O-105 Contribution of ART to fertility rates and family size

Abstract

Abstract In the last three decades declining fertility has become an increasing global trend. One-half of the global population today lives in countries where the period Total Fertility Rate is below 2.1 births per woman. Many countries in Europe and Asia are experiencing “ultra-low” fertility rates of 1.0-1.4 births per woman. This decline in births creates both social and economic challenges. In addition, most countries have gone through a long period of increasing average age at birth. The shift in births at older ages has been accompanied by a concomitant decline in completed family size. As the average age at having children has increased over time, the proportion of women experiencing difficulty in achieving a pregnancy has also increased, with assisted reproductive technology (ART) treatments becoming increasingly important in counteracting this decline. However, the demographic impact of ART widely varies across countries, with the proportion of babies born as a result of ART, ranging from almost 10% of birth in in some European countries to < 1% in Latin America and 2% in the USA. ART is increasingly being raised as a potential policy tool to increase fertility. While ART can broaden the range of possible responses to low fertility rates, there are a number of challenges in quantifying contribution to fertility rates. There are also a number of important unintended consequences that need to be taken into account when trying to estimate their effectiveness as a policy tool to increase fertility. In this presentation, the evidence for the contribution of ART to total and age-specific fertility rates in different settings will be summarized and compared with other pronatalist policies. The contribution of ART and other forms of fertility treatment to completed family size and childbearing timing will also be described and discussed. Assisted reproduction is making a modest and increasing contribution to the fertility rate of high-income countries, but its potential impact should not be overestimated.