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Global fertility rates are quickly declining and little is being done about it

A group of esteemed physicians convened by the International Federation of Fertility Societies (IFFS) highlight a concerning trend: the global fertility rate is on a downward spiral.

Their findings underscore the significant yet underrecognized impacts this trend has on economies and societies worldwide.

The physicians note a startling forecast: excluding migration, many countries might see their populations halve between 2017 and 2100.

By 2050, 77% of predominantly high-income countries, and by 2100, a staggering 93% of all nations, are projected to have fertility rates below the replacement level of 2.1 children per woman.

A global perspective on fertility

This team of experts includes fertility specialists from diverse nations, including Australia, Chile, Denmark, Egypt, Greece, The Netherlands, South Africa, Switzerland, the United Kingdom, and the United States, ensuring a global perspective on the issue.

With underpopulation looming as a critical concern, the paper presents a suite of recommendations for governments, policymakers, companies, healthcare professionals, and patients to combat infertility risks and improve the affordability and accessibility of fertility care.

Bart CJM Fauser, co-first author of the paper and IFFS Scientific Director, emphasizes the human right to family building. He highlights the challenges in accessing fertility care, noting its often prohibitive costs and limited availability.

“Choosing to have a family is a human right,” said Fauser. “But access to fertility care is often unaffordable, inaccessible, and inequitable and that needs to change.”

Disparities in access and human rights

The paper points out significant advancements in fertility treatments over the past three decades, benefiting infertile couples, singles, and members of the LGBTQ+ community. However, disparities in access and equity persist globally.

Edgar Mocanu, IFFS President, offers a silver lining: infertility is often preventable. He advocates for comprehensive education on fertility and contraception, empowering individuals to make informed decisions about family planning.

“The good news is that infertility is often preventable,” said Mocanu. “A simple step is offering balanced fertility and contraceptive education so that everybody can decide when to prevent pregnancy and when it is ideal for them to start a family, if they choose.”

Addressing infertility with a multifaceted approach

The paper addresses the alarming prevalence of infertility, affecting one in six individuals of reproductive age, with both sexes equally impacted.

Factors such as sexually transmitted infections, smoking, excessive alcohol intake, obesity, and poor nutrition contribute to decreased fertility in both sexes.

Additionally, environmental factors like air pollution and unregulated chemicals pose increasing risks.

The authors propose several solutions to bolster birth rates, including policy measures supporting families and working women.

Disparity in ART services

These encompass extended pregnancy leave compensation, childcare, parental leave, and broader access to assisted reproductive technology (ART) services.

Dr. Luca Gianaroli, IFFS Director of Education, notes the disparity in ART access. While some wealthy countries report over 10% of children born through fertility assistance, the high costs and varying availability remain barriers worldwide.

“While more than 10 percent of all children are born with fertility assistance in some wealthy countries, there is great variation in access to care and the high cost remains a barrier across the board,” said Dr. Gianaroli.

He calls for more countries to consider public funding for fertility treatments as a response to declining birth rates.

“A limited number of countries have started public funding of fertility treatment to mitigate falling birth rates, and the IFFS is asking that more countries consider providing financial assistance for individuals needing fertility care,” Gianaroli explained.

How to increase global fertility rates

The paper concludes with four primary action items, forming the backbone of their ‘More Joy’ global awareness and education campaign:

  1. Develop policies to reduce infertility risk factors and enhance the affordability, accessibility, and equity of fertility care.
  2. Create simpler, less intensive, and more cost-effective assisted reproductive technologies.
  3. Educate patients about infertility prevention and incorporate fertility awareness into family planning and contraceptive education.
  4. Improve infrastructure and support to expand care access, especially in low-resource countries.

In summary, the physicians firmly believe in the economic and societal benefits of providing fertility care, asserting that these advantages will only grow as populations age.

This crucial work lays the groundwork for addressing a global challenge that affects us all, calling for immediate action to safeguard our future generations.

The full study was published in the journal Human Reproduction Update.


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