Births following assisted reproductive technology double among older women in Scandinavia

Births resulting from assisted reproductive technology among women aged 40 to 49 years doubled from 2008 to 2018 in Denmark, Norway and Sweden, according to a study published in Acta Obstetricia et Gynecologica Scandinavica.

Researcher Ingela Lindh, MD, of the department of obstetrics and gynecology at Sahlgrenska Academy at Gothenburg University in Gothenburg, Sweden, and colleagues examined the total population of women in this age group, averaging approximately 1.5 million, using data from national health and prescription registers on birth, induced abortion and hormonal contraceptive use.

All three countries saw gradual increases in births following assisted reproductive technology (ART) during the study period. Demark saw the greatest increase, from 0.71 to 1.71 per 1,000 women. Sweden’s rate increased from 0.43 to 0.81 per 1,000, and Norway’s rate rose from 0.25 to 0.53 per 1,000 women.

Birth rates increased as well among women aged 40 to 44 years, from 9.5 to 12.3 per 1,000 in Denmark and 11.7 to 14.3 per 1,000 in Sweden but remained stable in Norway at approximately 11 per 1,000. Among women aged 45 to 49 years, birth rates showed a small increase in all three countries.

The use of hormonal contraception increased in all three countries as well. Among women aged 40 to 44 years, it rose from 24% to 31% in Denmark, 22% to 24% in Norway and 27% to 30% in Sweden. Among women aged 45 to 49 years, it increased from 15% to 22% in Denmark, 11% to 17% in Norway and 17% to 24% in Sweden.

Levonorgestrel-releasing intrauterine devices (LNG-IUDs) dominated hormonal contraception use among women aged 40 to 44 years in all three countries and was most common among women aged 45 to 49 years, with a clear increase in use in all three countries.

Induced abortion rates generally were low in Denmark and Norway among women aged 40 to 44 years, the researchers said, though Sweden saw a 30% to 50% increased rate between 2008 and 2013.

Among women aged 45 to 49, induced abortion rates decreased from 2.9 to 2.6 per 1,000 women in Denmark and from 2.6 to 2.2 per 1,000 women in Norway, while they increased in Sweden from 7.7 to 8.1 per 1,000 women.

These results are in line with trends indicating postponed childbirth, the researchers said. Also, LNG-IUDs enable women to plan and postpone reproduction, while ART helps women realize fertility goals at the end of their reproductive period, the researchers added.

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