Fertilisation

Assisted reproduction for less than one in two couples and between costs and waiting they resort to private

The Demetra network survey brings to light the couple's obstacles in accessing care. Age, waiting time and costs the most common problems to face

by Letizia Giostra

25 March 2026

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3' min read

Translated by AI

Versione italiana

3' min read

Translated by AI

Versione italiana

The dream of becoming parents breaks when the couple faces infertility problems. A difficulty for which various methods are resorted to and - among them - there is that of following a path of medically assisted procreation (Pma). A path taken by many women in the hope of fulfilling their wish, witha 72.6% increase in treatments over the last decade.

Yet even this alternative turns out to be an obstacle race. Age, waiting time and cost are just some of the factors that play an important role in the selections, while on the other hand there are the high numbers of drop-outs during the courses.

This is what emerged in the latest report by Demetra, the network of Pma clinics affiliated with the National Health Service. A double survey that photographs the phenomenon, giving a clear picture of access to treatment, where only 42% manage to be included in the pathways.

Those who resort to Pma

Infertility is the challenge for those who would like to conceive a child. Pma is therefore the last test to be passed for Italian couples, especially in a country where the demographic winter is increasingly harsh and treatments are increasing, with an average age at first child of almost 32 for mothers, the highest in Europe.

In 2024 fertility reached an all-time low with an average of 1.18 children per woman. It was also two years ago that Planned Parenthood was included in the Essential Levels of Care (LEA). A first milestone for spouses or cohabitants who can have access to treatment by paying co-payments. Remaining excluded are those who do not have a partner.

The race to the private

For the research, the cases of 480 women and 35 centres were examined, representing more than 50 per cent of the cycles in Italia, which calculates about 150,000 affected couples each year who fail to have children.

Yet according to the report, 43% of patients wait more than three months for a visit in the National Health Service. The consequence is that nine out of ten then turn to the private sector, where costs are the main factor.

The biological clock

But the economic wall is not the only one to be broken. Those who would like to become parents must also come to terms with age. "The biological clock does not wait, but the data tell of increasingly late access to reproductive medicine," is the comment of Laura Rienzi, professor at the University of Urbino and scientific director of the Ivirma Italia group.

The embryologist turns the spotlight on the 78% of candidates whoare over 35 years old. A factor, that of age, which brings into play a number of risks ranging from treatment failure to early abandonment.

Among women over the age of 40, 17.2% of pregnancies are due to Pma. A figure, says ISTAT researcher Cinzia Castagnaro, that rises to 32.1% if we consider women who become mothers for the first time after the age of 40.

The drop-out rate

When the pregnancy test comes back negative for the umpteenth time, it is the emotional burden that leads the woman to make the decision to abort.

Psychological support is requested by 35% of those considering Pma and up to 50% of those who have already gone through a cycle, but 40% of centres do not register those who choose to withdraw. Finally, between 20% and 50% of the total number of couples who abandon the process at the first negative outcome.

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