Birth rates are collapsing – can IVF help?
Optimum Strategic Communications
International Strategic Healthcare Communications
By Stephen Adams?
Birth rates are collapsing.?
This week, it was the turn of England and Wales’s Office for National Statistics (ONS) to report that the fertility rate has dropped to just 1.44 children per woman – the lowest rate since records began in 1938 (1). The replacement rate is 2.08.?
This isn’t unique. Birth rates are dropping all over Europe. China peaked at 1.413 billion people in 2021 and since then the contraction has gathered pace, with the population shedding 850,000 people in 2022 and 2.08 million in 2023 (2) (3). The driver: fewer births.?
Are these examples too predictable???
How about Iran? Its fertility rate is now 1.7 having free-fallen from more than six in the 1980s. It crashed below replacement level in 2017 (4).??
How about Colombia, which has seen the annual number of births drop more than a fifth in the last five years alone to 510,000? It’s no outlier: Colombia is typical of Latin America (5).?
Outside of Africa, birth rates are falling in most countries – and falling more rapidly than had been predicted just a few years ago.?
Let’s not get into the causes here but let’s touch on the consequences.??
If these trends continue, global population will peak decades earlier than had been thought – perhaps even by the 2060s – and might top-out at below 10 billion (6). Given the world population has doubled in the last 50 years from four to eight billion, the slow down is remarkable. In fact, it’s more like a handbrake turn.?
Most environmentalists will see this as a blessing.?
However, the rapid drop in birth rates will have serious consequences for societies and economies. There will be even fewer people of working age to support countries’ older populations than had been expected. Relatively speaking, falling birth rates accelerate population ageing.??
The impact is already upon us though. After years of bursting at the seams, London primary schools are now emptying. Some are closing. Where just a decade ago it was a struggle to get a place, now primary schools across the capital desperately advertise their benefits to prospective parents on the backs of London buses.?
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Governments are slowly waking up to the problem and wondering what they can do about it.??
Some countries, such as Italy and Hungary, have introduced so-called “pro-natalist” policies, with financial support of one form or another to help families have more babies. But the jury’s out as to whether cash incentives have a meaningful impact.??
Britain’s PM Sir Keir Starmer, for his part, recently intimated he would not start introducing any such policies, saying it was not his place to “tell people how to live their lives” (7).?
Set against this backdrop is the thorny problem of IVF provision - or more accurately, the provision of “assisted reproductive technologies” (ART), which include IVF.?
Fertility treatment is expensive and access to state-funding provision is consequently patchy, both in the UK and elsewhere.??
Yet if countries do want people to have more babies, directly helping those who actively want children might be a logical starting point.?
While Britain’s NHS is nominally the “National Health Service”, when it comes to IVF it’s a postcode lottery. Although the National Institute for Health and Care Excellence (NICE) stipulates the NHS should offer women who need it three full “cycles” of IVF, this rarely happens. Many local health authorities only offer one cycle: one shot at a baby.??
Just 27% of IVF cycles conducted in the UK in 2022 were NHS-funded, according to the Human Fertilisation and Embryology Authority (HFEA), a regulator (8).?
IVF isn’t cheap of course: the average cost of a single cycle in the UK is about ￡5,000 (9).??
But set against the uncertain ‘baby boosting’ benefits of trying to encourage the wider population to have children, governments might end up concluding that investing in IVF is good value for money.?
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