Educate. Empower. Reproduce. A call for action against the demographic winter

Global birth rates continue to be on a steady decline, falling below generational replacement levels in many countries, despite the implementation of national pro-natalist policies. Combined with longer life expectancy, this leads to the social and economic consequences of an ageing society supported by a shrinking pool of working-aged people. Age-related fertility decline is a key factor contributing to this situation, compounded by demographic and societal influences as well as individuals' life choices. The aim of this short article is to highlight the need for wide-ranging fertility educational initiatives to increase awareness of the impact of ageing on fertility, and to encourage collaboration among policymakers, healthcare providers and fertility specialists to improve access to evidence-based quality fertility care. Key factors influencing the current trend in birth rates are summarized and a range of responses are proposed, with some examples of recent initiatives, to address the need to improve birth rates and recover generational replacement-level fertility.