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Paul Yip

Tomas Sobotka

Bai Yiming

In the ongoing conversation about fertility and family planning, in vitro fertilisation (IVF) is often highlighted as a beacon of hope for the many couples grappling with infertility. The common argument is that it will help lift Hong Kong’s low fertility rate.
However, this is a false hope. The additional babies born because of widely accessible IVF comprise only a small percentage of the total births in countries such as Denmark, the Czech Republic and Israel.
The potential impact of IVF on the number of births is often overstated. IVF should not be seen as a readily available remedy for the challenges of a low fertility rate and declining and ageing populations. While it plays an essential role for many people aspiring to become parents, relying on IVF to boost birth rates is unrealistic.
IVF is a sophisticated medical procedure involving multiple stages – ovarian stimulation, egg retrieval, fertilisation and embryo transfer – and may require repeated cycles. This process offers a lifeline to those facing infertility, but success rates vary widely.
For women under 35 using their own eggs, the chance of a successful pregnancy is around 40 per cent per cycle. However, this chance shrinks significantly as women’s age increases, dropping to around 10 per cent for women over 40 and reaching close to zero by age 45. Men’s age also negatively affects IVF success rates, with the chances of successful pregnancy and delivery diminishing for couples where both partners are of higher reproductive ages.
The IVF success among women in their 40s can be dramatically improved when they use donor eggs from younger women or their own eggs frozen at a younger age. Even so, both options are fraught with practical and ethical issues and are costly and unrealistic for many couples.


These statistics underscore the urgency of timely intervention and highlight the importance of informed decision-making. Many prospective parents enter this journey with limited knowledge about the chances of success and risks, monetary and psychological costs.
This information gap can lead to unrealistic expectations and emotional turmoil. Gynaecologists, general practitioners and fertility clinics should prioritise clear communication, ensuring patients understand the entire journey and the risks involved.
Moreover, ethical considerations and honest advice about the stress prospective parents experience when they go through multiple rounds of IVF should be part of the equation. Couples should also not be rushed into opting for IVF when they still have a relatively high chance of achieving pregnancy naturally.
Rather than treating IVF solely as a medical procedure, we must position it within the broader context of social and health services. Fertility issues are societal challenges, reflecting trends that affect us all.


Couples should have access to affordable testing and IVF treatments as long as they have a realistic chance of achieving pregnancy. By integrating IVF services into comprehensive healthcare and social support systems, we can enhance accessibility and understanding.
While accessible IVF cannot lead to a sustained reversal in birth rates, broad financial support for IVF is crucial to alleviating the economic burdens that prevent many infertile people from accessing the most suitable treatment. Support for infertile couples should go beyond IVF provision. Consider the benefits of counselling services that address the emotional and psychological ramifications of infertility.
IVF must centre on protecting reproductive rights, emphasising that family decisions are a responsibility prospective parents share. Policies should empower both women and men, fostering a culture of mutual understanding and support. In many societies, gender stereotypes still prevail and infertility in couples is perceived as primarily a woman’s issue.
Men can be reluctant to undergo diagnostic examinations while their female partners often go through taxing tests. In reality, infertility is about as frequently a result of male as female-related factors. Countries such as Sweden have successfully promoted comprehensive education about reproductive health for all genders, resulting in a better-informed population.


It’s not enough to implement broad pro-natal policies aimed at increasing birth rates. Efforts should focus on removing barriers to achieving desired family sizes. Flexible parental leave, affordable housing and childcare can significantly ease the pressures that deter couples from having children.
In conclusion, while IVF is a crucial option for many, it should not be mistaken for a fix for population problems. Instead, we must foster an environment that encourages informed choices and respects the reproductive rights of all individuals.
By addressing the barriers to family planning and creating a culture of shared responsibility, we can build a society that values and supports the reproductive health of both men and women. Integrating IVF into a broader social services and healthcare framework will enhance accessibility, transparency and understanding, ultimately leading to more sustainable solutions to our population challenges.


The story begins …

Hong Kong’s new chapter

Hong Kong population

Expecting IVF to solve Hong Kong’s population problems is misguided

A technician fertilises eggs in a lab during the process of in vitro fertilisation. Photo: TNS

Hong Kong needs credible fertility policies, not baby photos in offices

A couple takes a selfie in front of a poster featuring a baby, during an exhibition of children’s products at the Hong Kong Convention and Exhibition Centre in Wan Chai on August 2. Photo: Xiaomei Chen

‘Freeze your eggs, free your career’: Hong Kong firm offers staff HK$280,000 baby incentive

Employees at Merck can be reimbursed up to HK$280,000 for treatments such as in-vitro fertilisation. Photo: Getty

Tony Cheng, managing director of Merck Hong Kong & Macau, says employees usually faced “an overlap between the prime periods for career advancement and childbirth rate”. Photo: Xiaomei Chen

Inside Asia’s multibillion-dollar baby-making industry, where little miracles don’t come cheap

The Asia-Pacific is fast running out of babies as birth rates plummet, causing demand for assisted-reproductive technology and fertility clinics to skyrocket. Photo: Shutterstock

IVF clinics have been sprouting up across the Asia-Pacific as couples look to have children later in life – reflecting wider social changes surrounding choice, economics and narrowing gender disparities. Photo: Shutterstock

Medical staff perform a fertility treatment at an IVF clinic in Bangkok. In vitro fertilisation is the most common type of assisted-reproductive technology used in fertility treatment. Photo: AFP

A baby lies inside a cot at a confinement centre in Singapore. Post-partum confinement – a prolonged period in which both mother and baby rest in seclusion – is common in Chinese and other Asian cultures. Photo: Bloomberg

A medical technician selects eggs for an IVF procedure. The treatment is complex, with only a limited chance of success. Photo: Reuters

Tube of eggs in cryogenic storage. Egg freezing limits the number of times a mother has to undergo egg-retrieval for subsequent ART treatments. Photo: Getty Images/Science Photo Library RF

A technician works at a fertility clinic in Kuala Lumpur. Malaysia is home to 10 of only 30 fertility centres certified by the Australia-based Reproductive Technology Accreditation Committee. Photo: AFP

A young mother feeds her baby in a park. Online support groups offer would-be parents guidance on fertility treatments and childcare. Photo: Shutterstock

Jacinda Ardern holds her baby daughter Neve in 2018. New Zealand’s former prime minister opened up about IVF and her struggles to conceive in her farewell speech to parliament last year. Photo: AFP

The birth of Hong Kong’s first test tube baby outraged the Catholic Church, calling it ‘artificial ma­noeu­vre to create life’

Hong Kong’s first test-tube baby, who was born in 1986. Pictures: SCMP

Dr Michael Tucker, Scientific Director of the in vitro fertilisation (IVF) centre at the private Hong Kong Sanatorium and Hospital, explains the fertilisation process of the territory's first test-tube baby at a press conference. The baby boy, who weighted 3.5 kilogrammes at birth, made his public debut without the presence of his parents earlier.

Opinion

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Hong Kong

Health & Environment

While IVF can be an important tool for infertile couples, it cannot take the place of broad social and financial support for hopeful parents


While IVF can be an important tool for infertile couples, it cannot take the place of broad social and financial support for hopeful parents.


Hong Kong society

Hong Kong healthcare and hospitals

Ageing society

Expresses the views, ideas and conclusions of the author. (Eg. Enough of Crazy Rich Asians, think of crazy poor Hongkongers.)


Expecting IVF to solve Hong Kong’s population problems is misguided

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}While IVF can be an important tool for infertile couples, it cannot take the place of broad social and financial support for hopeful parents

While IVF can be an important tool for infertile couples, it cannot take the place of broad social and financial support for hopeful parents