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Only a minority of countries provide required advance fertility treatments in Europe

Form the mid-1960s, European counties have been facing a steady decline in fertility rates. And thou advanced treatments are now available, only a minority of states offer the much needed cycles to cover the demands. 

Fertility rates steadily declined in European states starting with the mid-1960s. At the turn of the century, things started looking up only to go back down again a decade later. In 2010, Europe became the continent with the lowest fertility rates, measured as number of children born to each women. The numbers were so low that demographically speaking, Europe was no longer able to assure the replacement rate and was losing its population, fast.

Scientists looking at the data found not only that women were having fewer children but also, some of them did not want any children, while others were delaying starting a family and having babies.


The changes in social norms and the pressure of the economic environment have been found to be the leading causes when it comes to the changes brought to the demographic trend. And this is not common only to Europe but the decline can be felt in all developed and developing nations.

Countries, especially those in Western Europe have started promoting financial aids to help families with growing numbers of children and even promote having more than one offspring. Paid family leave, granted to mothers as well as fathers is just one such example.

States also offer support for women that decided to conceive later in life as many of them needed access to advance fertility treatment.

Spain, leading the way in offering treatment

Fertility treatment in Europe
source: 123rf

One country in particular, according to the European Society Of Human Reproduction And Embryology, stands out in particular when it comes to offering the much needed treatments. In Spain, a record 109,275 treatment cycles were performed, including IVF, ICSI, egg donation and intrauterine insemination (IUI). The number is higher than that recorded in France, the former front runner, indexing 90,434 treatment cycles.

The results presented by the ESHRE cover a total of 707,171 treatment cycles performed in 2014 and 146,232 babies born – and represents the largest and most accurate snapshot of ART in Europe.

“We began monitoring IVF in Europe in 1997,” said EIM Chairman Carlos Calhaz-Jorge, “and the rate of multiple pregnancy continues its slow but steady decline. Success rates seem to have stabilised, although outcome in egg donation and with use of frozen embryos is still moving upwards. The biggest upwards movement, however, is from treatments with frozen eggs, which have been revolutionised by the widespread introduction of vitrification.”

European countries, despite the fact that ICSI are proven to be more efficient, still largely offer IVF treatments but coverage of advanced fertility treatments are still patchy throughout the continent.


States like Denmark, Czech Republic, Belgium and Slovenia offer up more than 2000 treatment cycles per million population, while others, such as Malta, Portugal and Italy, offer considerably fewer.

One study calculated that the global need for advanced fertility treatments was around 1500 cycles per million population per year and the vast majority of European countries still offer way less than that.

Fertility tourism

Fertility treatment in Europe
source: 123rf

And there are also wide spread differences between how countries actually cover the costs of fertility treatments. Some might limit recipients given their age while other authorities might only cover the partial costs. In the end, the bill for receiving the treatment needed in order to get pregnant can reach thousands of pounds, especially if a woman needs several treatments.

This paved the way to fertility tourism, mostly bringing patients from the West to Central and Eastern Europe where treatments are less costly. But for those living in these states, the costs are still strenuous for middle income families.

According to Fertility Clinics Abroad, a 2016 price comparison showed that an IVF treatment in Britain might cost around £4782 while in Cyprus, a patient will pay around £2517. In Spain, the country that leads the charts in offering advanced fertility treatment, the bill will be of £3723. Even cheaper than Cyprus, the Czech Republic offers treatments at only £1795. At this price is no wonder that the country has 20 clinics specializing in fertility.

And while the differences in costs are high even within the European Union, states form outside the EU have also become increasingly popular when it comes to fertility tourism. Turkey but also India and Brazil are popular destinations for couples looking to conceive.
Ukraine, with over 19 fertility clinics is also a popular destinations, especially as the country accepts surrogacy and also allows older women to conceive via egg donation.

Sylvia Jacob