Becoming parents today 2015: the point of view of medical specialists in Italy
Low birth rate: Italians do not know much about infertility and its cures – say medical specialists.
Our country is afflicted by a serious problem: a low birth rate. This is the opinion of 88.7% of polled gynaecologists, andrologists and urologists, who believe that the low propensity of Italian to have children is largely owed to financial tightness (75.3% of respondents). 75% of these medical specialists also think that the economic crisis discourages couples from seeking assisted reproduction solutions to their problem. These are the highlights of the survey done in collaboration with CENSIS, the second on fertility and the companion piece of the one done last year on the general population. Again this time the findings provide useful insight into how things really are, with some surprises too, proving the value of surveys, and revealing aspects whose relevance had been underestimated.
One of these is the strong call for infertility and sterility screening programs for both men and women, at national and regional levels. Infertility is a serious issue in Italy and polled medical specialists emphasised the importance of raising public awareness about it, so that, on the one hand, people be encouraged to discuss the subject with their gynaecologist way before deciding to have a baby, and on the other hand, general practitioners bring up the discussion about it with their patients and provide first line counselling to them.
Let’s now examine the findings in more detail. In Italy, couples who had assisted reproduction treatments were 54,458 in 2012 (the year for which we have the latest official data), up 77% from 30,749 in 2005. Pregnancy was attained in 23.2% of those couples and 9,818 test-tube babies were born in 2012, up 169% from 3,649 in 2005.
Half of the medical specialists polled by CENSIS believe that infertility affects 20-30% of Italian couples versus World Health Organization estimates of 10-15% of couples. Infertility and sterility have grown, this is a firm belief of 91.3% of polled doctors. Half of the medical specialists think a couple should begin to worry after the first 12 to 24 months of failed attempts to conceive. However, 36% of them believe the couple should begin to worry earlier, after the first 6 to 12 months of failed attempts. 4.7% of those polled think it would help to bring it forward to the period within the first 6 months, while 9.3% would wait for at least 2 years. Among the general population, the percentage of those who think a couple should wait until after the first 2 years of failed attempts grows to 44%. Little less than half the medical specialists are of the opinion that the age at which a woman wishing to become a mother should begin to worry is over 35.
The majority of the polled sample said after 25 years of age is the right time to begin testing for possible infertility (the inability to carry pregnancy to term) and sterility (the inability to conceive). Those in favour of having regional and national infertility screening programs were 77.3% of respondents for women’s programs and an even higher percentage, i.e. 81.3% of respondents, for men’s programs.
Nearly half of infertility patients (46.6%) are treated at private practices, 39.7% at public-sector clinics and 13.7% at both of them. Almost 75% of medical specialists believe that couples with infertility problems tend to consult with more than one specialists before making a final decision about the one who will assume their care. 62% of medical specialists said their patients knew little or nothing about infertility, sterility and assisted reproduction techniques.
The vast majority (89.3%) of polled gynaecologists, andrologists and urologists stressed the importance of the legislation on assisted reproduction (Act 40/2004). And yet, they also emphasised the broad differences in its implementation in the various parts of the country. 88.7% of doctors underscored that the quality of assisted reproduction treatments is not the same in all Italian regions and that despite the statements of principles, ART treatments are not provided for free in all Italian regions (83..3% of respondents). In Italy, 54% of registered medical centres providing ART are private practices, a percentage that rises to 69% in the South of the country. 76% of medical specialists agree that Act 40/2004 should be reviewed. The first change to be made in the legislation should be the introduction of the possibility to use donor eggs or sperm (60.5% of respondents).
These are the main findings of ‘Becoming parents today: the point of view of medical specialists’, the research undertaken in collaboration with CENSIS in the hope that the insight provided by it will help take another step forward in informing both the large public and the medical community and raising their awareness.