Heartfelt pleas from families hoping to start or continue their IVF journey have emerged after Victoria implemented a three-month ban on new treatment cycles as its COVID-19 cases surge.
Non-urgent elective surgeries, including IVF, have been suspended yet again as hospitals grapple with increased admissions in the Omicron outbreak. It’s particularly concerning for older women or women with limited ovarian reserves when every month IVF is delayed has a direct effect on their chances of carrying a baby to term.
Experts are very worried the impact on Australia’s population growth could be permanent as population growth grinds to a near standstill.
There is a backlog of tens of thousands on all elective surgery waitlists.
Low fertility rates could be permanent
For women over 40, every month counts in IVF. One study found a delay of six months in women aged 40 to 42 decreased IVF live births by 11.8%. Another UK study estimated a six-month shutdown on IVF treatment due to COVID hospital pressures reduced the live birthrate by 1.6% with thousands fewer babies born.
Australian families are having families later in life and having fewer children. The median age of parents has steadily increased since the ‘80s. In 2020, it was 31.6 for mothers and 33.6 for fathers, compared with 26.5 and 29.4 in 1980. Most new mothers are aged between 30 and 34.
Fertility rates have decreased since the ‘70s too: women are having fewer children on average, decreasing from 2.9 in 1971 to 1.58 in 2020. Victorian mothers have the second-highest median age in the country behind the ACT at 32.3 and the lowest fertility rate at 1.43 babies per woman.
COVID is having a massive impact on family growth. ANU demographer and social researcher Liz Allen said: “We’re seeing people postponing and possibly even forgoing having children during periods of COVID because of the uncertainty.” Many people are not meeting prospective partners due to lockdowns.
This could have long-lasting impacts.
“When we see fertility fall to a low level, we only need to look to China and to South Korea to see that it’s very hard to bounce back from that,” Allen said. “The establishment of a new norm when it comes to that demographic measure could become entrenched and has a major historical impact … It’s a recipe for disaster.”
As Australia has seen, an ageing population has massive impacts on the economy, with fewer tax dollars and labour shortages. While there are arguments smaller populations are better for the climate, Allen believes this should be addressed with policy, not by pressuring parents to not have kids.
“We’re going to be pressured to do more with less as the population ages, and we’ll have a situation where we risk our living standards going backwards,” Allen said.
What affects fertility?
Despite popular belief, age isn’t the biggest thing affecting fertility. In fact, the widely cited statistic that women’s fertility drops off at age 35 is a myth, based on data from the 1700s. While the quality of eggs declines over time, the same is true for sperm.
Almost one in 20 children was born via IVF in Australia in 2020, but fertility specialist and University of Melbourne associate professor Alex Polyakov says much of this is due to women pursuing studies and careers before starting families.
“IVF was never designed to counteract fertility decline due to age because we have to rely on the presence of good quality eggs to be successful in IVF,” he said.
“The biggest problem is that a lot of women that I see that are older or single [and starting a family] is because they couldn’t find a partner to settle down with to have children … I think it’s a social thing, I don’t think it’s medical.”
Australia has strict regulations around egg and sperm donation. Donors can’t be paid, but can be reimbursed for their travel and medical costs and are not reimbursed for their time or lost work.
Most Australian states and territories limit donors to contributing to five families, including their own. This has led to more and more families travelling abroad to use egg banks, known as reproductive tourism. The eggs cannot be imported to Australia, so the entire IVF treatment has to be done offshore. Pandemic travel bans further affected that.
Families want more kids but are hindered by policy
While many people are choosing to not have children, many families want more kids — data from the Household, Income and Labour Dynamics in Australia Survey showed people weren’t achieving their desired family size, hindered by poor policy and support. Allen says for families to reach their desired size, four main policy areas must be addressed.
“From my perspective as a demographer that’s housing affordability, gender equality — including childcare — employment security, and climate change,” she said.
“At the moment, the future is being decided by people at one end of the demographic spectrum, possibly at the cost of people at the other end of the demographic.”
