Ziebe Søren, Devroey Paul
Fertility Clinic, Rigshospitalet, Section 4071, University Hospital of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Hum Reprod Update. 2008 Nov-Dec;14(6):583-92. doi: 10.1093/humupd/dmn038. Epub 2008 Sep 11.
The decline in the total fertility rate in the latter half of the 20th century in many European countries is becoming increasingly important in determining the demographic composition of Europe and its individual member states. This review focuses on discussion surrounding how assisted reproductive technology (ART) can impact declining fertility rates.
This article summarizes key aspects of presentations given at the 'State of the ART 2007-ART and Society' meeting held in Lyon, France, in June 2007. For each topic, searches were conducted in MEDLINE and other databases and the results, alongside unpublished data and personal opinion, were presented to the Workshop Group. Individual subjects were discussed and any disagreements or omissions resolved.
Although reduced fertility rates will have an impact on total population number, it is the change in the age structure of the population that is likely to be the most challenging factor faced by the European Union (EU). With evidence suggesting that an ageing population threatens future standards of living and social cohesion, managing demographic change through integrated policy response has become an important component of EU legislation. However, current measures fail to tackle the contribution that ART may play in alleviating falling fertility rates. Indeed, ART can have an important impact on economic and demographic factors, and should be incorporated into a population policy mix. Current barriers to ART include legislative restriction across different EU countries, limited availability to ART and current perception of ART in society.
The inclusion of ART as part of a population policy mix in Europe is justified but must involve better communication among ART professionals, politicians and the general public.
20世纪后半叶,许多欧洲国家的总生育率下降,这在决定欧洲及其各个成员国的人口构成方面变得越来越重要。本综述着重讨论辅助生殖技术(ART)如何影响生育率下降。
本文总结了2007年6月在法国里昂举行的“2007年ART现状——ART与社会”会议上发言的关键内容。针对每个主题,在MEDLINE和其他数据库中进行了检索,并将结果连同未发表的数据和个人观点提交给了研讨会小组。对各个主题进行了讨论,并解决了任何分歧或遗漏。
尽管生育率下降会对总人口数量产生影响,但人口年龄结构的变化可能是欧盟面临的最具挑战性的因素。有证据表明,人口老龄化威胁着未来的生活水平和社会凝聚力,通过综合政策应对来管理人口变化已成为欧盟立法的重要组成部分。然而,目前的措施未能解决ART在缓解生育率下降方面可能发挥的作用。事实上,ART会对经济和人口因素产生重要影响,应纳入人口政策组合中。目前ART面临的障碍包括欧盟不同国家的立法限制、ART的可及性有限以及社会对ART的当前认知。
将ART纳入欧洲人口政策组合是合理的,但必须在ART专业人员、政治家和公众之间进行更好的沟通。