“Priorities have changed. In general, a less favorable context for birth rates has been created. In Italy, as in Spain, couples tend to postpone parenthood due to multiple socioeconomic factors. Women have made progress in terms of empowerment, taking on responsibilities in the professional field that were previously a male prerogative. Motherhood is no longer seen as an obligatory stage, but as a conscious choice. But this, due to the lack of concrete support from the institutions, makes it more difficult for those who wish to have children to do so at a biologically optimal age”. Thus Antonio Pellicer, president and founder of the IVI Group and one of the leading experts in PMA in Europe, analyzes with Adnkronos the factors that impact the current demographic trend.
The numbers of medically assisted procreation show how much the context has changed. From 2010 to today, the average age at birth of Italian women has risen from 31 to over 33 years. In twenty years, the demand for medically assisted procreation (PMA) treatments has almost doubled, resulting in more than 200 thousand children being born in our country. But the National PMA Register also shows a worrying fact. The average age of women who undergo PMA cycles has increased considerably, going from 34 years in 2005 to 37 years in 2022. This change is also reflected in the growing percentage of women over 40 who access these treatments, which it has gone, in two decades, from 20.7% to 34% in 2022. This shift towards an older age is not just a statistical fact, but the mirror of a broader social change.
“There has been a significant change in the way new generations perceive parenthood – underlines Professor Pellicer – in the past, having children was often seen as a social obligation, an inevitable stage of adult life. Today, however, the young generations no longer feel this burden and do not wish to be forced to make this choice. Parenting has become a conscious and thoughtful decision, which is placed in a context of very different values and living conditions compared to the past. To encourage parenthood – suggests Pellicer – society should create a favorable context in which the choice to have children can be free and supported by policies that guarantee well-being and security for families. There are many couples who wish to have children, despite everything, but this choice is closely linked to the desire to be able to guarantee their children an environment in which they can grow up in conditions of well-being. In this context, career path and personal fulfillment play a fundamental role.
“In fact, the growth in the importance of a career and the value of personal fulfillment has not been accompanied by an adequate development of welfare, support and help tools. At the end of university studies – she explains – women are at the peak of fertility, but both partners are at the beginning of the path to achieving independence and economic stability, buying a house is more difficult, and so the years pass. The result is that couples often choose to have children at a time that seems ideal to them, but which could be biologically late.” In our society, the desire for a child appears at more than thirty years of age, but “there is a biological clock that no one can stop – underlines Pellicer – In this context, reproductive medicine, although not always the solution, could help reverse the trend. Couples, however, should be helped more in their infertility treatment journey with better information.”
It is important, for example, to know that “after the age of 36-37, the quality of eggs tends to worsen, making conception more difficult. PMA offers a solution when age, or other biological factors, reduce your chances of conceiving naturally, but the key is awareness. Freezing healthy eggs in your thirties helps you preserve your fertility for the future. In fact, while the quality of the eggs decreases with age, the ability of the uterus to carry on a pregnancy is maintained up to the age of 45-48. Furthermore, with PMA, it is possible to select the best eggs and healthy embryos, to increase the chances of success, and reduce the time to achieve a pregnancy. Up to the age of 38, with fertilization techniques, 50% of healthy embryos are obtained, at 42 years of age, only 30% can be implanted, 70% in fact are not healthy, but at 44 years of age the percentage of useful embryos is reduced at 10%. This is the biological clock.”
In the event that the quality of the eggs of an aspiring mother are not of good quality or previous attempts have failed, it is possible to resort to heterologous MAP which involves the use of eggs donated by a woman outside the couple. “In this case – highlights Pellicer – the success rate becomes greater than 90% if at least 3 embryos are used, offering many couples the possibility of realizing the dream of having a child”. Another thing PMA can do is shorten the time to conception. “Every month, the probability of a couple, at the peak of fertility, therefore between the ages of 23 and 25, of having a child naturally is around 22%, but as relationships intensify, the probability of having a pregnancy increases. In the case of Pma, the pregnancy begins at the very moment the embryo is placed in the uterus with a probability of 65%. To reach 90%, 3 embryos are needed: if in fact the first attempt is not successful, you can try the following month and in the other. We even reach 98% with 5 embryos.”
Be careful, though. “We must be honest – warns Pellicer – Despite the progress of reproductive medicine, it is always better to try to have children before the age of 37, when fertility is still high. The Pma cannot replace the importance of encouraging the search for a child at a younger age. Even in the most advanced countries in the field of MAP, such as Denmark and Spain – specifies the professor – only 10-11% of children are born thanks to these techniques. In Italy we are around 4%. In any case, 90% or more of newborns come from natural pregnancies. This means that birth support must be integrated with solid social and cultural policies – not one-off bonuses but services and tax breaks – which encourage couples to become parents when they are at a more biologically favorable age”.
#Pellicer #Ibid #Priorities #changed #couples #welfare #support #birth #rate