In the ongoing conversation about fertility and family planning, in vitro fertilisation (IVF) is often highlighted as a beacon of hope for the many couples
grappling with infertility. The common argument is that it will help lift Hong Kong’s low fertility rate.
However, this is a false hope. The additional babies born because of widely accessible IVF comprise only a small percentage of the total births in countries such as Denmark, the Czech Republic and Israel.
The potential impact of IVF on the number of births is often overstated. IVF should not be seen as a readily available remedy for the challenges of a low fertility rate and declining and ageing populations. While it plays an essential role for many people
aspiring to become parents, relying on IVF to boost birth rates is unrealistic.
IVF is a sophisticated medical procedure involving multiple stages – ovarian stimulation, egg retrieval, fertilisation and embryo transfer – and may require repeated cycles. This process offers a lifeline to those facing infertility, but success rates vary widely.
For women under 35 using their own eggs, the chance of a successful pregnancy is around 40 per cent per cycle
. However, this chance shrinks significantly as
women’s age increases, dropping to around 10 per cent for women over 40 and reaching close to zero by age 45. Men’s age also negatively affects IVF success rates, with the chances of successful pregnancy and delivery diminishing for couples where both partners are of higher reproductive ages.
The IVF success among women in their 40s can be dramatically improved when they use donor eggs from younger women or their own eggs frozen at a younger age. Even so, both options are fraught with practical and ethical issues and are
costly and unrealistic for many couples.
These statistics underscore the urgency of timely intervention and highlight the importance of informed decision-making. Many prospective parents enter this journey with limited knowledge about the chances of success and risks, monetary and psychological costs.
This information gap can lead to unrealistic expectations and
emotional turmoil. Gynaecologists, general practitioners and fertility clinics should prioritise clear communication, ensuring patients understand the entire journey and the risks involved.
Moreover, ethical considerations and honest advice about the stress prospective parents experience when they go through multiple rounds of IVF should be part of the equation. Couples should also not be rushed into opting for IVF when they still have a relatively high chance of achieving pregnancy naturally.
Rather than treating IVF solely as a medical procedure, we must position it within the broader context of social and health services. Fertility issues are societal challenges, reflecting trends that affect us all.
Couples should have access to affordable testing and IVF treatments as long as they have a realistic chance of achieving pregnancy. By integrating IVF services into comprehensive healthcare and
social support systems, we can enhance accessibility and understanding.
While accessible IVF cannot lead to a sustained reversal in birth rates,
broad financial support for IVF is crucial to alleviating the economic burdens that prevent many infertile people from accessing the most suitable treatment. Support for infertile couples should go beyond IVF provision. Consider the benefits of counselling services that address the emotional and psychological ramifications of infertility.
IVF must centre on protecting reproductive rights, emphasising that family decisions are a responsibility prospective parents share. Policies should empower both women and men, fostering a culture of mutual understanding and support. In many societies, gender stereotypes still prevail and infertility in couples is perceived as primarily
a woman’s issue.
Men can be reluctant to undergo diagnostic examinations while their female partners often go through taxing tests. In reality, infertility is
about as frequently a result of male as female-related factors. Countries such as Sweden have successfully promoted comprehensive education about reproductive health for all genders, resulting in a better-informed population.
It’s not enough to implement broad
pro-natal policies aimed at increasing birth rates. Efforts should focus on removing barriers to achieving desired family sizes.
Flexible parental leave, affordable housing and childcare can significantly ease the pressures that deter couples from having children.
In conclusion, while IVF is a crucial option for many, it should not be mistaken for a fix for population problems. Instead, we must foster an environment that encourages informed choices and respects the reproductive rights of all individuals.
By addressing the barriers to family planning and creating a culture of shared responsibility, we can build a society that values and supports the reproductive health of both men and women. Integrating IVF into a broader social services and healthcare framework will enhance accessibility, transparency and understanding, ultimately leading to more sustainable solutions to our population challenges.
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