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Reproducing Anachronism: Ageing, Fertility and Inequality in Reproductive Governance.
Giulia Cavaliere1, James Rupert Fletcher2
1University College London, London, United Kingdom.
The Journal of Medicine and Philosophy
|May 21, 2026
Summary
Current fertility service governance, based on age and cause, perpetuates reproductive inequality. Reforming these anachronistic restrictions is crucial for realizing reproductive aspirations and promoting equal opportunity.
Area of Science:
- Reproductive Health
- Sociology of Health
- Public Policy
Background:
- Most countries restrict fertility services based on age and cause of infertility.
- These restrictions are increasingly misaligned with demographic trends and individual circumstances.
- Existing governance frameworks may hinder rather than support reproductive aspirations.
Purpose of the Study:
- To critically examine the governance of fertility services within the context of reproductive ageing.
- To argue that current age- and cause-based restrictions perpetuate inequalities.
- To propose reforms for a more equitable and responsive system of reproductive healthcare.
Main Methods:
- Analysis of demographic trends impacting women's reproductive lifecourse.
- Critique of existing age- and cause-based criteria for accessing fertility services.
- Examination of the social and policy implications of current governance models.
Main Results:
- Age- and cause-based restrictions on fertility services are anachronistic and inequitable.
- These policies fail to account for contemporary demographic realities and individual reproductive journeys.
- Current governance perpetuates constraints on achieving reproductive aspirations and exacerbates inequality.
Conclusions:
- De-responsibilizing infertility and reconsidering access restrictions are necessary.
- Reproductive aspirations should be recognized as a public good.
- Reforms are needed to ensure reproductive governance aligns with citizens' circumstances and promotes equal opportunity.
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