What Can Modern Medicine Do Against the Lack of Children in Germany?

Complete German Version (PDF, 1.5 MB)

Germany is one of the countries in the world with the fewest children. Family policies have been trying to change this for some time. A new study of the Berlin Institute investigates whether reproductive medicine can also contribute to this effort.

12.8 million people in Germany between the ages of 25 and 59 long to have children or wished for them at an earlier point in time. 1.4 million of these people were unsuccessful at getting pregnant, even though they “tried” for more than one year. The problem of unintentional childlessness due to medical reasons was, up until recently, rarely publicly discussed. This could change in light of decreasing birth rates: on average over the last 10 years (1997 to 2006), 14,000 fewer babies were born each year in comparison to the preceding year. This decrease would have been even more drastic if around 95,000 children had not been born in the period from 1997 to 2005 as a result of artificial insemination (an average of approximately 10,000 babies per year).

A new study entitled "Unintentionally Childless", which was conducted by the Berlin Institute for Population and Development together with the Allensbach Institute for Public Opinion Research investigates the question of how reproductive medicine can contribute to mitigating the demographic crisis in Germany. The study concluded that aside from modern family policies and increased prevention of infertility due to medical reasons, medicine could help couples whose wish for children has gone unfulfilled and, by doing so, could increase birth rates to a certain extent. If artificial insemination (in-vitro fertilisation or IVF) were used to the same extent as in Denmark, the country with the highest number of IVF treatments per inhabitant, medicine could even make a significant contribution.

In 2002, the proportion of IVF children in relation to the total number of newborns was 1.9 percent in Germany. The figure even reached 2.6 percent in 2003, only to decrease to 1.4 percent and finally to 1 percent in the year 2005. The sharp increase and the decrease that followed it are, among others, due to the fact that since the German Health Care Reform took effect on 1 January 2004, the statutory health insurance companies only pay 50 percent of the costs for a maximum of three treatments, whereas before they paid for four treatments in full. For this reason, many couples who would have otherwise waited underwent treatment in 2003. The average proportion for the years 2000 to 2005 is 1.65 percent.

In Denmark however, where couples with an unfulfilled wish to have children can receive three fully paid treatments as long as they are conducted at a public health clinic, IVF children contribute to birth rates to a larger degree: In 2002 they made up 4.2 percent of the total number of newborns, with an average of 3.96 percent between the years of 2000 and 2005—almost 2.5 times the number in Germany.

Calculations performed as part of the new study of the Berlin Institute show that the proportion of IVF newborns remaining at the average level of the past years ("German model") would have an already recognisable influence on Germany’s demographic development up to the year 2050. The effects would be clearly recognizable if this proportion would increase to Denmark’s level immediately (i.e. from 2007 onwards) and remain at that level until 2050 ("Danish model").

According to the German model, the proportion of IVF children, their children and their children’s children would increase to 3 percent by the year 2050 among 0- to 4-year-olds at that time. According to this calculation, a total of about 750,000 children in Germany would directly or indirectly owe their lives to the methods of reproductive medicine.

According to the Danish model, the total proportion of IVF children, including their children into the second generation, would reach 7.2 percent by 2050 among 0- to 4-year-olds at that time. This proportion would be almost 2.5 times as high as in the first scenario. All in all according to the Danish model, 1.6 million children would be born in Germany by the year 2050 who would directly or indirectly have resulted from artificial insemination.

You can view the german version of the complete study here (PDF, 1.5 MB).

For questions and interviews Dr. Reiner Klingholz can be reached at + 49 30 31017560 and Sabine Sütterlin can be reached at + 49 15 11-6 66 49 49.