Invited Speaker - Proposed model for distinguish between biological and psych-social economic factors in childlessness

Many industrialised regions, face a reproductive crisis, with fertility rates well below the sustainability level (2.1 children per woman) for decades. In countries where industrialisation was well underway in the early 20th century, e.g. Japan, there are now more deaths than births. In Denmark, where birth rates dropped below the sustainability level more recently, population decline has not yet occurred. However, the changing reproductive pattern is already noticeable in the form of societal problems with an increasing ‘burden of elderly people’ and a lack of younger people in the workforce, including the health care system. We must expect that these trends will continue and have stronger effects for the coming generations.

A common interpretation of the demographic data has been that the changing social and economic roles of women in our industrialised societies are to be blamed for the unsustainable reproductive pattern. Economic and socio-psychological factors are fundamental to people’s plans to have children. However, many pregnancies are unplanned, showing that the fecundity of people of reproductive age is still important for the number of births in a time with effective contraception. Surprisingly, many authors of demographic scientific papers and the media seem to ignore that population fecundity is far from constant. The World Health Organization recently reported that globally, one person in six is infertile, making infertility the most prevalent non-communicable disease among people of childbearing age. There is even strong evidence that reproductive health problems are increasing and may be interconnected, e.g. increasing incidences of testicular germ cell cancer, decreasing semen quality, increasing incidence of undescended testis and widespread infertility and need for assisted reproductive technology.

We propose a three-stage project which allows the retrieval of absolute measures of the population's reproductive health on its fertility (outlined in Endocrine Views 2023: https://www.ese-hormones.org/media/5453/endocrine-views-summer-2023-issue-51_web.pdf).

The project is interdisciplinary and combines clinical, biomedical, demographical and epidemiological methods to reach its goal.