The impact of a decline in fecundity and of pregnancy postponement on final number of children and demand for assisted reproduction technology
Abstract
BACKGROUND: Over the past decades, the proportion of couples who resort to infertility treatment has tremendously increased, and fertility (the final number of children) sharply declined. We explored the roles of two potential causes of these trends: a temporal decline in the couples' fecundability and a postponement of age at initiation of pregnancy attempts. METHODS: We conducted a Monte-Carlo simulation for the reproductive history of 100,000 women based on the fertility and socio-demographic characteristics of the 1968 birth cohort in France. Declines in fecundability of various amplitudes have been implemented, as well as increases in the distribution of age at initiation of pregnancy attempts. RESULTS: A decline in fecundability by 15% implied a decrease in fertility by 4%, and an increase in the proportion of couples eligible for infertility treatments by 73%. An increase in the mean age at initiation of first pregnancy attempt by 2.5 years from 25 years entailed a decrease by 5% in fertility and an increase by 32% in the proportion of couples eligible for infertility treatments. CONCLUSION: A relatively important decrease in fecundability and an increase by 2.5 years in age at first pregnancy attempt are likely to have only a limited impact on fertility. However, they may have a large impact on the proportion of involuntarily infertile couples, likely to resort to assisted reproduction techniques.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Preliminary studies point to the increasing contribution of fertility care to the overall population and the economic benefits for society that result from every new person born from fertility care.
“Furthermore, preliminary studies point to the increasing contribution of fertility care to the overall population and the economic benefits for society that result from every new person born from fertility care (Connolly et al., 2008, 2009, 2021; Leridon and Slama, 2008;Habbema et al., 2009; Faddy et al., 2018).”
From Declining global fertility rates and the implications for family planning and family building: an IFFS consensus document based on a narrative review of the literature (2024) · cites this paper as Leridon and Slama, 2008
The 'Impact of ART on fertility rate' section (page not available) models additional births from assisted reproduction, and the table discussed under 'Assumptions concerning the decline in fecundability' shows a small increase in total fertility when eligible couples use ART. The paper does not establish that fertility care's contribution to the population is increasing over time or assess the economic benefits of people born through fertility care. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Evidence for decreasing quality of semen during past 50 years.
Carlsen, E., Giwercman, A., Keiding, N., & Skakkebæk, N. E. (1992) · BMJ · doi:10.1136/bmj.305.6854.609 · Cited by 2,768 · see citing works
Skakkebæk, N. E., Meyts, E. R., & Main, K. M. (2001) · Human Reproduction · doi:10.1093/humrep/16.5.972 · Cited by 2,261 · see citing works
Europe's second demographic transition.
van de Kaa, D. J. (1987) · PubMed · Cited by 1,935 · see citing works
Sperm Morphology, Motility, and Concentration in Fertile and Infertile Men
Guzick, D. S., Overstreet, J. W., Factor-Litvak, P., Brazil, C. K., Nakajima, S. T., Coutifaris, C., Carson, S. A., Cisneros, P., Steinkampf, M. P., Hill, J. A., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa003005 · Cited by 1,336 · see citing works
Decline in Semen Quality among Fertile Men in Paris during the Past 20 Years
Auger, J., Kunstmann, J. M., Czyglik, F., & Jouannet, P. (1995) · New England Journal of Medicine · doi:10.1056/nejm199502023320501 · Cited by 1,131 · see citing works
Body mass index in relation to semen quality and reproductive hormonesamong 1,558 Danish men
Jensen, T. K., Andersson, A., Jørgensen, N., Andersen, A., Carlsen, E., Petersen, J. H., & Skakkebæk, N. E. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.03.056 · Cited by 818 · see citing works
Bonde, J. P. E., Ernst, E., Jensen, T. K., Hjollund, N. H. I., Kolstad, H., Scheike, T., Giwercman, A., Skakkebæk, N. E., Henriksen, T. B., & Olsen, J. (1998) · The Lancet · doi:10.1016/s0140-6736(97)10514-1 · Cited by 791 · see citing works
Cultural Dynamics and Economic Theories of Fertility Change
Lesthaeghe, R., & Surkyn, J. (1988) · Population and Development Review · doi:10.2307/1972499 · Cited by 717 · see citing works
Factors that affect outcome of in-vitro fertilisation treatment
Templeton, A. A., Morris, J. K., & Parslow, W. (1996) · The Lancet · doi:10.1016/s0140-6736(96)05291-9 · Cited by 709 · see citing works
The question of declining sperm density revisited: an analysis of 101 studies published 1934-1996.
Swan, S. H., Elkin, E. P., & Fenster, L. (2000) · Environmental Health Perspectives · doi:10.1289/ehp.00108961 · Cited by 708 · see citing works
Leridon, H. (2004) · Human Reproduction · doi:10.1093/humrep/deh304 · Cited by 507 · see citing works
Assisted reproductive technology in Europe, 2003
Anderssen, A. N., Goossens, V., Gianaroli, L., Felberbaum, R. E., de Mouzon, J., & Nygren, K. G. (2007) · STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) · Cited by 441 · see citing works
Semen quality in relation to biomarkers of pesticide exposure.
Swan, S. H., Kruse, R. L., Liu, F., Barr, D. B., Drobnis, E. Z., Redmon, J. B., Wang, C., Brazil, C. K., Overstreet, J. W., & Study for Future Families Research Group (2003) · Environmental Health Perspectives · doi:10.1289/ehp.6417 · Cited by 429 · see citing works
Hauser, R., Meeker, J. D., Duty, S., Silva, M. J., & Calafat, A. M. (2006) · Epidemiology · doi:10.1097/01.ede.0000235996.89953.d7 · Cited by 424 · see citing works
Hauser, R. B., Meeker, J. D., Singh, N. P., Silva, M. J., RYAN, L. M., Duty, S., & Calafat, A. M. (2006) · Human Reproduction · doi:10.1093/humrep/del428 · Cited by 405 · see citing works
Ferraretti, A. P., Goossens, V., Kupka, M. S., Bhattacharya, S., de Mouzon, J., Castilla, J. A., Erb, K., Корсак, В. С., Andersen, A. N., (EIM), T. E. I.-M., et al. (2013) · Human Reproduction · doi:10.1093/humrep/det278 · Cited by 371 · see citing works
Reduced Fertility Among Overweight and Obese Men
n, M. S., Sandler, D. P., Hoppin, J. A., Blair, A. E., & Baird, D. D. (2006) · Epidemiology · doi:10.1097/01.ede.0000229953.76862.e5 · Cited by 369 · see citing works
Human Fertility: The Basic Components.
B., J., Léridon, H., & Helzner, J. F. (1978) · Population and Development Review · doi:10.2307/1972295 · Cited by 330 · see citing works
Postponement of Childbearing and Low Fertility in Europe
Sobotka, T. (2004) · University of Groningen research database (University of Groningen / Centre for Information Technology) · Cited by 322 · see citing works
Slama, R. (2002) · Human Reproduction · doi:10.1093/humrep/17.2.503 · Cited by 308 · see citing works
Self-citationRubes, J., Selevan, S., Evenson, D., Zudová, D., Vozdová, M., Zudová, Z., Robbins, W., & Perreault, S. (2005) · Human Reproduction · doi:10.1093/humrep/dei122 · Cited by 302 · see citing works
Risk of testicular cancer in subfertile men: case-control study
Møller, H., & Skakkebak, N. E. (1999) · BMJ · doi:10.1136/bmj.318.7183.559 · Cited by 276 · see citing works
Semen Quality and Reproductive Health of Young Czech Men Exposed to Seasonal Air Pollution
Selevan, S. G., Borkovec, L., Slott, V. L., Zudova, Z., Rubeš, J., Evenson, D. P., & Perreault, S. D. (2000) · Environmental Health Perspectives · doi:10.1289/ehp.00108887 · Cited by 265 · see citing works
Assisted reproductive technology in Europe, 2002. Results generated from European registers by ESHRE
for the European Society of Human Reproduction and Embryology (ESHRE) The European Ivf-monitoring programme (EIM) (2006) · Human Reproduction · doi:10.1093/humrep/del075 · Cited by 263 · see citing works
Jensen, T. K. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh002 · Cited by 246 · see citing works
Urinary Phthalate Metabolites and Biomarkers of Reproductive Function in Young Men
Jönsson, B., Richthoff, J., Rylander, L., Giwercman, A., & Hagmar, L. (2005) · Epidemiology · doi:10.1097/01.ede.0000164555.19041.01 · Cited by 240 · see citing works
Berrington, A. M. (2004) · PubMed · Cited by 235 · see citing works
Evidence for Decreasing Quality of Semen During Past 50 Years
Carlsen, E., Giwercman, A., Keiding, N., et al. (1993) · Obstetrical & Gynecological Survey · doi:10.1097/00006254-199303000-00023 · Cited by 233 · see citing works
Skakkebæk, N. E., Meyts, E. R. D., & Main, K. M. (2001) · Apmis · doi:10.1111/j.1600-0463.2001.tb05770.x · Cited by 224 · see citing works
Dynamics of Human Reproduction
Wood, J. W. (2017) · Routledge eBooks · doi:10.4324/9780203792780 · Cited by 220 · see citing works
Does smoking during pregnancy affect sons’ sperm counts?
Storgaard, L., Peter Bonde, J., Ernst, E., Spanô, M., Yding Andersen, C., Frydenberg, M., & Olsen, J. (2003) · Epidemiology · doi:10.1097/01.ede.0000059922.73864.3e · Cited by 158 · see citing works
DDT and DDE exposure in mothers and time to pregnancy in daughters
Cohn, B. A., Cirillo, P. M., Wolff, M. S., Schwingl, P. J., Cohen, R. D., Sholtz, R. I., Ferrara, A. M., Christianson, R. E., van den Berg, B. J., & Siiteri, P. K. (2003) · The Lancet · doi:10.1016/s0140-6736(03)13776-2 · Cited by 148 · see citing works
Jensen, T. K., Henriksen, T. B., Hjøllund, N. H., et al. (1998) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009576 · Cited by 147 · see citing works
Meeker, J. D., RYAN, L. M., Barr, D. B., Herrick, R. F., Bennett, D. H., Bravo, R., & Hauser, R. B. (2004) · Environmental Health Perspectives · doi:10.1289/ehp.7234 · Cited by 144 · see citing works
A new estimate of permanent sterility by age: Sterility defined as the inability to conceive
Léridon, H. (2008) · Population Studies · doi:10.1080/00324720701804207 · Cited by 130 · see citing works
Towards less confusing terminology in reproductive medicine: a proposal
Habbema, J. D. F. (2004) · Human Reproduction · doi:10.1093/humrep/deh303 · Cited by 130 · see citing works
Exposure to Organochlorine Compounds and Effects on Ovarian Function
Windham, G. C., Lee, D., Mitchell, P. R., Anderson, M., Petreas, M. X., & Lasley, B. L. (2005) · Epidemiology · doi:10.1097/01.ede.0000152527.24339.17 · Cited by 126 · see citing works
Fertility and offspring sex ratio of men who develop testicular cancer: a record linkage study
Lindahl‐Jacobsen, R., Bostofte, E., Engholm, G., et al. (2000) · Human Reproduction · doi:10.1093/humrep/15.9.1958 · Cited by 105 · see citing works
Bonde, J. P., Hjøllund, N. H., Jensen, T. K., Ernst, E., Kolstad, H. A., Henriksen, T. B., Giwercman, A., Skakkebæk, N. E., Andersson, A., & Olsen, J. (1998) · Reproductive Toxicology · doi:10.1016/s0890-6238(97)00096-8 · Cited by 104 · see citing works
The Question of Declining Sperm Density Revisited: An Analysis of 101 Studies Published 1934-1996
Swan, S. H., Elkin, E. P., & Fenster, L. (2000) · Environmental Health Perspectives · doi:10.2307/3435055 · Cited by 81 · see citing works
Polychlorinated Biphenyls and Menstrual Cycle Characteristics
Cooper, G. S., Klebanoff, M. A., Promislow, J. H. E., Brock, J. W., & Longnecker, M. P. (2005) · Epidemiology · doi:10.1097/01.ede.0000152913.12393.86 · Cited by 80 · see citing works
Hoorens, S., Gallo, F., Cave, J. A. K., & Grant, J. (2007) · Human Reproduction · doi:10.1093/humrep/dem181 · Cited by 75 · see citing works
Measuring sterility from incomplete birth histories
Larsen, U., & MENKEN, J. A. (1989) · Demography · doi:10.2307/2061519 · Cited by 55 · see citing works
Trihalomethane Levels in Home Tap Water and Semen Quality
Fenster, L., Waller, K., Windham, G., Henneman, T., Anderson, M., Mendola, P., Overstreet, J. W., & Swan, S. H. (2003) · Epidemiology · doi:10.1097/01.ede.0000077980.52697.01 · Cited by 54 · see citing works
Les naissances sont retardees mais la fecondite est stable
Toulemon, L., & Mazuy, M. (2001) · Population (French Edition) · doi:10.2307/1535003 · Cited by 53 · see citing works
Towards less confusing terminology in reproductive medicine: a proposal
Habbema, J. D. F., Collins, J. A., Léridon, H., et al. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.04.024 · Cited by 53 · see citing works
How Would a Decline in Sperm Concentration Over Time Influence the Probability of Pregnancy?
Slama, R., Jensen, T. K., Scheike, T., Ducot, B., Spira, A., & Keiding, N. (2004) · Epidemiology · doi:10.1097/01.ede.0000129520.84568.87 · Cited by 53 · see citing works
Self-citationFactors that affect outcome of in-vitro fertilisation treatment
(1997) · International Journal of Gynecology & Obstetrics · doi:10.1016/s0020-7292(97)83415-7 · Cited by 43 · see citing works
Les naissances sont retardées mais la fécondité est stable
Toulemon, L., & Mazuy, M. (2001) · Population · doi:10.3917/popu.104.0611 · Cited by 28 · see citing works
Semen Quality and Reproductive Health of Young Czech Men Exposed to Seasonal Air Pollution
Selevan, S. G., Borkovec, L., Slott, V. L., et al. (2000) · Environmental Health Perspectives · doi:10.2307/3434998 · Cited by 27 · see citing works
L'évolution démographique récente en France
Prioux, F. (2000) · Population · doi:10.3917/popu.p2000.55n3.0475 · Cited by 25 · see citing works
Histoires de familles, histoires familiales : les résultats de l'enquête Famille de 1999.
Lefèvre, C., & Filhon, A. (2005) · HAL (Le Centre pour la Communication Scientifique Directe) · Cited by 22 · see citing works
La reproduction humaine en regime malthusien. Un modele de simulation par la methode de Monte-Carlo
Jacquard, A. (1967) · Population · doi:10.2307/1528903 · Cited by 19 · see citing works
La famille idéale : combien d'enfants, à quel âge ?
Toulemon, L., & Léridon, H. (1999) · Archined · Cited by 14 · see citing works
Social Inequalities in Access to Contraception in France
Bajos, N., Oustry, P., Léridon, H., Bouyer, J., Job-Spira, N., Hassoun, D., & The COCON Group (2004) · Population (English Edition) · doi:10.2307/3654912 · Cited by 11 · see citing works
How effective is assisted reproduction technology? A model assessment
Léridon, H. (2005) · Revue d Épidémiologie et de Santé Publique · doi:10.1016/s0398-7620(05)84774-1 · Cited by 8 · see citing works
L'évolution démographique récente en France
Prioux, F. (2002) · Population · doi:10.3917/popu.204.0691 · Cited by 8 · see citing works
La reproduction humaine en régime malthusien. Un modèle de simulation par la méthode de Monte-Carlo
Jacquard, A. (1967) · Population · doi:10.3917/popu.p1967.22n5.0920 · Cited by 1 · see citing works
Flagged first, then by citations
Research works printed but not linked: 6
- Bajos N, Leridon H, Job-Spira N. Contraception and abortion in France in the 2000s. Introduction. Population-E 2004;59:347-356.
- Belaisch-Allart J, Bachelot A, De Mouzon J, De Vecchi A, Renon C. Age et PMA. Contracept Fertil Sex 1997;25:503-506.
- Jacquard A. La reproduction humaine en re ´gime malthusien: un mode `le de simulation par la me ´thode de Monte Carlo. Population 1967;22:897-920.
- Prioux F. L'e ´volution de ´mographique re ´cente en France. Population 2001;56:571-610.
- Toulemon L, Leridon H. La famille ide ´ale: combien d'enfants, a `quel a ˆge ? INSEE-Premie `re 1999;652:1-4.
- Toulemon L, Mazuy M. Les naissances sont retarde ´es mais la fe ´condite ´est stable. Population 2001;4:611-644.
Cited by
Sorted by citations
Demographic and medical consequences of the postponement of parenthood
Schmidt, L., Sobotka, T., Bentzen, J. G., Nyboe Andersen, A., & on behalf of the ESHRE Reproduction and Society Task Force (2012) · Human Reproduction Update · doi:10.1093/humupd/dmr040 · Cited by 656 · see citing works
Fauser, B. C. J. M., Adamson, G. D., Boivin, J., Chambers, G. M., de Geyter, C., Dyer, S., Inhorn, M. C., Schmidt, L., Serour, G. I., Tarlatzis, B., et al. (2024) · Human Reproduction Update · doi:10.1093/humupd/dmad028 · Cited by 224 · see citing works
“…studies point to the increasing contribution of fertility care to the overall population and the economic benefits for society that result from every new person born from fertility care (Connolly et al. , 2008, 2009, 2021; Leridon and Slama, 2008; Habbema et al. , 2009; Faddy et al. , 2018).”
BackgroundLatest‐Late Fertility? Decline and Resurgence of Late Parenthood Across the Low‐Fertility Countries
Beaujouan, E. (2020) · Population and Development Review · doi:10.1111/padr.12334 · Cited by 124 · see citing works
Late Motherhood in Low-Fertility Countries: Reproductive Intentions, Trends and Consequences
Sobotka, T., & Beaujouan, É. (2018) · Preventing Age Related Fertility Loss · doi:10.1007/978-3-319-14857-1_2 · Cited by 90 · see citing works
Lazzari, E., Gray, E., & Chambers, G. (2021) · Demographic Research · doi:10.4054/demres.2021.45.35 · Cited by 35 · see citing works
Delayed Fertility as a Driver of Fertility Decline?
Beaujouan, E. (2023) · The Springer Series on Demographic Methods and Population Analysis · doi:10.1007/978-3-031-29666-6_4 · Cited by 21 · see citing works
Leridon, H. (2017) · Population · doi:10.3917/popu.1703.0463 · Cited by 20 · see citing works
Self-citation
- Authors
- Leridon, H., & Slama, R.
- Affiliations
- Université Paris-Sud (FR)
- ORCID
- Slama, R.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-04-11
- Volume
- 23
- Issue
- 6
- Pages
- 1312-1319
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2135358455
- Cited by
- 151
- References
- 58
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 9 · 2023: 11 · 2022: 3 · 2021: 7 · 2020: 5 · 2019: 2 · 2018: 6 · 2017: 12 · 2016: 4 · 2015: 11 · 2014: 11 · 2013: 12 · 2012: 9
- FWCI
- 12.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Archined (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Social Sciences › Demography › Family Dynamics and Relationships
- Keywords
- fertility decline, involuntary infertility
- MeSH terms
- Adult, Age Factors, Female, Fertility, Humans, Infertility, Male, Pregnancy, Socioeconomic Factors, Reproductive Techniques, Assisted
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
