The Global Fertility Decline
NICE has published a draft update to their Fertility Guidelines*. Why is this important? Well, since 2004, NICE (The National Institute for Health and Care Excellence) has recommended the NHS should provide those eligible in the UK under 40 years of age with up to three full cycles of IVF. The new proposed guidelines offers the potential of three further cycles if the first cycles prove unsuccessful.
This news comes in a week when it has also been reported** that the French government are to write to all 29 year old French adults reminding them of their biological clock and the potential of egg freezing. This is part of a 16 point plan to take on a decline in the national birth rate in France.
Just last month, the BBC reported that China’s birth rate has also ‘hit a record low***’.
As global fertility continues to be discussed in the headlines, I wanted to share some of the most recent conclusions within the medical profession as to why this decline could be happening.
The following information was presented at BFS Fertility 2026, which is a major annual conference hosted by the British Fertility Society, and was held earlier this month in Edinburgh. In a lecture titled: ‘Declining Global Fertility and Future Dependence on ART’, the Australian Reproductive Biologist John Aitken suggested the following areas are driving a global decline in fertility:
1. Lifestyle factors such as smoking, a higher BMI, and poor diet.
2. Environmental factors such as toxicants, heat, and infections.
3. Biological and Socioeconomic Factors.
4. Age related markers in women such as advanced maternal age, which is linked to lower antral follicle count and lower anti-Müllerian hormone levels, and a higher risk of genetically abnormal embryos with advancing maternal age.
5. Age related markers for men, such as advancing paternal age, which is associated with increased oxidative stress, as well as possible links between oxidative damage and chromosomal issues in sperm. Also discussed was an association between advancing paternal age and risks such as autism, schizophrenia, bipolar syndrome, and Marfan syndrome.
Mr Aitken underscored a broad, multifactorial decline in fertility across regions, with growing reliance on ART (Assisted Reproductive Technology). The increasing use of ART is noted alongside declining natural fertility. He also noted that a population decline in Western economies is mirrored in some developing economies, that ageing impacts both female and male reproductive health, with measurable biomarkers and potential neurodevelopmental and genetic risks.
Please see links to each article referenced below.
* https://www.progress.org.uk/nice-publishes-draft-update-to-fertility-guideline/
