The effect of in vitro fertilization on birth rates in western countries
Open accessAbstract
BACKGROUND: We will assess to what extent in vitro fertilization (IVF) is effective in increasing the number of births overall and whether earlier application of IVF will increase this number. METHODS: We simulate 100 000 women trying for their first and second child. Natural and IVF pregnancy rates and infertility rates are age-dependent and based on published data. The age at which women start trying for their first child is based on the Netherlands 2002 data. Three cycles of IVF are given during a 12-month period after 1 or 3 years of trying to conceive unsuccessfully. Main outcome measures are live born deliveries and children, both naturally conceived or after IVF, as well as numbers of singletons, twins and triplets, the total fertility rate (TFR) and the number of IVF cycles performed. RESULTS: Full access to IVF after 3 years increases the TFR by 0.08 children. Applying IVF after 1 year leads to an additional TFR increase of 0.04, with double the number of IVF cycles and twin and triplet children, and a shift from naturally conceived children to IVF children. CONCLUSIONS: Full access to IVF after 3 years is important. It does increase the TFR. Early availability of IVF would further increase the TFR, but with side-effects and high costs.
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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 Habbema et al., 2009
The Discussion reports that IVF increased the total fertility rate in the authors’ simulated cohort, supporting a contribution to population births. It does not establish economic benefits to society from each person born through fertility care; the Discussion instead notes financial and healthcare costs. Page numbers were not provided in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe impact of ART on TFR appears to be approximately a 0.05-0.10 increase where access to fertility treatment is widely available.
“While it is difficult to isolate the overall effect of ART in raising fertility rates from other behavioral and policy drivers, the impact appears to be approximately a 0.05–0.10 increase in TFR where access to fertility treatment is widely available (Grant et al., 2007; Habbema et al., 2009; Lazzari et al., 2021).”
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 Habbema et al., 2009
The Discussion reports a modeled TFR increase of 0.08 with full access to IVF after three years, within the claimed range. It also calls the modeled results an upper bound: not everyone would use IVF even if it were freely available, so the effect in an actual population would be smaller. The paper therefore supports the approximate modeled IVF effect, but not a general estimate for ART wherever treatment is widely available. (LLM, conf=0.84)
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- Authors
- Habbema, J. D. F., Eijkemans, M. J. C., Nargund, G., Beets, G., Leridon, H., & te Velde, E. R.
- Affiliations
- Erasmus MC (NL)
- St George's Hospital (GB)
- Netherlands Interdisciplinary Demographic Institute (NL)
- Corresponding author
- Habbema, J. D. F.
- ORCID
- Eijkemans, M. J.C.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-02-20
- Volume
- 24
- Issue
- 6
- Pages
- 1414-1419
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2135954933
- Cited by
- 78
- References
- 35
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 6 · 2020: 6 · 2019: 2 · 2018: 1 · 2017: 6 · 2016: 2 · 2015: 1 · 2014: 4 · 2013: 13 · 2012: 11
- FWCI
- 10.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Archined (submittedVersion)
- KNAW Research Portal (The Royal Netherlands Academy of Arts and Sciences) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- in vitro fertilization, total fertility rate, birth rate, infertility, age at first pregnancy, IVF cycles, spontaneous conception, access to assisted reproduction
- MeSH terms
- Adult, Birth Rate, Europe, Family Characteristics, Female, Fertilization in Vitro, Health Policy, Humans, Parity, Pregnancy, Pregnancy, Multiple, Cohort Studies, Pregnancy Rate
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