Background: Global family-planning policies have traditionally centered on contraceptive methods to manage unintended pregnancies and control population growth. As a result, many countries now face declining fertility rates, with half exhibiting levels below replacement. Predictions suggest significant population declines by 2100, prompting concerns over societal ramifications. Consequently, there's a growing interest in fertility optimization policies to counteract declining populations, including child-friendly incentives and public funding for fertility treatments. However, the extent of investment in such policies varies widely among nations. This paper, the first of its kind from the International Federation of Fertility Societies (IFFS), reviews disparities in fertility care access amidst global population trends.
Objective and Rationale: Traditional family-planning paradigms overlook the concept of "family building," which encompasses various methods for individuals or couples to create or expand their families. This paper aims to raise awareness of family-building methods beyond natural conception, including assisted reproductive technologies (ART), surrogacy, adoption, and foster care. It underscores the need for education programs to prevent infertility and increase family-building awareness.
Search Methods: Invited global leaders conducted a narrative review of literature, searching PubMed for peer-reviewed papers and reviews. The review was collaboratively developed, with each section prepared by expert teams. Regular discussions ensured consensus among authors and review board members, culminating in a comprehensive document.
Outcomes: Advances in fertility care have expanded family-building opportunities, particularly since the 1990s. However, access to care remains highly variable, with cost being a significant barrier for most patients. Despite this, fertility care contributes substantially to global population growth, offering economic benefits for society.
Wider Implications: While declining fertility rates may alleviate environmental concerns, underpopulation poses challenges for many nations. Although child-friendly policies have been implemented, disparities in fertility care access persist. This paper sheds light on the need for equitable access to fertility care amidst changing demographic landscapes.
