Are Age Limits for Assisted Reproduction Adapting to Late Fertility Trends?

Marie-Caroline Compans , Wittgenstein Centre for Demography and Global Human Capital

Against the backdrop of delayed childbirth since the 1980s, high-income countries have witnessed a rise in demand for infertility treatments. The impact of medically assisted reproduction (MAR) on births exhibits significant variation across countries, because of differences in policies. This study focuses on age-based eligibility criteria for MAR and its public reimbursement. Age rules are often debated, increasingly in light of ongoing trends of childbearing delay. Here, I ask how MAR policies have adapted to the rise in late births and contemplate the potential contribution of MAR. Analyzing data from 24 high-income countries, the timing of age-based policies is compared with trends in age-specific fertility rates at 40+ and 48+. I categorize countries into six distinct groups: those aligning limits with the prevalence of late fertility (strict regulations and low late-births rates in some CEE countries / permissive age rules coupled with a high prevalence of late fertility in some Nordic countries). Most countries maintain strict limits that became inconsistent with late fertility levels, as these regulations have not been revisited since their enactment. In such contexts, policies may adapt to shifts in family behaviours through the regulation of ‘social’ egg freezing. Only a handful of countries adapted age limits to late fertility trends. Finally, some pronatalist policies have permissive age criteria to access MAR despite the low prevalence of late childbearing. In turn, this demographic perspective contributes to debates around age limits for MAR and provides insights into the potential impact of MAR on fertility trends.

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 Presented in Session 119. Flash session Policy Development and Measurement