  A growing share of the world's population is being born via assisted
reproductive technology (ART), including in-vitro fertilisation (IVF). However,
two concerns persist. First, ART pregnancies correlate with predictors of poor
outcomes at birth--and it is unclear whether this relationship is causal.
Second, the emotional and financial costs associated with ART-use might
exacerbate defensive medical behaviour, where physicians intervene more than
necessary to reduce the risk of adverse medical outcomes and litigation. We
address the challenge of identifying the pure effect of ART-use on both
maternal and infant outcomes at birth by leveraging exogenous variation in the
success of ART cycles. We compare the obstetric outcomes for ART-conceived
births with those of spontaneously-conceived births after a failed ART
treatment. Moreover, we flexibly adjust for key confounders using double
machine learning. We do this using clinical registry ART data and
administrative maternal and infant data from New South Wales (NSW) between
2009-2017. We find that ART slightly decreases the risk of obstetric
interventions, lowering the risk of a caesarean section and increasing the rate
of spontaneous labour (+3.5 p.p.). Moreover, we find that ART has a
statistically and clinically insignificant effect on infant health outcomes.
  Keywords: Fertility, Assisted reproduction, IVF, Caesarean Section,
Obstetric, Infertility. JEL classification: I10, I12, I19.
