School of Medicine, University of Glasgow, UK.
Applied Statistics Group, University of the West of England Bristol, UK.
Reprod Biomed Online. 2021 Jun;42(6):1087-1096. doi: 10.1016/j.rbmo.2021.03.017. Epub 2021 Mar 23.
The economic and reproductive medicine response to the coronavirus disease 2019 (COVID-19) pandemic in the USA has reduced the affordability and accessibility of fertility care. What is the impact of the 2008 financial recession and the COVID-19 recession on fertility treatments and cumulative live births?
The study examined annual US natality, Centers for Disease Control and Prevention IVF cycle activity and live birth data from 1999 to 2018 encompassing 3,286,349 treatment cycles, to estimate the age-stratified reduction in IVF cycles undertaken after the 2008 financial recession, with forward quantitative modelling of IVF cycle activity and cumulative live births for 2020 to 2023.
The financial recession of 2008 caused a 4-year plateau in fertility treatments with a predicted 53,026 (95% confidence interval [CI] 49,581 to 56,471) fewer IVF cycles and 16,872 (95% CI 16,713 to 17,031) fewer live births. A similar scale of economic recession would cause 67,386 (95% CI 61,686 to 73,086) fewer IVF cycles between 2020 and 2023, with women younger than 35 years overall undertaking 22,504 (95% CI 14,320 to 30,690) fewer cycles, compared with 4445 (95% CI 3144 to 5749) fewer cycles in women over the age of 40 years. This equates to overall 25,143 (95% CI 22,408 to 27,877) fewer predicted live births from IVF, of which only 490 (95% CI 381 to 601) are anticipated to occur in women over the age of 40 years.
The COVID-19 recession could have a profound impact on US IVF live birth rates in young women, further aggravating pre-existing declines in total fertility rates.
2019 年冠状病毒病（COVID-19）大流行对美国的经济和生殖医学产生了影响，降低了生育护理的可负担性和可及性。2008 年金融危机和 COVID-19 衰退对生育治疗和累计活产儿有何影响？
本研究检查了 1999 年至 2018 年美国每年的出生率、疾病控制与预防中心体外受精（IVF）周期活动和活产数据，涵盖了 3286349 个治疗周期，以估计 2008 年金融危机后 IVF 周期数量的减少，并对 2020 年至 2023 年的 IVF 周期活动和累计活产儿进行了前瞻性定量建模。
2008 年的金融危机导致生育治疗出现了 4 年的停滞，预计 IVF 周期将减少 53026（95%置信区间[CI] 49581 至 56471）个，活产儿将减少 16872（95%CI 16713 至 17031）个。类似规模的经济衰退将导致 2020 年至 2023 年 IVF 周期减少 67386（95%CI 61686 至 73086）个，35 岁以下的女性总体上减少 22504（95%CI 14320 至 30690）个周期，而 40 岁以上的女性减少 4445（95%CI 3144 至 5749）个周期。这相当于 IVF 活产儿总数减少 25143（95%CI 22408 至 27877）个，其中只有 490（95%CI 381 至 601）个预计发生在 40 岁以上的女性。
COVID-19 衰退可能对美国年轻女性的 IVF 活产率产生深远影响，进一步加剧总生育率的持续下降。
