Racing Against Time: Integrating Assisted Reproduction into European Natality Policies

Europe faces an accelerating demographic shift driven by several factors, including persistently low birth rates and delayed parenthood, resulting in population ageing and shrinking reproductive potential.While natality policies have traditionally focused on family benefits, gender equality, and work-life balance, these measures alone are insufficient to reverse fertility trends.The postponement of childbearing reduces natural fecundity, increases adverse perinatal risks, and heightens demand for assisted reproductive technologies (ART).However, ART success rates decline sharply with age, and access remains uneven due to regulatory restrictions, age limits, and financial barriers.Significant cross-country disparities in ART utilization stem from varied funding models and eligibility criteria, challenging the principle of universal health care.This article argues for the strategic integration of ART into natality policies, framing infertility as a public health issue.It outlines priority actions: dedicated funding for public ART centers, investment in laboratory technology, a national data registry, centralized waiting list management, establishment of a public gamete bank, promotion of research, and uniform referral criteria.Such measures aim to ensure equitable, efficient, and transparent access while safeguarding financial sustainability.