Abstract
PURPOSE: Overcoming infertility through assisted reproductive technology (ART) is stressful and requires a high level of investment. Infertility, ART, and associated stress may continue to affect the family even after birth. This systematic review and meta-analysis compared psychological outcomes in families formed through ART (ART families) and families formed through natural conception (NC families), while examining factors that may promote healthy development in ART families. METHODS: We systematically searched PsycINFO, PsycArticles, and PubMed for studies published up to mid-October 2024 comparing aspects of psychological family functioning in ART and NC families beyond the first year postpartum. Eighty-nine studies were included in the review and 33 in the random-effects meta-analysis. RESULTS: Mental health and parental relationship quality were comparable between ART and NC parents. Compared to NC mothers, ART mothers reported slightly lower parenting stress, comparable to better mother-child relationships, and higher parental commitment. ART and NC children showed comparable intelligence and cognitive and psychomotor development, with evidence of better language skills and slightly lower school performance in ART children. Psychosocial development was marginally better in ART children according to mothers' reports, although mental health outcomes were comparable or slightly worse. CONCLUSION: Overall, family functioning after ART seems to be similar to that of NC families. ART parents may exhibit protective sociodemographic characteristics, high resilience, and strong maternal commitment, potentially buffering infertility, ART, and stress effects. Further investigation is warranted to address methodological limitations evident in the existing literature and to explore protective factors in ART families.