Demographic causes and implications of increased use of ART: the case of the Czech Republic in the European context

Jiřina Kocourková, Charles University, Prague
Boris Burcin, Charles University, Prague
Tomáš Fait

According to WHO's definition the reproductive health implies that people have the capability to reproduce and the freedom to decide if and when to have a child. Reproductive health of individuals is influenced by many factors like age, lifestyle, habits, genetics, etc. Recently demographic aspect of reproductive health has become more important in European countries due to postponement transition towards a late-childbearing regime. The time span available for reproduction has narrowed and affected the possibility for an increasing proportion of women to achieve their desired fertility due to infertility. The potential effect of ART pushes the age limit of childbearing to increasingly later stages of the life course. The aim of the study is to evaluate the importance of increased use of ART for the recent and future fertility trends in the Czech Republic. Comparative analysis based on demographic and ART data is used. In the 1990s a trend towards later childbearing contributed greatly to the decline in TFR in the Czech Republic. Recently, recuperation of delayed births has resulted in the increase of TFR to 1.5. The highest increase in fertility rates occurred in the age group of 35-39, in which the contribution of ART treatments usually is greatest. In 2005 the estimated share of children born after ART in the Czech Republic (3%) was close to countries with the highest share (Nordic countries). However, the Czech Republic registered only half the number of ART cycles per million inhabitants than countries on the top and faced lowest low TFR of 1.28. We argue that spreading of ART is particularly relevant in the countries caught in the low fertility trap as higher impact on fertility level could be expected. The risk of further delay of childbearing encouraged by ART treatment could be partly reduced by couples seeking help sooner.