Effects of Increased Access to Infertility Treatment on Infant Health Outcomes: Evidence from Twin Births

Marianne Bitler, Public Policy Institute of California (PPIC)

Reproductive technologies have radically improved since the introduction of the first fertility drugs in the late 1960s. These technologies make conception possible for many couples who otherwise would have been unable to reproduce. We analyze twin births, where use of reproductive technologies is relatively common. This paper examines the association between advanced reproductive technologies and birth outcomes during 1981–1999. It also examines the effect of subsidies for the use of infertility treatment on birth outcomes. Subsidies in the form of state mandates to cover infertility treatment are associated with small but statistically significant negative effects on gestation, birth weight, and the 5-minute Apgar score, and the effects are larger in magnitude for older mothers. These results suggest that effects of investment by these mothers are outweighed by impacts of either the infertility treatments themselves or by the selection into pregnancy of the infertile mothers.