Falling birth rates: stable policies are needed on welfare and reproductive health
The French experience suggests that no single incentive is capable, on its own, of reversing the trend: the role of healthcare and assisted reproductive technology (ART) in supporting births within a framework of equitable access
The desire to have children remains. It is the possibility of fulfilling that desire that is dwindling. The most significant figure, in fact, is not merely that fewer children are being born in Italia. It is that many of the children people wish to have will never be born. 62.2 per cent of people of childbearing age who decide against having more children cite economic, work-related or social reasons. The demographic crisis thus appears not so much as a rejection of parenthood, but rather as the result of the gap between aspirations and reality: job insecurity, difficulties in accessing housing, inadequate services and the fear that motherhood will hinder one’s career.
The effects of ageing
These obstacles delay the decision to try for a child. However, social timing and biological timing do not coincide.
As a scientist and embryologist, I consider this misalignment to be crucial. With age, the ovarian reserve and the biological quality of the oocytes progressively decline; the likelihood of chromosomal abnormalities in the embryo also increases, which can affect implantation and the continuation of the pregnancy. Male fertility can also be affected by age, medical conditions, lifestyle and environmental exposures.
It is not a question of setting the ‘right’ age to have children, but of ensuring that essential information is not only provided once the first difficulties arise. A choice is only truly free when it is an informed one.
The Fertility Manifesto
At the first AIFe National Congress in Montecitorio, we presented the Fertility 2030 Manifesto. The proposal is to integrate reproductive health into public policy: education, prevention, early diagnosis, fertility preservation and equitable access to care must all become part of the same system.
The first area where action is needed is schools. The younger generations should be aware of the role played by age, infections, smoking, obesity and conditions such as endometriosis and varicocele, but also of what research now makes possible, from fertility preservation to medically assisted reproduction. Not to influence their choices, but to broaden their options.
