Human Reproduction Update Advance Access originally published online on September 11, 2008
Human Reproduction Update 2008 14(6):583-592; doi:10.1093/humupd/dmn038
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Assisted reproductive technologies are an integrated part of national strategies addressing demographic and reproductive challenges
1 The Fertility Clinic, Rigshospitalet, Section 4071, University Hospital of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark 2 Center for Reproductive Medicine of the Vrije Universiteit Brussel (VUB), Brussels, Belgium
3 Correspondence address. Tel: +45-35-45-49-97; Fax: +45-35-45-40-99; E-mail: soeren.ziebe{at}rh.regionh.dk or sziebe{at}rh.dk
BACKGROUND: The decline in the total fertility rate in the latter half of the 20th century in many European countries is becoming increasingly important in determining the demographic composition of Europe and its individual member states. This review focuses on discussion surrounding how assisted reproductive technology (ART) can impact declining fertility rates.
METHODS: This article summarizes key aspects of presentations given at the ‘State of the ART 2007—ART and Society’ meeting held in Lyon, France, in June 2007. For each topic, searches were conducted in MEDLINE and other databases and the results, alongside unpublished data and personal opinion, were presented to the Workshop Group. Individual subjects were discussed and any disagreements or omissions resolved.
RESULTS: Although reduced fertility rates will have an impact on total population number, it is the change in the age structure of the population that is likely to be the most challenging factor faced by the European Union (EU). With evidence suggesting that an ageing population threatens future standards of living and social cohesion, managing demographic change through integrated policy response has become an important component of EU legislation. However, current measures fail to tackle the contribution that ART may play in alleviating falling fertility rates. Indeed, ART can have an important impact on economic and demographic factors, and should be incorporated into a population policy mix. Current barriers to ART include legislative restriction across different EU countries, limited availability to ART and current perception of ART in society.
CONCLUSIONS: The inclusion of ART as part of a population policy mix in Europe is justified but must involve better communication among ART professionals, politicians and the general public.
Key words: assisted reproductive technology / demographics / fertility / infertility / SWOT analysis
Received on April 14, 2008; revised June 25, 2008; accepted on August 4, 2008