Changing families and sustainable societies: Policy contexts and diversity over the life course and across generations

Principal Investigator: Melinda Mills


The objective of this project is to examine the changing role of children, with a specific focus on the rise, determinants, and societal consequences of assisted reproduction, late fertility, and childlessness. The project is located within the large-scale integrating project “Families and Societies—Changing families and sustainable societies. Policy contexts and diversity over the life course and across generations,” ( coordinated by Stockholm University. The collaborative research project is financed in the European Union’s Seventh Framework Programme.


Our project focuses on the recent and striking fertility trend within Europe, the rapid diffusion of various types of assisted reproductive technologies (ART). The state of research, however, has not yet adequately addressed the demographic, regulatory and economic aspects of ART and the longer-term societal consequences. We extend existing knowledge by focusing on the following advances:

1) Assessing differences in the regulatory and economic availability of ART across Europe. Previous studies have shown that there is considerable variation in both the regulation and financing of ART across Europe, with the cost of ART treatment largely a reflection of the national healthcare system costs, government subsidization, and insurance regulations. Current research has lacked a comprehensive comparison of these institutional components and the consequences for utilization and filiation.

2) Relating availability and costs to utilization and inequality. A further extension is the link to the availability and costs of ART to utilization and to aspects of inequality. Our central hypothesis is that in countries where ART is expensive or less subsidized, individual demand for these services will not be met or only met for those who can afford them.

3) Going beyond general ART figures in Europe to an in-depth examination of the demographic dimension. Although ESHRE, the European Society of Human Reproduction and Embryology, produces regular reports about ART use in Europe (, they remain general and miss the demographic dimension and larger societal implications. The demographic dimension of ART has been virtually ignored. This WP will examine new aspects including: age patterns of ART attempts over time, rapid decline in treatment success after ages 38–40 and cumulated treatment success over a cohort’s lifetime to identify childless women who undergo treatments without success.

4) Examining the societal consequences of ART. The societal implications of ART have been under-researched, demanding the need to examine the link of ART to observed births and fertility rates, linking ART to the ongoing rise of childbearing at later ages, rise and decline of multiple births and relationship to legislation and recommendations, and examination of sex selection and/or unusual sex ratios at birth after ART.

5) Addressing uncertainty about filiation (i.e. judicial condition of being a child of certain parents). There will also be progress to address the growing public debate and policy concerns for more coherence in national laws to regulate or legislate the right to ART treatment, cost of assisted conception, and filiation.


Funding Provider

Changing families and sustainable societies: Policy contexts and diversity over the life course and across generations

European Union (Seventh Framework Program)

Research Associate