From Fertility Intentions to Parenthood: Longitudinal Evidence on MAR, Involuntary Childlessness, and Well-Being

Mine Kühn , Tilburg University
Zafer Büyükkeçeci, MPIDR
Mikko Myrskylä, Max Planck Institute for Demographic Research

Infertility affects an estimated 17.5% of adults worldwide and is increasingly recognized as a major public health concern. Medically assisted reproduction (MAR) provides a potential pathway to parenthood, yet the process is often lengthy, emotionally demanding, and uncertain in its outcome. Despite the growing prevalence of infertility and MAR use, little is known about how the broader process of trying to conceive—whether successful or not—affects well-being and health over time. Using 14 waves (2008–2022) of longitudinal data from the German Family Panel (pairfam), this study investigates how well-being evolves before and after fertility attempts, shifting the analytical baseline to the onset of trying to conceive. We compare four groups: (1) those who conceived via MAR, (2) those who discontinued MAR and remained childless, (3) those who conceived naturally, and (4) those who remained involuntarily childless without treatment. Event-centered fixed-effects models trace changes in life satisfaction, mental health, physical health, and self-rated health across anticipation, short-term, and long-term periods. Results show that involuntarily childless individuals—regardless of MAR use—experience persistent declines in life satisfaction and physical and self-rated health, whereas successful conception (natural or via MAR) is associated with recovery or stabilization of well-being. These findings suggest that it is involuntary childlessness, rather than MAR treatment itself, that underlies adverse outcomes. By linking fertility attempts to multiple dimensions of well-being, this study broadens the childbearing–happiness framework and highlights the need for policies addressing the psychosocial and health inequalities associated with infertility and childlessness.

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 Presented in Session 89. Flash Session Medically Assisted Reproduction and Infertility