Call for free fertility treatment to boost Europe's population
Dr Kirsty Horsey
Progress Educational Trust24 June 2006
Europe's increasing demographic crisis could be helped by providing free fertility treatment to more women, says RAND Europe, an independent research organisation, at the annual conference of the European Society of Human Reproduction and Embryology (ESHRE) in Prague, Czech Republic. The research was funded by the biopharmaceutical company Ferring.
By the year 2050, it is estimated that the number of Europeans over the age of 65 will have doubled, from the current rate of 15 per cent of the population, to 30 per cent. This will inevitably have grave financial implications in terms of increased healthcare and pension costs, coupled with there being correspondingly fewer young people in the workplace. Demographers say that 2.1 children per woman are needed to sustain existing population levels, however, the average number of children for couples in Europe is less than this: the highest average is 1.9 in Ireland and France and the lowest is 1.3 in Spain and Italy.
RAND Europe has looked at ways in which European governments could begin to address the issue - one of their suggestions is that increased provision of fertility treatments would increase the birth rate. 'Assisted reproductive technology could be considered part of a population policy mix', said Dr Jonathan Grant, the director of RAND Europe, adding that 'the message to governments is that you need lots of different policies if you want to increase fertility rates and ART could be one of those policies'. Some countries have other ways of encouraging couples to have children, such as family-friendly tax policies, or generous provisions for maternity and paternity leave and childcare. Some others provide free fertility treatments, which Grant said could be considered by the UK, because it might increase the birth rate. 'What we are seeing is that ART could make a small but not insignificant contribution to the overall total fertility rate', he said.
In 2004, health ministers in the UK recommended that all health authorities should follow guidance issued by the National Institute of Health and Clinical Excellence (NICE), which had recommended that three cycles of IVF should be offered to all infertile couples, subject to certain clinical criteria, to end the 'postcode lottery' of provision. Shortly afterwards, the then health secretary, Sir John Reid, announced that all infertile couples where the woman was aged between 23 and 39, and fitting certain other additional criteria - including having no other children living with them - should be given just one free cycle of IVF on the NHS from April 2005, with a view to increasing provision further in time.
However, last November, a study of PCTs showed that at least 23 were not providing any NHS-funded fertility treatment by the April 2005 deadline. Eighteen others were only offering IVF under 'exceptional circumstances' and many others were denying treatment to women in their late thirties. Earlier, in September 2005, research published by the UK's Audit Commission showed that a 'postcode lottery' still exists in many aspects of the provision of medical services, including the provision of fertility treatment on the NHS. The report suggested that the problems continue to exist because of poor planning and financial management in the NHS. Another example of the continued 'postcode lottery' came to light in July 2005, when ten PCTs in the county of Hampshire were shown to be refusing to fund IVF treatments, despite the Government's promises. They said that, because of limited funding, IVF treatment in the county has to be a low priority. Earlier this month, on National Infertility Day, Dame Suzi Leather - Chair of the UK's Human Fertilisation and Embryology Authority (HFEA) - said that she would like to see the Government follow through on its stated desire to fully implement the NICE guidelines'.
Clare Brown, chief executive of the patient support group Infertility Network UK (IN UK) said that she agreed 'wholeheartedly with the suggestion that ART should be used to mitigate the consequences of falling birth rates'. She went on to say that 'it is important to plan ahead and address the social and economic consequences of the declining birthrate' and pointed out that 'with more couples leaving it until later to start their family, more will experience fertility problems'. She added: 'These couples are in a position to make a difference and we need to provide more funding for ART to help them overcome the problems they may encounter'.
Reproduced with permission from BioNews, an email and online sources of news, information and comment on assisted reproduction and genetics.