What’s Happening with the Infertility Epidemic?

Posted on by Paul Turek, MD

Are we approaching the Armageddon of infertility in America? It might seem that way looking at our long term decline in birth rates. To replace ourselves from generation to generation, we need each woman to have 2.1 births during her life. In the 1970s, that rate was at an all-time low of 1.74; in the late 2000’s it was 2.05, and now it is 1.9, all well below sustainability. It begs the question of whether children are still wanted in a modern world.

Going Granular

One driver of birth rates is the fertility potential of the population. Another factor is the collective decision of potentially fertile women to have children. Let’s look at what’s been happening with these two issues lately.
The newest data addressing the state-of-fertility in America was published this week by the government and is based on 22,682 face-to-face interviews of US women (12,279) and men (10,403).

Should We Have Kids?

Regarding our decision to have children or not, the age at first marriage is a key indicator of this issue. The latest data from the Feds suggests that first marriages are occurring later than ever: 26.6 years for women and 28.6 years for men. That could certainly keep our birth rates down.

Can We Have Kids?

The second key factor is whether those who want children are actually able to have them. The failure to conceive is what we all know as “infertility,” and the newest findings on this are somewhat unexpected. Here are the Fed’s facts on infertility from this week’s report:

  • 6% of married women in the US ages 15-44 were infertile in 2010 (latest data)
  • 8.5% of married women in the US ages 15-44 were infertile in 1982 (30 years ago)
  • This decrease in infertility represents a difference of almost 1 million women in the US.
  • For unmarried women trying conceive with a male partner, the infertility rate is even lower at 4.9%

So, given a stable US population, it appears that fewer women are infertile now than a generation ago. Does that mean we fertility specialists are doing a good job?

It’s Complicated

Unfortunately, it’s premature to pat ourselves on the back. This is because the following factors could also play a role in these changing rates:

  • Many women surveyed (up to 44 years old) may have been beyond the scope of fertility treatments and never tried to conceive.
  • The latest survey was conducted in the midst of our generation’s greatest recession, a time in which couples often don’t seek to have any, or more, children.
  • The average cost of raising an infant to age 17 years is now approaching $300,000 which may “price out” some couples from child bearing.
  • Since fertility treatments are more widely available now than ever, fewer couples might have waited for the required 12 months to be deemed “infertile” before seeking medical help.

Cut it any which way you want. What impresses me the most is that women are waiting longer than ever to have children, but the overall rate of infertility has not increased. To me, this means that smarter decisions are being made by patients, providers or both to reduce the ravages of the infertility epidemic.