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Review
. 2025 Sep 12:S0015-0282(25)01909-0.
doi: 10.1016/j.fertnstert.2025.09.012. Online ahead of print.

The "Baby Bust": Awareness of the gap between desired and actual family size and review of practical options

Affiliations
Review

The "Baby Bust": Awareness of the gap between desired and actual family size and review of practical options

Dominique de Ziegler et al. Fertil Steril. .

Abstract

Decreasing birth rates are a worldwide phenomenon with potentially alarming consequences. This decline results either from women choosing not to have children or from couples ending up with a smaller family size than initially intended, a phenomenon called the fertility gap. In the latter case, delaying parenthood plays a key role in not achieving the desired reproductive objective. This review will examine age-related fertility decline, couple awareness, and factors contributing to the postponement of parenthood. We will also review potential strategies to prevent fertility gaps in couples wishing to conceive and how family values can be revived. Efforts to assess current levels of fertility awareness and identify ways to improve this knowledge will be highlighted. We will critically evaluate measures implemented worldwide for enhancing fertility and explore their relative effectiveness based on reported experience. Finally, we will analyze potential signs of fertility rebounds - some of which may already be emerging - and critically assess possible means to amplify these effects.

Keywords: Age-related fertility decline; Fertility awareness; Fertility gap.

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