13 January 2024
The global decline in fertility rates needs to be addressed according to an International Federation of Fertility Societies (IFFS) consensus paper published in Human Reproduction Update on 10 January 2024.(1) It reports that half the countries around the world have a fertility rate below population replacement level. It goes on to predict that many countries will experience population decline of more than 50 percent between 2017 and 2100, leading to serious demographic changes and implications for societies around the world. As such, there needs to be greater focus on the human right to have a family, family-friendly policies and better access to fertility care.
Why are declining global fertility rates a problem?
Between 1990 and 2021 the global population replacement level fell from 3.3. to 2.3 children per woman. This IFFS consensus paper reports that by 2050 and 2100 respectively, 77 percent of mainly high-income countries and 93 percent of all countries will have a total fertility rate below population replacement level of 2.1 children per woman. This matters because it is driving significant increases in ratios between elderly people and younger adults, bringing with it serious economic challenges and issues around the care of the elderly. Aging populations lead to increased healthcare, social care and pension costs, whilst declining population levels mean there are fewer younger adults in work paying taxes and generating wealth to cover these costs.
This paper goes on to state that different rates of fertility decline amongst nations will contribute to immigration and emigration, leading to increased political and social conflict. This will lead to changing attitudes and approaches towards parenthood, gender roles and gender equality. It will also lead to disagreement between different age groups about their societal contributions.
What can be done to address declining global fertility rates?
This IFFS consensus paper reports that different countries around the world are taking a range of child-friendly measures to address declining fertility rates, including:
- Financial incentives (e.g. covering maternity and paternity leave, tax credits or reductions and financial contributions towards childcare costs).
- Improved access to fertility care and treatment.
- Greater awareness of infertility and prevention.
- Increased focus on the human right to build a family.
The paper goes on to state that there needs to be equitable social policy and access to fertility care across society, with any approach to having children which places undue responsibilities on people trying to build a family contravening the principle of social justice. It also states that social justice mandates that those people who wish to have a family should have a right to do so and that providing fertility care is important for social justice. As a result, the paper states that public policies need to balance the needs of both the individual and society for social justice, family building, fertility care and the economic implications of decreasing population.
How big a challenge is global infertility?
However, declining global fertility rates remain a serious ongoing challenge. This IFFS consensus paper reports that between 48 million and 186 million couples around the world of reproductive age are living with infertility. Concerningly, it reports that both male and female reproductive health is getting worse, particularly in industrialised areas, indicating environmental links with endocrine-disrupting chemicals and pesticides. You can read more about the impact of environmental factors on fertility in previous blog Can Microplastics Affect My Fertility?. It further reports that there is some evidence that decreased male fertility is due to annual reductions of 1.4% in sperm concentration and 1.6% in total sperm count. You can read more in previous blog Male Infertility And Reproductive Health: A Growing problem?.
Importantly, advances in assisted reproductive technologies and fertility care over the last 30 years have significantly improved people’s family building outcomes. But, the paper goes on to state that whilst up to 10 percent of children in some wealthy countries are born as a result of infertility therapies, there are big variations in access to treatment between different countries around the world. The high costs of fertility treatment mean it is unaffordable for many people in low and middle-income countries. The inability to access fertility treatment also disproportionately affects women and minorities. This needs to change.
The Value of Fertility and Family Law, Advisory and Consultancy
Given declining global fertility rates, infertility challenges and socio-economic issues leading to delayed family building and later-life parenthood, it is more important than ever to maximise and protect individual fertility and pathways to parenthood.
Specialist and bespoke fertility and family law strategies, advisory and consultancy help inform effective approaches to (in)fertility and maximise reproductive health and outcomes, as well as proactively manage family building journeys. They identify and address a range of legal and practical issues and risks associated with family creation and fertility treatment, putting family building and life on a firm foundation and maximising successful results. In doing so, they address:
- Complex personal and family situations.
- Legal and practical aspects of fertility preservation.
- Family building options and issues arising from impaired fertility/infertility, cancer diagnosis/illness, unsuccessful conception attempts, change in gender, change in personal circumstances, age and later-life parenthood.
- Posthumous conception with the eggs, sperm and embryos of a deceased loved one (e.g. due to illness or accident).
- Legal and practical aspects of assisted conception with a known donor, anonymous/identity-release donor or co-parent (e.g. legal parentage, parental rights, financial responsibility and dispute mitigation).
- Legal and wider aspects of international surrogacy or a UK surrogacy arrangement.
- Legal parentage issues and disputes (e.g. concerning DNA testing, direct-to-consumer genetic testing, rectification of birth certificate, declaration of parentage, step-parent adoption, recognition of overseas adoption, parental order).
- Care and upbringing of children following a dispute with an ex-partner, parent, donor or surrogate (e.g. contact, residence, financial arrangements, parental responsibility, specific issue or prohibited steps).
- Issues with importing frozen gametes and embryos into the UK for use in fertility treatment and surrogacy (e.g. due to anonymous and commercially obtained gametes and embryos which engage UK public policy restrictions).
- Issues exporting frozen gametes and embryos abroad for use in fertility treatment and surrogacy (e.g. consent and storage term difficulties).
- Expert witness fertility, surrogacy and donor conception law services.
If you need to put in place effective legal and practical strategies or require advisory and consultancy to navigate fertility and pre-conception, assisted reproductive technologies, fertility treatment, global family building and effective parenting contact Louisa Ghevaert by email firstname.lastname@example.org or telephone +44 (0)20 7965 8399.
- Bart C J M Fauser, G David Adamson, Jacky Boivin, Georgina M Chambers, Christian de Geyter, Silke Dyer, Marcia C Inhorn, Lone Schmidt, Gamal I Serour, Basil Tarlatzis, Fernando Zegers-Hochschild, IFFS Demographics and Access to Care Review Board, Declining global fertility rates and the implications for family planning and family building: an IFFS consensus document based on a narrative review of the literature, Human Reproduction Update, 2024;, dmad028, https://doi.org/10.1093/humupd/dmad028
Images: Louisa Ghevaert, CEO & Founder Louisa Ghevaert Associates