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Human fertility does not decline: evidence from Sweden
O Akre1, S Cnattingius, R Bergström
1Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. olof.akre@mep.ki.se
Fertility and Sterility
|June 9, 1999
Summary
Human fertility improved significantly over time, with fewer cases of subfertility (involuntary childlessness) observed in recent birth cohorts. This trend is linked to factors like education and potentially the eradication of gonorrhea.
Area of Science:
- Reproductive health
- Epidemiology
- Demography
Background:
- Human fertility patterns are influenced by various societal and medical factors.
- Understanding temporal trends in fertility is crucial for public health.
- Subfertility, defined as involuntary childlessness, impacts reproductive health and family planning.
Purpose of the Study:
- To analyze changes in human fertility over time.
- To investigate the risk of subfertility across different birth cohorts and demographic factors.
Main Methods:
- Utilized time-trend analyses and age-period-cohort modeling.
- Included 401,653 primiparous women aged 20 years or older in Sweden (1983-1993).
- Defined subfertility as one year or more of involuntary childlessness.
Main Results:
- Subfertility risk significantly decreased in successive maternal birth cohorts.
- The risk of subfertility increased with maternal age.
- Higher levels of formal education were associated with a decreased risk of subfertility.
Conclusions:
- Favorable developments in fertility are evident, outweighing potential minor decreases in male fertility.
- A decrease in secondary subfertility, possibly due to gonorrhea eradication, is proposed as a primary explanation.
- Public health initiatives and educational attainment appear to positively influence fertility outcomes.