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Peter Foreshaw Brookes's avatar

Thank you for this thought provoking piece. I have two concerns:

-There seems to be a risk that subsidising ART could incentivise people to postpone attempting to conceive. Whilst this is not a problem per se, it would straight away reduce the reproductive rate per unit time (in delaying parenthood), and therefore not be as effective at combating ageing population as the completed fertility effects would suggest. More notably, it also seems to me that many people, if they do delay believing that ART has them covered, would end up childlessness who would not otherwise - ART is still not that effective for older prospective parents and people have misinformed impressions of their efficacy. I worry about this unintended consequence.

-If we reach a point where a large number of people owe their lives to ART, and the bulk of these because of infertility, it seems to me that this will massively increase genetic risk factors for biological infertility. This has obvious issues for long run creation of human generation after generation.

Of course, I am sympathetic to infertility struggles that people have and I am not opposed to measures helping them. But I think it is worth considering these effects, so we can think of solutions. E.g., alongside ART subsidies could be information campaigns ensuring that people do not overestimate their effects. E.g., reliable PGS's for fecundity could enable embryo screening to offset the increase in genetic risk of infertility.

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