Assisted reproductive technology and pregnancy outcomes in Italy: between threats and opportunities

Alessandra Burgio, Istituto Nazionale di Statistica (ISTAT)
Cinzia Castagnaro, Istituto Nazionale di Statistica (ISTAT)
Maria-Letizia Tanturri, Università di Padova

Despite a restrictive legislation in Italy, ART has allowed new opportunities for many Italian couples previously considered sterile or desiring to have children at later age (72 thousands in 2011). The phenomenon – although still marginal (2.2% of births) – is having an impact on Italian fertility patterns (e.g. an increase of late fertility and of twin births) that in demographic literature on Italy is almost neglected. This paper tries to fill the knowledge gap using a combination of administrative data: Birth Assistance Certificate (CEDAP) data set and the Register of miscarriages (AS). Three are the research questions. First, we want to identify the differential characteristics (e.g. age, education, citizenship, residence) distinguishing mothers giving births by ART fecundation from those who have not used ART. Second, we evaluate whether the pregnancies and the deliveries when ART fecundation is used are different to a certain extent from the average (for instance in terms of duration of gestation, of medicalization of pregnancy, of the type of delivery). Finally, we investigate whether ART fecundation (according to different techniques) may influence the probability to have a live birth versus an adverse outcome (miscarriage or stillbirth). First results show that ART treatment is more often linked to mother’s higher age at birth and childlessness. Unexpectedly, there is small effect of education and occupational status on ART conception. Conception by ART is linked to a (perceived?) more risky pregnancy, premature births and not physiological delivery. It is not found a significant effect of the method of ART used on the likelihood to have a live birth versus an adverse outcome. A younger age and no previous miscarriages are factors linked to reproductive success.