We’re getting fewer and fewer. Especially in Europe and Asia, in countries like Italy, Portugal, Romania and even China, more people are dying than are being born. In Germany, too, the birth rate has been declining for decades. According to the Federal Statistical Office, 6.6 percent fewer children were born in Germany in 2022 than on average in the comparative period from 2019 to 2021. There is no simple explanation for the fall in the birth rate; there are many reasons – infertility is one.
According to a new report by the World Health Organization (WHO), one in six people in the world is biologically unable (or only with difficulty) to father children. There are practically no differences between rich and poor countries. The WHO speaks of infertility when regular, unprotected sexual intercourse over a longer period of time – a year or more – does not result in pregnancy. The organization is therefore striving to make fertility treatments more affordable and thus more accessible.
Infertility can cause significant distress and stigma, and can affect people’s mental health. Nevertheless, it is unaffordable for many people to undergo artificial insemination. Such services are often simply not offered in the vicinity. The treatments are expensive and in most countries have to be paid for out of pocket.
The problem is also known in Germany. The Ministry of Family Affairs (BMFSFJ) reports that almost every tenth couple between the ages of 25 and 59 in this country is unintentionally childless. Since reproductive medical treatment is not only a financial burden for those affected, but also physically and mentally, the ministry has launched an initiative. Its goal is to give financial support to couples who want to have children. However, the funding is subject to conditions. One of them is that the woman must not be older than 40 and the man must not be older than 50.
A problem, because more and more women over the age of 40 are actually looking for help in fertility clinics. In 2011 there were still around 8,000 women from this age group, ten years later the number was already more than 12,600 patients. “The numbers are not increasing exorbitantly, but a trend can be felt,” said Andreas Tandler-Schneider, board member of the German IVF register, which collects data on treatments from more than 130 fertility centers nationwide, the German Press Agency. Women are often surprised at how bad the prospects of having a baby are despite reproductive medicine.
Women have less time to have children than men. While men are constantly forming new sperm, women are born with a certain number of egg cells and no more are produced over the course of their lives. This number of egg cells decreases continuously from birth. While there are initially around one million egg cells, at the beginning of puberty there are only around 300,000. From around the age of 35, the quality of the remaining egg cells also decreases. At the age of 40, one in 100 women has exhausted their egg reserve. As a result, many women are no longer able to have children years before the menopause, the onset of which usually makes pregnancy finally impossible.
There is no such fixed point for men. From a biological point of view, they do not become infertile. But their time window in which they can father children is also limited. The fertility window for men begins to close around the age of 40 – how quickly this varies from man to man. Lifestyle has an influence on this. Smoking, too much alcohol, cannabis, competitive sports and heat can be detrimental to fertility. It has been proven that in old age the man, if he is healthy, continues to produce sperm, but that the quality deteriorates. To make matters worse, the spermatozoa become sluggish. You move less and lose speed.
The WHO advocates that more help be made available everywhere for infertile people at a manageable cost. “The sheer number of people affected shows that access to fertility treatments needs to be expanded and that health research and policy must no longer sideline this issue so that safe, effective and affordable avenues to parenthood are available to all who wish standing,” said WHO chief Tedros Adhanom Ghebreyesus.
For this report, the WHO selected and evaluated 133 from more than 12,000 studies worldwide between 1990 and 2021.
Source: BMFSFJ, federal funding guidelines, with material from the dpa
