Psychobiological stress outcomes in mothers, fathers, and children after successful assisted reproduction

Aims/background: Breaking the cycle of infertility through assisted reproductive technology (ART) can be burdensome for couples, potentially impacting the family. Our study investigated long-term effects of infertility and ART stress on families by comparing families formed through ART with those formed through natural conception (NC). Design/methods: Two-child families (children aged 1-14), with the first-born conceived through ART (ART-1; = 47), the second-born conceived through ART (ART-2; = 19), or both children conceived naturally (NC; = 52), were assessed. Parents completed questionnaires on stress, mental health, and parenting. Fingernail and saliva samples were collected to assess salivary cortisol awakening response (CAR), fingernail cortisol, and cortisone. Results: Infertility and ART were retrospectively described as highly stressful, varying by sex, parity, and protractedness of procedure. After successful ART, most parents no longer felt burdened by infertility and treatment, aligning with NC parents regarding stress and mental health. Yet, ART parents appeared more involved in parenthood, including greater importance of motherhood, maternal family-work conflict, and parental overprotection. ART mothers and their children had higher fingernail cortisol and cortisone than NC mothers and their children. No group differences were observed in the CAR. Past infertility and ART stress correlated with parenting and maternal chronic stress. Conclusion: Successful ART can bring subjective relief. However, the experience of infertility and ART may manifest as high involvement in parenthood, especially among mothers, and contribute to psychobiological stress in ART mothers and their children. Longitudinal research and targeted psychological support should promote family functioning after ART.