The MARTE project investigates the consequences of medically assisted reproduction (MAR) for the well-being of adults, children, and families. While MAR use is increasing globally, existing evidence about its effects remains limited, often based on small, non-representative samples and lacking an understanding of whether these associations are causal. Key questions—such as whether MAR affects child development, adult mental health, or family stability—have not been comprehensively or causally addressed.
Understanding the implications of MAR is a public health and societal priority. Over 10 million births globally have involved MAR, with a growing number of adults undergoing treatment—some successfully, others not. Yet, the long-term consequences for health, education, family functioning, and mental well-being are poorly understood. This evidence is crucial for informing clinical guidelines, public health resource allocation, fertility policy, and counselling for couples considering or undergoing MAR.
MARTE set out to:
• Project A: Assess the impact of MAR on adults’ physical and mental health, life-course trajectories, and relationship stability, distinguishing between those who conceived through MAR and those who did not.
• Project B: Investigate how children conceived through MAR fare across multiple domains (e.g. physical health, mental health, education) compared to their spontaneously conceived peers—including their own siblings.
• Project C: Examine parent–child relationships in MAR families during adolescence, using data from both parents and children.
The project innovated by using large-scale population register data from Finland, Sweden, Norway, Utah and the UK, and applied quasi-experimental designs (e.g. sibling comparisons) to test causality. It also addressed gaps in knowledge about the longer-term consequences of MAR, variation by treatment type, the role of selection and cross-country comparability.
Conclusion of the action
The project generated compelling and policy-relevant findings:
• Adults who underwent MAR but did not conceive showed higher rates of long-term psychotropic use and union dissolution.
• Children conceived through MAR had worse birth outcomes but similar or better longer-term cognitive and educational outcomes, largely due to their parents’ socio-economic advantage.
• MAR-conceived adolescents had higher rates of mental health issues compared to their naturally conceived siblings, suggesting some potential vulnerabilities.
• No evidence was found that MAR conception negatively affects the quality of parent–child relationships during adolescence.
