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Governments ‘fail to to address’ declining global fertility rates, warn doctors

While there have been advances in fertility care, doctors have said that equity remains a challenge across countries, cultures and economies



The global fertility rate is declining and most governments are failing to recognise and address the impact on economies and societies, a group of doctors has warned.

Not including the effects of migration, many countries are predicted to have a population decline of more than 50 per cent from 2017 to 2100, the doctors wrote in a new paper, published in Human Reproduction Update

“By 2050, 77 per cent of predominantly high-income countries, and by 2100, 93 per cent of all countries will have a total fertility rate below the replacement level of 2.1 children per woman,” the paper’s authors, who included fertility specialists from Australia, Chile, Denmark, Egypt, Greece, The Netherlands, South Africa, Switzerland, the UK and the US, added.

With underpopulation becoming a great concern in an increasing number of countries, the paper aimed to provide recommendations for what governments, policymakers, companies, healthcare professionals and patients could do to address infertility risk factors and make fertility care more affordable and accessible.

“Choosing to have a family is a human right,” said Bart CJM Fauser, co-first author of the paper, scientific director at the International Federation of Fertility Societies (IFFS) and professor emeritus of reproductive medicine at Utrecht University.

“However, access to fertility care is often unaffordable, inaccessible, and inequitable and that needs to change.”

The authors pointed out that there had been “major advances in fertility care that have dramatically improved family building opportunities over the last three decades,” but equity remains a challenge across countries, cultures and economies.

Edgar Mocanu, IFFS president, said: “The good news is that infertility is often preventable. A simple step is offering balanced fertility and contraceptive education so that everybody can decide when to prevent pregnancy and when it is ideal for them to start a family, if they choose.”

One in six people of reproductive age grapple with infertility and the problem affects women and men equally. Some sexually transmitted infections, smoking, excessive alcohol intake, obesity and poor nutrition could negatively affect both male and female fertility, the physicians wrote.

Alarmingly, infertility risk factors, such as air pollution and the proliferation of harmful and poorly regulated chemicals, are increasing, making it critical for policymakers to develop and implement policies that reduce environmental infertility risk factors.

Solutions to improving birth rates, the doctors said include “policy measures supporting families and working women” such as compensation for extended pregnancy leave and childcare, parental leave and increased access to assisted reproductive technology services (ART).

Dr Luca Gianaroli, IFFS director of education and former chairman of the European Society of Human Reproduction and Embryology, said: “While more than 10 per cent of all children are born with fertility assistance in some wealthy countries, there is great variation in access to care and the high cost remains a barrier across the board.

“A limited number of countries have started public funding of fertility treatment to mitigate falling birth rates and the IFFS is asking that more countries consider providing financial assistance for individuals needing fertility care.

“The economic benefits to society of providing fertility care clearly exceed the cost of treatment and these benefits will only increase as populations become more aged,” he added.

Sorina Mihaila is the Femtech World editor, covering technology, research and innovation in women's health and wellbeing.


Start-up raises US4.2m to address disparities in women’s mental health

LunaJoy Health seeks to address the complex needs of high-risk women



LunaJoy Health co-founders Sipra Laddha, MD and Shama Rathi, MD

The US telehealth start-up LunaJoy Health has raised US$4.2m in funding to address disparities in women’s mental health.

LunaJoy aims to eliminate inequalities in mental health and “redesign” the way women access care.

The platform, which offers mental health therapy, counselling and medication management, is developing care models that cater to underserved populations, providing care that seeks to address the complex needs of high-risk women.

The funding round, supported by Y Combinator, FoundersX Fund, Goodwater Capital, Magic Fund, VentureSouq, Nurture Ventures and NorthSouth Ventures, is hoped to help the company expand its capabilities and close disparities in maternal health care.

“The support from our investors, coupled with the current focus on maternal health improvements through TMaH funding, sets the stage for the change we need to see so badly across the industry,” said Sipra Laddha, co-founder and CEO of LunaJoy Health.

Mental health is a lifetime pursuit, and we want to design a way to engage and support women with a variety of needs and varying degrees of risk.

“By using technology, we can measure and treat symptoms more effectively, delivering a better service model to meet rising demand and a shortage of therapists in the US.”

This financial and strategic support, Laddha said, will help LunaJoy roll out its “novel” integrated care programme, LunaCare, across select communities in need of maternal mental health.

The investment will also facilitate the integration of advanced technology solutions to enhance care coordination and patient monitoring.

Surbhi Sarna, partner at Y Combinator, said: “LunaJoy Health’s mission to bring a new standard to maternal health care for Medicaid mothers aligns perfectly with our goal of supporting scalable solutions to the world’s most pressing challenges.

“We are proud to back such a vital initiative that promises significant impact.”

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New survey to ‘amplify’ marginalised voices in healthcare decision-making

UK charities enter partnership to address gender gap and advocate for inclusive healthcare policies



The gynaecological health charity Cysters and Endometriosis UK have announced a partnership to amplify women’s voice in healthcare decision-making.

Despite progress in healthcare data collection, there remains a gap in representing the experiences of marginalised groups, particularly for those impacted by conditions and diseases like endometriosis.

Decision-makers in Parliament and the NHS often rely on data and statistics to inform policy and resource allocation. However, these datasets may not accurately reflect the experiences of marginalised communities.

A recent report from Endometriosis UK that gathered data on the experiences of being diagnosed with endometriosis in the UK found that whilst the ethnicity of respondents who identified as ‘white’ was proportionate to the data collected in the Census 2021, the remaining data was not illustrative of the ethnic diversity of the UK, with 15 per cent of respondents choosing not to respond to the ethnicity question.

To address this gap and advocate for inclusive healthcare policies, Cysters and Endometriosis UK are launching a new survey initiative aimed at amplifying the voices of marginalised groups in healthcare decision-making.

“We know that the current statistics are not inclusive of all communities, particularly marginalised groups,” said Neelam Heera-Shergill, founder of Cysters.

“By encouraging those from marginalised communities to share their experiences through this survey, they will be helping us to advocate for the changes that are needed, backed by evidence from their communities.

“In addition to delving into the diagnosis journey for people of colour and the unique barriers they encounter. We aim for this research and findings to pave the way for additional funded research on all menstrual-related conditions affecting people of colour.”

The survey seeks to gather insights into the experiences of marginalised communities, particularly concerning conditions and diseases like endometriosis.

Participants are encouraged to share their experiences openly and honestly, knowing that their responses will contribute to shaping more inclusive healthcare policies.

Sarah Harris, a researcher at Cysters, said: “We urge everyone to participate in this survey and share it far and wide. Together, we can ensure that all voices are considered in the conversation surrounding healthcare policy and resource allocation.”

The survey is anonymous and takes approximately 15 minutes to complete. To participate, visit Delayed Diagnosis of Endometriosis Among People of Colour in the UK Survey.

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Menstrual care start-up launches period equity initiative across college campuses

The initiative is hoped to facilitate access to period care and educate students on the use of more sustainable products



Cherie Hoeger, founder and CEO of Saalt

The US menstrual care start-up Saalt has launched a new initiative aimed at addressing period poverty and environmental sustainability.

The Period Equity Initiative aims to reduce 100 million tampons from the environment while combatting period poverty.

Institutions, including Harvard University, Vanderbilt University, Northwestern University, the University of Utah and the University of Nebraska, are already participating in the programme.

One in five female college students in the US have had to decide between buying period products and paying for other basic essentials like food and other bills according to a nationwide survey.

The initiative, a direct response to the demand for more units for student populations, underscores the issue of period poverty, which affects students across America, challenging the misconception that it is solely an “overseas problem”.

Saalt aims to make period care accessible and affordable through the subsidisation of reusable period products, such as cups, discs, and period underwear, to participating universities and their campus affiliates.

The project is hoped to not only facilitate access to period care, but also educate students on the use of more sustainable products, which are designed to be reused rather than discarded.

“Every day we hear from customers about how life-changing Saalt cups are for them,” said Cherie Hoeger, founder and CEO of Saalt.

“Creating period equity and managing the environmental impact created by disposables are pressing matters that demand urgent attention and innovative solutions.

“Through our Period Equity Initiative, we’re taking a proactive approach to tackle these challenges by leveraging our expertise and aligning with universities across America to make a big impact closer to home.”

The Period Equity Initiative, Hoeger added, furthers Saalt’s commitment to making period care more affordable, accessible and sustainable.

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