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I've previously posted on the Motte about the Swedish state-funded Investigative Committee For a Future with Children (Swed. Utredningen för en framtid med barn) with instructions to look into the recent decline in fertility and suggest solutions to the problem. The fourth report dropped a few weeks back, this time focusing on involuntary childlessness and infertility: “Involuntary childlessness: prevalence, causes, treatment and consequences” As before, here's a link in case you know Swedish or want to use an AI to give you the uptake. https://framtidmedbarn.se/rapport/nr-4-ofrivillig-barnloshet-forekomst-orsaker-behandling-och-konsekvenser/
In contrast to the other three reports previously released, this one actually got some major government attention, and shorly after it was made public an extra investment into fertility treatments was announced. That's all well and good, and I'm sure it will help suffering couples – but I am also increasingly worried that the committee is losing the thread. These last two reports (the previous of which focused on economic differences between different family formations) have deftly dodged all the bigger questions at play in this crisis. Biologically-related infertility is obviously an exceedingly small cause of declining fertility, and in any serious discussion it must be pretty far down the list of priorities. I get the feeling this particular issue is getting a whole report's worth of attention not because it's key to a solution, but because it's conveninent and doesn't involve questioning anyone's life choices by wrestling with difficult and dangerous questions.
One of the difficult and dangerous questions I've wrestled with recently is a particular form of dissonance. It might surprise a few of you, but Sweden actually has an extensive Total Defense Duty (yes, literal translation) technically applicable to all Swedish citizens between the age of 16 and 70. Everyone and their grandma really is expected to make significant sacrifices, perhaps even give their lives, in the event of war. In the information pamphlet the government regularly sends out to facilitate crisis-preparation there's a classic mantra (in the more literal Sanskrit meaning of that noun, man-tra, i.e. support or instrument for the mind) that I think has been included since centuries back – alla uppgifter om att motståndet ska upphöra är falska – all reports that resistance is to cease are false. Liberty or death. Noble stuff!
Yet the most central part of ensuring the continued existence of a sovereign Swedish state, i.e. the creation of a new generation of Swedes, is apparently not even a moral, let alone a legal, duty on the part of the citizen? Everyone is expected to die fighting the Russians, but it's wholly acceptable to make choices whose aggregate consequences ends with Sweden going the way of the Dodo? That old Goldfinger-line pops into my head. "You expect me to have children?" "No, Mr. Bond, I expect you to die!" Really, what is the point of this gung-ho never-surrender sentiment, and for that matter all the increases in defence spending in Europe, if we're just going to allow death to conquer us all from within? There are ideas here which should be connected, yet they seem to lie strewn all about in disorder in a way that's both frustrating and disheartening to see.
Apart from that, I'm also not entirely sure unreservedly making it even easier to postpone getting children is truly the right way to approach this problem. Unpopular though it might be among certain cohorts to point out, the solution to declining fertility reasonably also should somehow involve convincing women to have children while they're still young; not enabling every pregnancy to be geriatric.
In short, the material focus in the debate is starting to worry me. I hope that the next reports will be a bit meatier and tackle the larger cultural and ideological questions at play.
I'm not going to get into the whole cultural debate around declining TFR or putative causes. I am painfully pragmatic, and what I intend to demonstrate is that there is a technological solution to the problem (the best kind of solution, mwah):
A country as wealthy as Sweden can circumvent the dysgenic concerns raised by @sleepyegg through embryo selection. The primary costs are the IVF itself, which should be in the realm of affordability for the middle class and above (who suffer disproportionately from reduced TFR). If not, I think any sane government should be willing to spend enormous sums of money to prevent population collapse.
You can screen for a lot of things, including strong proxies for health/mutational load. The screening itself is a trivial fraction of the cost compared to the egg extraction, freezing and IVF, and as mentioned it's the IVF that's the costly part.
Further, implantation success rates are remarkably stable even for older women. It's the age of the ova itself that matters, someone using eggs they harvested at 25 when they're in their late 30s is way more likely to succeed (for a given number of cycles) than that person using recently harvested eggs.
In other words, the uterus can handle things just fine for a very long time. The eggs continue to degrade the longer they stay in the ovary. You're already born with all the eggs you'll ever have if you're a woman, or as man, though that depends on when you last went to the supermarket. The success rate for implantation or the dysgenic effects of mutational load on the viability or overall health of the eggs/children increase precipitously once you're in your 30s. It's no coincidence that the risk of Down syndrome shoots up with increasing maternal age around that time.
The problem is, of course, that few governments have crossed the minimum sanity threshold to do these things. The fruit couldn't hang much lower without already being in the dirt.
Recommended reading:
https://www.lesswrong.com/posts/dxffBxGqt2eidxwRR/the-optimal-age-to-freeze-eggs-is-19
As a matter of fact, I would strongly recommend everything GeneSmith has ever written on the topic. I'd trust him to smith my genes, or those of my children.
Seems unworkable because while the process and technology is sound, the main barrier is individual lack of planning. Suppose you made IVF 100% subsidized and free, you still have to convince young women to undergo an invasive surgical procedure. Many women would probably delay it until it was too late to be worth doing. Countries like Israel which make heavy use of IVF have religious-cultural-social pressure for young women to bear children, so the women are more likely to freeze their eggs early.
Still, there would be some takers for free or partially subsidized IVF. Just need to convince the voting public it is worth the cost, a benefit for future generations that will not generate direct benefits for them.
Young women, the demographic known to be particularly fond of cosmetic surgery? Hmm..
The easiest answer is to
bribepay them. I expect plenty of takers if it's a $10k one-off, with heavy government encouragement.As far as I can tell, my proposal involves less demanding all-encompassing public propaganda or government intervention than any alternative I can name. Is it a perfect solution? Of course not, but praying away cratering TFRs might be cheap and also wouldn't work.
Well, I'd vote for $10k subsidies, but good luck to any politican who tries to get the public behind it. There would probably be serious opposition from women too old to benefit from it, and it would be reframed as a form of neo-patriarchal enslavement of wombs.
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It's no longer a technological solution and has become a social and political problem, so you're kind of back where you began.
Why not cut out the middleman and pay them $10k for their first baby, no IVF required? Or $10k for each baby born before whatever cut-off age where IVF becomes relevant. There's a few dials you can adjust there and it seems like less government involvement and propaganda required than adding in the IVF step.
I wish to note that my proposal is not mutually exclusive with anything you've said.
What differentiates $10k for egg-harvesting from a direct reward for natality?
So the real target for my proposal are people who want kids, but have a tendency to postpone things till it's way too late. At that point, having eggs preserved (preferably from way earlier) would be an absolute godsend. To contrast, if they wanted to get the $10k for the child then, it's far more likely that it's too late. That's true regardless of how badly they want the kids.
The benefit of the wider embryo-selection policy is that avoids or minimizes dysgenic effects. Even if $10k means a lot more to the poor, you can still screen and select for the higher quality potential children. Conveniently, the same markers that promise general good health also correlate positively with IQ. Follow the LW link for a better exploration of that point. You don't even need to do the politically difficult thing of actively selecting for IQ, you can just say you want healthier kids (by pretty standard definitions of health) and get IQ points as a happy little accident.
And even if there's no embryo selection? Well, at least we have good eggs for the IVF. That should make a difference. There's plenty of other things you could reasonably try, but I'm not writing a policy whitepaper here.
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