. Using data from the Norwegian Population Register linked with the primary care Health Reimbursements Database and the Medical Birth Register, this paper investigates educational differences in primary care diagnoses of subfertility, and how these are linked to the probability and timing of having an ART birth. We ask whether having a diagnosis differs by education, and whether having an ART conception differs by education among those with a diagnosis. Results suggests that the proportion of women receiving a subfertility diagnosis does not differ by education in Norway. However, given a diagnosis, the hazard of having an ART conception is greater among middle and high educated women, compared with the low educated group. This education effect remains when adjusting for age at diagnosis, partnership status, income and distance to nearest treatment provider.

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 Presented in Session 45. Assisted Reproduction