The impact of a decline in fecundity and of pregnancy postponement on final number of children and demand for assisted reproduction technology
The impact of a decline in fecundity and of pregnancy postponement on final number of children and demand for assisted reproduction technology
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DOI：
10.1093/humrep/den106
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发表时间：
2008-06-01
影响因子：
6.1
通讯作者：
Slama, R.
中科院分区：
文献类型：
--
作者：
Leridon, H.;Slama, R.
背景：在过去的几十年里，诉诸不孕症治疗的夫妇比例急剧增加，而生育率（最终孩子的数量）急剧下降。我们探讨了这些趋势的两个潜在原因的作用：夫妇生育能力的暂时下降和开始怀孕尝试的年龄推迟。方法：基于法国1968年出生队列的生育和社会人口学特征，我们对10万名妇女的生殖史进行了蒙特卡洛模拟。生育能力出现了不同幅度的下降，开始尝试怀孕的年龄分布也有所增加。结果：生育能力下降15%意味着生育率下降4%，符合不孕不育治疗条件的夫妇比例增加73%。首次尝试怀孕的平均年龄从25岁增加2.5岁，导致生育率下降5%，有资格接受不孕症治疗的夫妇比例增加32%。结论：生育能力相对重要的下降和首次尝试妊娠年龄增加2.5岁可能对生育能力的影响有限。然而，它们可能会对非自愿不育夫妇的比例产生很大影响，这些夫妇可能会求助于辅助生殖技术。
BACKGROUND: Over the past decades, the proportion of couples who resort to infertility treatment has tremendously increased, and fertility (the final number of children) sharply declined. We explored the roles of two potential causes of these trends: a temporal decline in the couples' fecundability and a postponement of age at initiation of pregnancy attempts. METHODS:We conducted a Monte-Carlo simulation for the reproductive history of 100 000 women based on the fertility and socio-demographic characteristics of the 1968 birth cohort in France. Declines in fecundability of various amplitudes have been implemented, as well as increases in the distribution of age at initiation of pregnancy attempts. RESULTS: A decline in fecundability by 15% implied a decrease in fertility by 4%, and an increase in the proportion of couples eligible for infertility treatments by 73%. An increase in the mean age at initiation of first pregnancy attempt by 2.5 years from 25 years entailed a decrease by 5% in fertility and an increase by 32% in the proportion of couples eligible for infertility treatments. CONCLUSION: A relatively important decrease in fecundability and an increase by 2.5 years in age at first pregnancy attempt are likely to have only a limited impact on fertility. However, they may have a large impact on the proportion of involuntarily infertile couples, likely to resort to assisted reproduction techniques.