MINISTER of Health and Wellness Dr Christopher Tufton has endorsed suggestions made by a local fertility expert that alternative reproduction options, such as egg freezing and in vitro fertilisation (IVF), are worth exploring to address Jamaica’s drastically declining birth rate.

According to Jamaica’s Population Health Status Report 2000–2022 the country continues to face a low birth rate problem, with the total number of live births in the country declining sharply over the last 20 years.

Overall, the report said Jamaica’s crude birth rate, which is the number of annual live births per 1,000 population, declined by 10.2 percentage points from 21.7 per 1,000 population in 2000 to 11.4 per 1,000 population in 2022.

The country has also fallen below the replacement-level fertility rate of 2.1 for the first time, and is currently at 1.9.

Dr Sharifa Frederick, clinical director at the Caribbean Fertility Centre, reasoned that the decline is due to women or couples waiting longer to have children.

“Some couples want to delay having a child together because they want to be more financially stable, or some women want to find that right partner, and it takes time, so you have a lot of people who are trying to have a child in the older age group. They will, of course, be less successful than if they tried when they were younger, and so I believe that is one of the reasons why the birth rate has fallen. If we can now provide appropriate fertility services for the ageing population then I think we can turn around the declining birth rate,” she told the Jamaica Observer.

Egg freezing is a process in which a woman’s eggs are extracted, frozen, and stored as a method to preserve the ability to reproduce. When pregnancy is desired, a woman can thaw her eggs, fertilise them, and have them transferred to the uterus as embryos. On the other hand, IVF is a process that involves retrieving eggs from ovaries and manually combining them with sperm in a lab for fertilisation. The embryo is then transferred to the uterus. If a woman’s eggs are not suitable, she can receive donor eggs to help with the IVF process.

Dr Frederick stated that, in her experience, these procedures are popular among Jamaican women and couples in their 30s and 40s who are looking to have children but are experiencing challenges. If Jamaica invests in these services, the issue of an ageing population can be fixed.

Her comments were welcomed by Dr Tufton, who said that, over time, these alternative reproduction options may need to be explored.

“It’s not a conversation that has taken place within the Government per se, and certainly not in the ministry, but it happens here in Jamaica. Many Jamaicans go abroad and do it, and it happens elsewhere in the world, so it is not out of the agenda of conversations. From my perspective, based on all that is happening, as well as some of the health implications of women who may be affected with one thing or the other, it’s something that I think we should explore,” he told the Observer.

“The preservation of eggs or otherwise is something that is and has emerged more as a mainstream option than as an alternative or a rarely considered feature. The science of that has evolved and has become a lot better, and it has become a lot better not just because of the wants, but also the need because of the complications associated with child rearing and birth,” said the minister.

He noted that globally fertility rates are dropping because people are leaving child rearing until a later age, but there are also other factors to consider.

“In Jamaica, we have a challenge because we have seen a decline in birth rates. A decade or so ago, we were up to 40-plus thousand a year. We are now hovering around 30,000 because of other issues — cultural and economic issues, the movement of people across borders, migration as well as early onset of illness and non-communicable diseases in particular. These are reducing the child-rearing numbers and challenging over time the population, which has social and economic implications,” said Dr Tufton.

“The point is, if you were to argue the issue within that context, both science as well as socio-economic reasons, then the policy response would have to adjust to deal with some of that reality. Some of that policy response may be to encourage more child rearing if people can afford it, so it can be a communication issue,” he reasoned.

Dr Frederick noted that while alternative options, such as IVF and egg freezing, are expensive, there are some countries where the procedure is covered by insurance. However, that is not the reality in Jamaica.

“I think if the insurance companies were to buy into this and provide coverage for infertility care, then it would be more affordable for persons to access fertility care. If these insurance companies were to come on board with us and recognise infertility as a chronic disease, just like hypertension and diabetes, then we could really adjust the birth rate issue,” she said, calling on the Government to also take action.

In response to questions about subsiding the procedures, Dr Tufton said, “I am not sure we are there yet. That conversation would have to be had, but is it something that we think represents an important option.”

Minister of Health and Wellness Dr Christopher Tufton. Photo: JIS

Dr Sharifa Frederick, clinical director at the Caribbean Fertility Centre.