What does the future of fertility look like?

There is no joy like the joy of becoming a parent. Sadly, for millions of people around the world, they will never experience that joy.

November 2 is World Fertility Day and comes just months after a World Health Organization report which showed 1 in 6 people worldwide experience infertility issues.

Fewer people are having children with birth rates falling worldwide. The increasing cost of living, more women in the workforce, lower child mortality and climate change all being partly responsible.

This has been accompanied by rising demand for Assisted Reproductive Technologies (ARTs) which has become big business in developed and developing economies. The global fertility market is expected to reach USD$84 billion in 2028.

The time is ripe to ask whether legal, social, economic and technological arrangements have kept up. What are the challenges evolving alongside the rapid growth of the fertility industry and what legal and ethical problems do they pose?

Rising longevity and falling birth rates put pressure on public finance and compel governments to make policies to reverse demographic decline.

The distance between the lab and the clinic is shrinking as new fertility treatments increase people's chances of having babies in less painful ways.

Australia's first public egg and sperm bank opened in July 2023 as part of the Victorian state government's initiative to establish a Public Fertility Service.

Despite the prevalence of ART for close to 50 years, access to fertility treatment remains a fraught question. Should governments and the private sector play a greater part in improving quality of care and regulatory control?

AI's increasing role in improving chances of having a baby has the potential to revolutionise reproductive healthcare but with ethical and medico-legal safeguards in place. To make ART and AI-led treatments more democratic remains a problem to be addressed.

In India, the social discourse of infertility is met with stigma but finds no recognition in its health policies. For reproductive rights to go hand-in-hand with fertility governance can ensure better reproductive health outcomes for poorer populations.

Male infertility, meanwhile, remains the elephant in the room, laying the burden of conception squarely on women's shoulders. That infertility among men can be indicative of other underlying ailments is frequently ignored.