Childlessness, delayed childbearing and assisted reproduction in Australia

Abstract

The continuing postponement of parenthood is considered an important contributor to the overall decline in fertility that has taken place in high-income countries over the second half of the last century. Delayed childbearing implies that reproduction is concentrated in a narrower window and at ages when the biological capacity to conceive is lower because of the increase in infertility with age. Research on the factors that affect fertility recovery is still limited. This is an important topic for at least two reasons. First, parenthood remains a central life goal, with most people wishing to have at least one child, preferably two. Hence, it is essential for their wellbeing that they can fulfil these aspirations, even at older ages. Second, the ability of women who have delayed childbearing to fulfil their reproductive plans later in life can have important implications for overall fertility trends. Indeed, as fertility at younger ages continues to decline, a compensatory increase in fertility at older ages needs to take place to support fertility levels. The focus of this thesis is to understand and analyse the ways in which assisted reproduction, conceptualised as a contextual driver of fertility recuperation, affects fertility recovery in the context of delayed childbearing using Australia as a case-study. Information was gathered from a wide range of data sources: the census, population registries, social surveys, and clinical data repositories to answer both descriptive and analytical research questions. The variety of data sources used is considered a strength of this thesis, as it provides insights from a multitude of viewpoints. Demographic methods and tools, including survival analysis, decomposition techniques, and projections, are used to study the factors associated with delayed childbearing and childlessness, the contribution of assisted reproduction to current and future fertility levels and the barriers to its utilisation. The thesis has eight chapters. These include: an introduction in Chapter 1, conceptual framework, and literature review in Chapters 2, followed by five analytical chapters and a conclusion in Chapter 8. Each analytical chapter is organised as a self-contained piece of analysis, that, together with the other chapters, contributes to the understanding of how assisted reproduction affects fertility trends in the context of delayed childbearing in Australia. Chapter 3 analyses the change over time in the level of ultimate childlessness and completed family size of Australian cohorts of women by detailed categories of educational attainment. Chapter 4 provides an investigation of how life trajectories affect the likelihood of delaying childbearing and of remaining permanently childless among a sample of Australian men and women. In Chapter 5 the contribution of assisted reproduction to period fertility rates and in relation to parity transition is quantified. Chapter 6 provides an estimate of the contribution of assisted reproduction to future cohort fertility rates and of its implications for fertility recuperation. Chapter 7 evaluates how geographic proximity to fertility services and socio-economic status affect the likelihood of women undertaking infertility treatments. Chapter 8 provides a summary of the major findings of the analytical chapters, outlines policy implications and potential new venues of research, and speculates on the future trends regarding late and assisted fertility in Australia, and, more broadly, in low-fertility countries. Results from this work show that the potential for a decline in ultimate childlessness and for a stabilisation in fertility levels is low. In the present context of ongoing postponement of the steps leading to family formation, assisted reproduction may well increase its contribution to fertility rates in the future and become a crucial force behind the recuperation of births at older ages. Show more