A serious decline in world population numbers and its major economic and social ramifications in coming decades can be addressed by recognition of the lifelong benefits generated by children born from assisted reproduction.

This was the thrust of the 2022 ASPIRE Congress Bruno Lunenfeld Lecture by eminent reproductive specialist, Professor David Adamson, who said millions of people globally were living with infertility.

He said the world was spiralling towards a reduced total fertility rate that would see population numbers fall below replacement thresholds in coming decades, particularly in the Asia Pacific region.

Professor Adamson, who is Chair of the International Committee Monitoring Assisted Reproductive Technologies (ICMART), said the repercussions of population decline would result in critical demographic changes, including the proportions of children, working age people and older individuals who are unable to look after themselves.

He urged new levels of advocacy on behalf of those striving for parenthood saying that assisted reproduction was only reaching 15 to 20 per cent of people who could benefit from treatment.

A reproductive endocrinologist and surgeon based at Stanford University in the United States, Professor Adamson said assisted conception should be extended to all people to overcome inequities in access to care, and that simplifying and reducing the cost of IVF and associated treatments would contribute to this cause.

He said collection and presentation of data, such as that gathered by ICMART from 79 countries, was also vital in creating policy changes in societies where infertility was not adequately recognised.

“Our data demonstrates that despite equivalent infertility rates among demographic groups, women who report decreased access to infertility care are less educated, have lower incomes, are without health insurance and access to reliable primary health care.

“These nationally-representative findings highlight the need to further address disparities in access to infertility care by targeting these particular populations of underserved women.

“The cost of assisted reproduction to create more people is offset by the net benefits to individuals and societies. There is eight times the return on investment in the provision of accessible and affordable assisted reproduction.

“This is achieved through the lifetime working contribution of people from assisted conception as future tax paying citizens.”

“Apart from their productivity, the net impact of fertility care is highly positive for societies and it contributes to enhanced quality of life for families and friends.”

Professor Adamson called for an urgent global action plan to improve access to fertility care involving continued and improved collection of data, education of stakeholders including patients, policy makers and publics, and efforts to reduce costs of treatment.

“We need to look at new technologies, such as laboratory automation and artificial intelligence, to get equivalent assisted reproductive outcomes at lower costs. This is essential if we are to make inroads, especially in low to middle income countries.”

“Access to Fertility Care” on ASPIRE newsletter Volume 7, Issue 3 (August 2022). Read more here .