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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.
I do think there are some technological solutions, but many of them have nothing to do with pregnancy. From my perspective as a stay at home dad and parent of 3, in a neighborhood full of kids, I think most parents are accurately estimating the number of kids they can have and then having that many kids.
Shout-out to @HereAndGone2's post below pointing out the difficulties involved in potential surgery options. Throwing out surgery options feels easy, but actually going through with it is generally scary.
I'll go through the list of blockers and how I think Tech is impacting them:
I'll just end with the general observation that if you give parents more money but there aren't areas where they can trade money for more time then the money doesn't help them. As a single person you might think of money as the incentive in and of itself. But the calculations change a bit when you are a parent. Money is fully a means to an end. The ends being providing childcare, and enjoying your children. Technology that allows for that tradeoff is good. Technology that cheapens that tradeoff rate is great. Technology that adds a new time burden as part of the rat race or through regulation is terrible.
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