Reproductive Health in a Country with One of the World’s Lowest Fertility Rates


Over the past decade, the birth rate in Italy has consistently decreased, making it one of the countries with the lowest birth rates in the world but also one of the top reproductive medicine markets in Europe.

According to Italy’s national statistics office, births in Italy between 2020-2021 hit their lowest level since the unification of Italy in 1861. In addition to the country’s drop in fertility, Italians, as in other European countries, tend to postpone parenthood to a later age and while the average age of an Italian mother at childbirth in the 1990s was 29.9 years, in 2020 it was nearly two years older.



Recent PharmaBoardroom interviewees reflected on this alarming state of affairs. Jan Kirsten, Managing Director & President of Merck Italia told us: “… Italy is the country that struggles most with live births in Europe. It is far below European averages, with the over-age component being extreme as well. A very important root cause of this … is that if couples who want to conceive get too old, then natural conception is not working. And if we do not take that on in Italy, all together, I mean institutions, companies like Merck, as well as academia, we will get a bigger problem, a socio-economic problem.”

Perhaps because of these challenges, reproductive medicine in Italy is a space with huge potential. “Italy is one of the top four markets for reproductive medicine in Europe. There is Spain, which is one of the centres of reproductive health in the world, Germany, France, and Italy. It is indeed a large market,” said Federico Gomes de Freitas, General Manager Italy – Ferring Pharmaceuticals in a recent interview.

Compared to the birth rates around the world, Italy is one of the 20 countries which registered the lowest fertility rate in 2021. The leader of the global ranking was Taiwan, with an average of 1.07 babies per mother.

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