The pandemic aggravates the already worrying decline in the birth rate in Spain

S. F.

MADRID

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The arrival of the Covid-19 pandemic has affected the birth rate, as it is expected to fall between 5 and 10 points this year, as revealed during the ‘Innovation in Fertility’ meeting, organized by the company Merck, with the participation of the Spanish Fertility Society (SEF), the Association for the Study of Reproduction Biology (ASEBIR) and the Higher Council for Scientific Research (CSIC), coinciding with the celebration of World Fertility Day, which is celebrated this Friday.

This reduction has been due, fundamentally, to the decision of the families to postpone the search for a child until the end of the pandemic and to the impossibility of going to the assisted reproduction units during the months of confinement, which caused the births to fall. up to 20 percent during December 2020 and January of this year.

According to World Health Organization, infertility is a disease of the male or female reproductive system defined by the inability to achieve a pregnancy after 12 months or more of regular unprotected intercourse. According to the latest data from the Ministry of Health, 9 percent of Spanish babies are the result of assisted reproduction, which positions Spain as one of the leading countries in this type of treatment. “We can boast of being one of the leading countries in assisted reproduction in the world. This is possible due to a more permissive legislation than in other countries and to an excellent technical and care quality in our breeding centers ”, comments ASEBIR’s president, Dr. Antonio Urríes.

Covid-19 and birth rate

Since the state of alarm was decreed until its reopening at the end of April 2020, approximately 14,000 assisted reproduction cycles were stopped and, as a consequence, after 9 months, about 4,000 fewer children were born in Spain, according to estimates by SEF and ASEBIR.

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Until the arrival of the pandemic, 1 in 10 births occurred thanks to assisted reproductive techniques. However, the health crisis caused by the virus implied a significant reduction in the number of cycles carried out, with the consequent impact on the birth rate. For this reason, the director of the Institute of Economy, Geography and Demography of the CSIC, Diego Ramiro, points out that «the first effect is the reduction of fertility due to an increase in the age of older couples; second, the economic crisis generated by Covid-19 will cause a drop in fertility similar to what we already experienced in the 2008 crisis; And third, the number of couples without descendants will grow, so that when these people reach old age they will not have the same family network around to take care of them in case they need it, and there will be a greater demand for social and health assistance resources in the future. ».

Viruses and gamete quality

The current low birth rate could continue to decline if quality information is not provided to those who are considering having a child through fertility techniques, reducing their fear of doing so during the pandemic. “To date, there is no scientific evidence that makes reference to the affectation of the gametes (ovules and spermatozoa) by the virus. In fact, according to the latest published works, the risk of finding viral particles in the ejaculate or in the testicle can be considered very low or null. Nor has viral RNA been found in the oocytes of patients infected by SARS-CoV-2 “, says Dr. Urríes.

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Regarding the compatibility between fertility treatment and vaccination, this specialist assures that “there are no reasons to postpone or cancel the performance of a technique of reproduction assisted by the vaccine”, therefore he recommends that “patients are vaccinated when they are corresponds according to their vaccination schedule, without this having to interfere with their treatments.

Older and better informed patient

The profile of the patient who currently attends assisted reproduction clinics are women who are older than 10 years ago. Before, the average was 35 and now it is close to 39 years. According to the president of the SEF, Luis Martínez Navarro, this makes pregnancies difficult. “There is also an increase in patients without a male partner who, in addition, tend to be of high age,” he points out. “When looking for the first child at an advanced age, sometimes there are problems to get the second child, since it can coincide with the end of the reproductive stage, when fertility is exhausted,” he adds.

In addition, access to information on assisted reproduction processes has increased for those who need to use them. «The current patient is more informed, but sometimes also misinformed, and that is why it is important to always trust the specialist. In addition, they attach great importance to the safety of the treatment and, as it should be, they are very demanding with the quality of the treatment, ”says Martínez.

Reduce interference in the life of the patient

“Human assisted reproduction laboratories possibly represent the area of ​​biomedicine that incorporates more technical and scientific advances year after year,” says Dr. Urríes, “advances that have resulted in more information, better decision-making and greater security in procedures, ”he explains.

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With increasingly abundant and better technological possibilities, “the work must now focus on ensuring that the process adjusts as much as possible to current demands and needs, which includes introducing digital solutions that allow greater control of patients in remote control and greater flexibility to make this process interfere as little as possible in their daily life, ”says Julio Varela, director of Merck’s Fertility Unit. In fact, the Merck survey ‘First steps towards motherhood’ sheds light on this, revealing that 7 out of 10 patients would have liked to have more contact with their doctor during the process.

The assisted reproduction process has a great emotional implication for the patient or the couple. During the treatments, there are ups and downs and episodes of stress, an emotional drain that can be increased if these interfere with the daily and work routine of the patient. The psychological component is precisely the main aspect to improve during assisted reproduction treatment for 41 percent of women who undergo these processes, as reflected in the Merck Survey “First steps towards motherhood”, referred to above.

At this point, different experts agree that, in assisted reproduction, the objective is to advance in a way that increases the rate of positive results (child at home), while improving the patient’s experience and reducing stress emotional that the process may cause. “I believe that technological solutions mark this path and we are heading towards it”, concludes Varela.

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