Task Force Reproduction and Society

Steering Committee

Coordinator

Paul Devroey

Brussels, Belgium

E-mail paul.devroey@uzbrussel.be

Members

Mark Connolly

St. Prez, Switzerland

E-mail mark@gmasoln.com

Dik Habbema

Rotterdam, the Netherlands

E-mail j.d.f.habbema@erasmusmc.nl

Stijn Hoorens

Cambridge, United Kingdom

E-mail hoorens@rand.org

Tomas Kucera

Prague, Czech Republic

E-mail kuceras@volny.cz

William Ledger

Sheffield, United Kingdom

E-mail w.ledger@sheffield.ac.uk

Henri Leridon

Paris, France

E-mail leridon@ined.fr

Lone Schmidt

Copenhagen, Denmark

E-mail L.Schmidt@socmed.ku.dk

Egbert R. te Velde

Utrecht, the Netherlands

E-mail e.r.tevelde@azu.nl

Position statement

There are several risk factors affecting our fertility including postponement of having the first child, advanced female age, obesity, smoking, and sexually transmitted diseases. As part of outlining current and future problems concerning infertility it is important to obtain quality data characterizing the size and type of the problems. This will enable us to outline and implement multiple strategies for reducing the number of future infertile couples, increase awareness of the potential risk factors and at the same time to ensure availability of high-quality assisted reproduction treatment to couples already affected.

Two points are of crucial importance today in Europe: the very low level of fertility (number of children per woman) in some countries, and the postponement of births to later ages in almost all countries. Many factors can be considered to explain these trends, such as the growing secularization and individualism, the rise in the level of education and of the rate of women’s employment, the spread of effective contraceptive methods etc.

Studies among young adults not yet having children shows that around 95% of them expect to have children later in life. The majority of EU couples would have liked to have a family of 2 children or more. If they do not always succeed in reaching this number, this is partly due to infertility problems.

Population-based studies from industrialized countries investigating the cumulative occurrence of infertility problems among women who have tried to achieve parenthood conclude that up to one in four couples report some kind of infertility problems. Further, at the end of their reproductive career 3-6% of women involuntarily never have delivered a child and a further 4-6% has involuntarily not been able to deliver a subsequent child. About half of the infertile couples are seeking medical care. Over the past ten years demand for IVF and related assisted reproductive technologies have steadily increased. In order to offer couples the best possible treatment the timing and choice of treatment must be an individualized, balanced choice, based on etiology and duration of infertility.

Data from demographic research indicates that a consistent and long lasting combination of incentives - including the availability of long parental leave, child care facilities and different kinds of financial support, may help to reduce the incompatibility between having a family and a job thereby preventing further decline of birth rates. Fecundity – the biological capacity of a couple to conceive and have a baby – is often related to life style. Moreover, many Europeans underestimate the age-related decline of fecundity and have too optimistic perceptions of IVF.

Economic conditions and in particular the personal finances of couples are an important factor that can influence fertility planning. This is explained by the observation that many couples seek financial stability prior to starting a family. For many couples as a result of delaying their reproduction decisions they often find themselves infertile and requiring medical care to fulfill their fertility desires. For many couples the situation is confounded by the low priority that fertility treatments sometimes have within many health services; with the end result being limited funding and the need to ration scare resources to those considered to be most in need. Because of limited access to care couples often have to pay out of pocket for treatments, where once again economics will define for many couples whether or not they can afford treatment. In countries without adequate funding of fertility treatments many couples are unable to achieve their desired family size.

Objectives of the Task Force

To review and synthesize knowledge and evidence on the demography, reproductive epidemiology and health economics of fertility, in order to:

1. Promote universal access to essential reproductive health care both with regard to preventive measures and treatment possibilities.

2. Provide information to colleagues, citizens, policymakers and other stakeholders in Europe on the current situation and trends in fertility, infertility and underlying risk factors.

3. Campaign for
   - increase public awareness concerning risk factors affecting a couple’s fecundity
   - a realistic perception of what can/can’t be overcome by ART
   - factors affecting an earlier onset of family building among young couples

4. Based on current evidence to provide estimates of the consequences of reducing risk factors on infertility prevalence 

In order to make things operational the taskforce will have to prioritize and select individual focus areas and present its finding through reports, international workshops and pre-congress courses. Further, the task force can offer its participation in meetings with policy makers, politicians and media’s in both national and international settings.

The task Force is currently working on 4 positions papers addressing the following topics:

"Consequences of the postponement of having children"

"Why people postpone pregnancy?"

"The impact of life style and prevention of infertility"

"Cost and consequences of ART"

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