Abstract

This study examines the socioeconomic impacts of integrating Assisted Reproductive Technology (ART) into South Korea’s national health insurance (NHI) system, focusing on birth rates, marriage timing, and the interval between marriage and first childbirth. Using data from the 2015–2021 Korean Demographic and Health Surveys and a linear probability model, the findings reveal that while ART accessibility increased the probability of first childbirth through ART by 13.1%, it also delayed marriage and time to first childbirth. Subgroup analysis shows that employed women exhibited greater delays due to career prioritization, while non-employed women were more responsive to cost reductions, with ART usage increasing by 20%. Our analysis also shows that NHI coverage significantly promotes marital pregnancy across all income and wealth levels, with varying effects on assisted reproductive treatment and marriage timing based on economic status. This study bridges the gap between medical and socioeconomic ART research by situating its analysis within the underexplored Korean context, offering insights into the interplay between ART policies and demographic trends. The findings underscore the need for comprehensive policies addressing delayed family formation alongside ART support.