The impact of assisted reproduction on fertility trends in the Czech Republic

Tereza Pachlová, Charles University in Prague
Boris Burcin, Charles University in Prague
Jirina Kocourková, Charles University in Prague

Over the last two decades, changes can be observed in reproductive patterns in the Czech Republic: a decrease in total fertility rate below replacement level and a continuous increase in the age of the mother at first childbirth. The combined continuous postponement of childbearing and decline in female fecundity with age is leading to an increase in the number of women seeking assisted reproductive treatment. Assisted reproductive technologies (ART) can be used to enable fertility in infertile couples or offset the decrease in fertility due to falling fecundity related to the postponement of childbearing. The aim of this article is to estimate the impact of ART on birth rates and on future demographic development in the Czech Republic. It will also analyse one selected aspect relating to the development of ART, and that is the proportion of multiple births. Further, it will assess the extent to which ART compensates for the fall in fecundity associated with the later age at which women attempt to give birth naturally. Ultimately, it will project the use of ART in the Czech Republic, showing the estimated share of ART on the future development of the total fertility rate and the proportion of children born following ART. In the Czech Republic, the proportion of children born following ART has recently been around the non-negligible level of 3.5 %. Our analysis of data from 2008 to 2012 shows that the importance of ART for the fertility rate increased simultaneously with an increase in the fertility rate until 2009. Assisted reproduction made the greatest contribution to the total fertility rate in 2009 and 2010. Moreover, the high proportion of multiple births resulting from an increase in the use of ART fell as efforts were made to reduce the number of embryos transferred in an assisted reproductive cycle.