In this article, we will be taking a look at the 25 countries with the lowest fertility rates. If you do not want to learn about the global infertility market, head straight to the 6 Countries with the Lowest Fertility Rates.
Countries with the lowest fertility rates like Hong Kong, Macau, Singapore, and Taiwan, among others, exhibit a unique demographic trend that significantly impacts their population dynamics and socio-economic landscape. In countries experiencing declining birth rates due to factors like urbanization, women's access to education and careers, and shifting societal norms, policymakers face opportunities and challenges in areas like healthcare, labor force participation, and social welfare. Understanding these dynamics offers insights into future population trends and global demographics.
Global Infertility Market and Statistics
The global infertility market is a significant sector dedicated to addressing the challenges faced by individuals struggling with infertility. According to the World Health Organization (WHO), approximately 1 in 6 people globally are affected by infertility, accounting for around 17.5% of the adult population worldwide. This high prevalence underscores the urgent need to enhance access to affordable and high-quality fertility care for those in need.
Major players in the infertility treatment market include Thermo Fisher Scientific, Cook Group, Vitrolife, and other leading companies. The rising infertility rates worldwide, coupled with the increasing demand for infertility treatments, are key drivers fueling market growth.
The WHO report highlights that millions of people face catastrophic healthcare costs due to seeking infertility treatment, making it a major equity issue and a medical poverty trap for many affected individuals. In the United States, major cities like New York, Los Angeles, Chicago, and San Francisco are known for their numerous fertility clinics and advanced reproductive technology centers. These urban hubs attract patients seeking infertility treatments such as in vitro fertilization (IVF) and intrauterine insemination (IUI). Financially, the global fertility services market was valued at USD 22 billion in 2022 and is expected to reach USD 68.32 billion by 2032, growing at a CAGR of 12% from 2023 to 2032.
The Global Contraceptive Market: Trends and Insights
The global contraceptive market is a dynamic industry crucial for family planning and reproductive health. Key players such as Teva Pharmaceutical Industries Limited (NYSE:TEVA), Organon Group Of Companies, and Church & Dwight Co., Inc. (NYSE:CHD) dominate this sector. Segmented into contraceptive drugs and devices, the latter led the market in 2022 due to advanced and long-lasting options. However, significant growth is expected in contraceptive drugs, particularly pills, patches, and injectables.
Teva Pharmaceutical Industries Limited (NYSE:TEVA) is a leading player in the contraceptive market, known for its innovative contributions and commitment to women's health. They've launched educational initiatives like the "Perfectly Imperfect" campaign to dispel misconceptions about emergency contraception, partnering with MTV and Her Campus to provide accurate information about products like Plan B One-Step. Looking ahead, Teva Pharmaceutical Industries Limited (NYSE:TEVA) is expected to continue investing in research and development for advanced contraceptive drugs and devices, leveraging its strong presence in women's health and other medical fields. The company aims to enhance product offerings, improve brand visibility, and meet consumer demands for reliable contraceptive solutions. In terms of financial performance, Teva Pharmaceutical Industries Limited (NYSE:TEVA) reported revenues of $4.5 billion in Q1 2024, with GAAP diluted earnings per share at $0.41 and non-GAAP diluted earnings per share at $1.00. Operating activities generated $1,184 million in cash flow, with free cash flow reaching $1,486 million.
Church & Dwight Co., Inc. (NYSE:CHD) a leading player in the contraceptive market, is renowned for its innovation and dedication to quality. Through focused R&D and strategic partnerships, the company remains ahead of market trends. Its Q4 2023 financial report demonstrates remarkable growth, with a 6.4% increase in net sales, bolstered by strategic acquisitions. Notable for products like Arm & Hammer and Trojan condoms, Church & Dwight Co., Inc. (NYSE:CHD) continues to contribute significantly to the contraceptive industry. Moving forward, the company anticipates sustained growth, with a commitment to innovation and expansion into e-commerce and international markets.
When considering safety, certain contraceptive methods stand out. Intrauterine Devices (IUDs) boast success rates exceeding 99%, making them among the safest long-term options. Similarly, contraceptive pills, especially combined hormonal ones, exhibit over 99% efficacy when used correctly. Condoms, both male and female variants, remain effective in preventing pregnancy and sexually transmitted infections when consistently and correctly utilized.
In the United States, where approximately 1 million abortions are performed annually, the significance of contraceptive methods like IUDs and other birth control options becomes apparent. The North American contraceptive market was valued at USD 6.89 billion in 2022, with a steady projected growth rate of 7.7% during the forecast period.
In addition to traditional contraceptive methods, fertility treatments like In-Vitro Fertilization (IVF) play a crucial role. IVF, commonly employed by couples struggling with infertility, involves fertilizing eggs by sperm outside the body. According to the Centers for Disease Control and Prevention (CDC), in 2021, there were 413,776 ART (Assisted Reproductive Technology) cycles performed in the United States. out of 413,776 Assisted Reproductive Technology (ART) cycles performed, 167,689 were dedicated to egg or embryo banking, where all produced eggs or embryos were frozen for future use.
The success rates of IVF vary depending on factors such as the woman's age, the cause of infertility, and the clinic's success rates. The cost of IVF varies widely based on factors such as geographic location and individual clinic pricing. On average, a single cycle of IVF in the United States costs around $12,000-$15,000, not including medications or additional procedures. Many insurance plans do not cover the cost of IVF, although some states require insurance companies to offer coverage for infertility treatments. The global contraceptive market's size is expected to reach $45 billion by 2033, indicating substantial demand for fertility treatments such as IVF.
25 Countries with the Lowest Fertility Rates
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Our Methodology
For our methodology, we have ranked the countries with the lowest fertility rates based on the number of children born per woman in 2023. For the accuracy of data, we relied on the CIA.
Here is our list of the 25 countries with the lowest fertility rates.
25. Cyprus
Children Born per Woman: 1.48
Cyprus has made significant strides in maternal and child health, reducing infant mortality from 11.0 to 2.6 per 1000 live births between 1990 and 2016. Challenges persist, including high rates of preterm births and cesarean sections (57%). In Northern Cyprus, infant mortality is low (0.8 per 1000), but cesarean rates are high (47.6% - 87.0%), necessitating further research. Limited data exists on infertility rates in both regions.
24. Serbia
Children Born per Woman: 1.46
Serbia stands among the countries with the lowest fertility rates. Neonatal mortality rates have decreased, but preterm births remain concerning. There's a gender disparity in neonatal mortality, with males having higher rates. High abortion rates are attributed to easy access and limited contraceptive knowledge.
23. Croatia
Children Born per Woman: 1.46
Croatia faces low fertility rates at 1.46 live births per woman, impacting various aspects of reproductive health including infant mortality, miscarriages, abortions, and infertility rates. Infant mortality has declined to 4.6 deaths per 1,000 live births, reflecting healthcare and social support improvements. Miscarriages are common, affecting 10.8% of women.
22. Andorra
Children Born per Woman: 1.46
Andorra is one of the countries with low fertility rates globally and has made strides in healthcare, resulting in a remarkably low infant mortality rate of 5.047 deaths per 1,000 live births, with a -2.84% decrease from the previous year. Since the 1950s, infant mortality has decreased by 90.14%. Andorra also exhibits a low birth rate of 7.94 per thousand population and a death rate of 14.56 per thousand population, with a net migration rate of zero annually, reflecting unique population dynamics.
21. China
Children Born per Woman: 1.45
China is facing a significant decline in fertility rates despite implementing the universal two-child policy in 2016, with the total fertility rate reported at 1.3 in 2020. While infant mortality rates have improved due to advancements in healthcare, miscarriages and abortions remain common. Infertility affects around 18% of couples in China, leading many to seek IVF as a solution.
20. Belarus
Children Born per Woman: 1.45
Belarus faces challenges with low fertility rates, impacting infant mortality, miscarriages, abortions, IVF, and infertility rates. While significant progress has been made in reducing infant mortality, miscarriages and abortions remain common concerns. IVF is widely used for infertility treatment, with success rates falling within the global average range.
19. Portugal
Children Born per Woman: 1.44
Portugal stands nineteenth among the countries with the lowest fertility rates, impacting infant mortality, miscarriages, abortions, IVF, and infertility rates. Infant mortality stands at 2.5 deaths per 1,000 live births. Miscarriages affect 15-20% of known pregnancies, while around 16,000 abortions were performed in 2020. IVF is commonly used for infertility, with improving success rates. Approximately 1 in 6 couples face infertility, with IVF costs ranging from €4,000 to €8,000 per cycle.
18. Bahamas
Children Born per Woman: 1.44
The Bahamas faces significant health challenges, including high infant mortality rates and low fertility rates. The infant mortality rate fluctuates, reaching 16 deaths per 1,000 live births in 2016. The GDP per capita is $32,933 highlighting financial constraints.
17. Greece
Children Born per Woman: 1.4
In Greece, the infant mortality rate is low at 3.3 per 1,000 live births due to the country's robust healthcare system providing prenatal and postnatal care. IVF procedures are common and increasing in Greece, addressing infertility issues. The average cost of IVF ranges from €4,000 to €6,000, with varying insurance coverage options available.
16. Costa Rica
Children Born per Woman: 1.4
Costa Rica's total fertility rates have dropped to 1.4 children per woman due to factors like higher education levels and improved reproductive rights. While the country has reduced infant mortality rates, miscarriages remain a challenge. Legal battles surrounding IVF and abortion have marked Costa Rica's reproductive healthcare landscape, with IVF being legalized in 2017.
15. Japan
Children Born per Woman: 1.39
Japan faces a steep decline in fertility rates, reaching 1.36 births per woman in 2019, despite being a leading user of assisted reproductive technology (ART). The country witnessed a significant number of ART cycles (458,101) in 2019, with a shift towards frozen embryo transfer cycles. Miscarriage rates are age-dependent, rising with maternal age, particularly among women over 34 undergoing ART.
14. British Virgin Island
Children Born per Woman: 1.37
The British Virgin Islands face low fertility rates, indicating challenges in sustaining population growth. Efforts to reduce infant mortality reflect improvements in healthcare access. Engagement with IVF varies based on healthcare infrastructure and cultural attitudes.
13. Bosnia and Herzegovina
Children Born per Woman: 1.37
Bosnia and Herzegovina grapples with one of the world's lowest fertility rates at 1.37 children per woman in 2023, impacting population growth. The country reports an infant mortality rate of 5.21 deaths per 1,000 live births, emphasizing the need for robust healthcare infrastructure. Miscarriages and abortions are significant aspects of reproductive health.
12. Mauritius
Children Born per Woman: 1.35
Mauritius has seen a dramatic decline in fertility rates, dropping to 1.4 children per woman by 2019 due to factors like limited land space and increased female participation in the workforce. Despite this, the country has made progress in reducing infant mortality rates, now standing at 9.523 deaths per 1000 live births in 2024. However, challenges like unsafe abortions persist, causing an estimated 1,600 deaths annually. Mauritius' economy has grown following the decline in fertility rates, with a rising per capita income to $3380, but population dynamics have shifted, posing health challenges related to an aging population.
11. Montserrat
Children Born per Woman: 1.32
Montserrat's low fertility rates impact infant mortality, with higher risks of prematurity and infant morbidity. Assisted reproductive technologies like IVF are relevant, with associated risks in IVF-conceived pregnancies such as neonatal death.
10. Poland
Children Born per Woman: 1.31
Poland's low fertility rates, influenced by delayed childbearing due to women's educational and career pursuits, stand at 1.46 live births per woman in 2022, making Poland stand among the countries with the lowest fertility rates. The country faces significant challenges with infant mortality and preterm births, driven by factors such as maternal age, health conditions, education, and professional activity. Fertility treatments like IVF contribute to preterm birth rates, mainly due to multiple gestation births.
9. Spain
Children Born per Woman: 1.29
Spain has one of the lowest fertility rates in the EU, with an average of 1.23 children per woman. Assisted reproductive techniques are common, with IVF treatments ranging from €3,000 to €5,000 for embryo donation and €3,500 to €4,700 for egg freezing, excluding medication costs. Spain's infant mortality rate is a crucial indicator of child health. Miscarriages affect around 12% of pregnancies in Spain, with older women facing higher risks.
8. Puerto Rico
Children Born per Woman: 1.25
Puerto Rico faces challenges in infant mortality, with 134 infant deaths in 2021. Birth defects contribute significantly to these deaths. IVF usage in Puerto Rico is relatively low at around 0.2% of live births, with concerns about preterm birth and birth defects. Financially, the high cost of IVF treatments poses a barrier to access, alongside emotional and physical challenges.
7. Moldova
Children Born per Woman: 1.25
Moldova's fertility rate has slightly increased to 1.321 births per woman in 2024, though it remains low globally. Challenges persist in infant mortality, with 14.2 deaths per 1,000 live births, emphasizing the need for improved healthcare services. Access to safe and legal abortions is crucial for women's reproductive health. In vitro fertilization (IVF) offers hope for couples facing infertility issues.
