Clutching at straws to reverse the birth dearth

Subsidies don't work. Speed dating doesn't work. What about IVF?

Withnations around the world failing to reproduce themselves, policywonks now realise that too few children could be far worse than toomany. Thechallenge now is to boost the number of births. Conventionalstrategies include baby bonuses, family benefits, extended maternityand paternity leave and more flexible working schedules for mothers.

Somecountries have come up with creative solutions. On the sensible sidethere is Portugal, with a birth rate of 1.5 children per woman. Facedwith the bankruptcy of its pension scheme within 10 years, it has debated makingpeople who have fewer children pay more into their retirement fund.On the loopy side there is Japan, where local governments aresubsidising speed dating to help time-poor office workers findspouses.

Butthe latest fad is promoting in vitro fertilisation (IVF). Last montha conference on assisted reproductive technology in Lyon heard thatthe low fertility of young Danish women has been almost entirelyoffset by generous government subsidies for IVF. With abirth rate 0f 1.9, almost replacement level, Denmarkis one of the few countries in Europe which has bucked the trendtowards falling birth rates. Nearly 1 Danish baby in 20 is antest-tube baby, IVF is socially acceptable, the government pays forup to six cycles of treatment and waiting times are short.

Withnews like this, it's hardly surprising that other governments areturning to IVF, since nothing else seem to work. These are desperatetimes for small countries with extinction on the horizon.Demographers say that no country’s birth rate has everrecovered after dropping below 1.5, so governments need to doeverything they can to avoid falling into a headlong decline.

Koreahas one of the lowest birth rates in the world – 1.16. PresidentRoh Moo-hyun recently vowed spend his last years in office tacklingthe problems of a rapidly ageing society. About 16,000 childlessKorean couples will be able to obtain a government subsidy for halfthe cost of their IVF treatment. Estonia is also subsidising IVF andhopes to increase the number of IVF babies to about 1 in 30.

Butwith so much at stake – the very survival of small countries withdistinctive cultures like Korea and Estonia – does this make sense?Or is IVF just a band-aid?

Despitelavish IVF subsidies, there is precious little research to supportthe contention that it will boost birth rates. One study which hasbeen cited by journals like New Scientist and The Economist waspublished last year by the Rand Europe thinktank. It argued that ifBritain supported IVF at Danish levels, there would be about 10,000more children each year.

Thecost of six free cycles of IVF would be an extra US$500 to $860million a year. While this is not cheap, it is less costly thanbribing women to have children by handing them government benefits.“If the countries of Europe do wish to keep their populations up,making IVF more widely available might be a good way of doing so,”The Economist chirpily concluded.

However,The Economist did not seem to have read the Rand report veryclosely. The authors were careful to note that this optimisticscenario assumes that women will not delay childbearing because ofthe greater availability of IVF. Because fertility declines steeplyafter 35, women who decide to postpone having a family until theyhave established themselves in a career may not be able to have achild, even with IVF. In fact, a recent poll by the Guardiannewspaper suggests that about 35 per cent of British women mightpostpone childbearing because of the availability of IVF.

Ifthis is true, says the report, “then it may actually have anegative effect on the [total fertility rate] and consequently leadto further ageing of the population”. This seems to be the case.When IVF is heavily subsidised, the Rand analysis shows that itboosts the birth rate slightly. When it is not, the availability of IVF actually depresses the birth rate. What happens is this. Many women in their fertile years balance the cost of having a child against the extra income they could earn in employment and defer having children. In the back of their minds they think that they will have IVF as a safety net.

The years tick on, and in their mid-30s, the alarm on their biological clock goes off. They begin trying for a child. Many of these older women will fail. If IVF is heavily subsidised, then many of these failures will clutch for their safety net. Some lucky ones will have children, giving a small fillip to the birth rate.

But if IVF is not subsidised, women discover to their dismay that it is horrendously expensive. They cannot afford it and they have to give up their dream of having children. So the availability of IVF acts as a will 'o the wisp, a flickering beacon of hope, allowing women to invest so heavily in their careers that they are unprepared for the inexorable fading of their precious fertility.

Thereport casts even more cold water on IVF as a way of rejuvenatingdying countries. The health of babies born to older women and fromIVF is poorer than children bornto younger mothers and through natural conception. Older women havemore Down syndrome children. There are far more multiple births forwomen with IVF treatment, which is associated with poor child health.IVF is also associated with low birth weight and prematurity and ahigher risk of birth defects. “These health effects and otherunintended consequences should be taken into account when assessingthe impact of [assisted reproductive technology] as part of apopulation policy mix,” it says.

Talkof IVF as a solution for declining birth rates is a sign thatclueless governments are clutching at straws. Low fertility is acomplex issue with social, economic, medical and environmentalfactors. But addressing these alone is just tinkering around theedges.

Ultimatelylow birth rates are a cultural and ethical problem, a sign of aworld-wide spiritual crisis. Having children is simply not viewed asa fulfilling life project any more by many couples. Only when youngmen and women turn away from consumerism and individualism will birthrates begin to climb beyond replacement levels.

MichaelCook is editor of MercatorNet.

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