I've made some tests using the sample app "Hello world" and deploying it on the same device I used for my alpha version app.
In the sample app, I used my ad unit IDs (the same I used in my alpha version app). Out of the box, it worked, I could see interstitial and rewarded video ads. I then modified the CreateAdRequest method in the sample app and added a call to TagForChildDirectedTreatment(true). It still worked. Then I added the call AddExtra("is_designed_for_families", "true") and it stopped working. I removed the call to AddExtra and it worked again.
I guess it simply is the lower fill rate issue?