How the UAE is seeking to address declining birth rates

Initiatives include egg freezing, which experts say empowers women to make informed decisions about their reproductive future

Fertility rates in the UAE continue to decline, with experts citing a focus on career over family as a crucial factor. AP

Living costs and poor health are impacting the number of new babies in the UAE amid concerns a falling birth rate could trigger a future labour shortage, fertility experts have said.

Better access to contraception and reproductive health services, plus more women delaying motherhood to focus on careers, are other contributing factors seen around the world.

Research in 2021 by the Institute for Health Metrics and Evaluation at the University of Washington found the average number of children born to a woman in her lifetime fell from 4.84 in 1950, to 2.23 in 2021.

Italy, Japan and South Korea have experienced some of the lowest shifts in fertility, with rates falling below 2.1 children per women.

Since the UAE legalised the procedure for both married and unmarried women in 2021, clinics in Dubai have seen a 2,000 per cent increase in egg freezing

Dr Diana Kayal,
fertility expert

Global figures are predicted to continue to decline to around 1.59 by 2100, the research found.

In the UAE, World Bank figures show fertility has dropped from 6.7 children per woman in 1960 to around 1.4 in 2022, a trend that could have future economic consequences.

“Economic pressures and the high cost of living influence family planning decisions, leading to families choosing to have fewer children by choice,” said Dr Charles Nagy, a consultant obstetrician and master surgeon of endometriosis care, at the Medcare Women and Children Hospital in Dubai.

“Cultural shifts towards prioritising personal and professional achievements over early family life, coupled with increased awareness and accessibility of fertility treatments, highlight the growing prevalence of fertility challenges.

“Overall, these social, cultural and medical factors have significantly increased the demand for fertility treatments in the UAE.”

Natural births

In March, Emirates Health Services recorded a total of 10,414 newborns delivered at hospitals in Sharjah, Umm Al Quwain, Ras Al Khaimah, and Fujairah in 2023. Of those, 6,714 were natural births.

At Abu Dhabi Department of Health facilities, more than 30,000 births were reported in 2023, 94 per cent of which were natural deliveries.

The emirate also recorded one of the region’s highest success rates for in vitro fertilisation (IVF) procedures.

Of the 4,800 couples who received IVF treatment in 2022, 42 per cent were successful.

Declining fertility rates are expected to continue worldwide, resulting in significant changes to population demographics, with more older people in society.

However, science is playing a significant role in attempting to get birth rates back on track.

New fertility treatments continue to emerge, as well as improved methods of growing and transferring embryos via IVF and intrauterine insemination – or artificial insemination – that boost chances of pregnancy by inserting specially prepared sperm directly into the uterus.

Genetic screening can help reduce risks and boost success rates, while modern techniques to freeze eggs and sperm are other improving areas of advanced reproductive technologies.

Stem cell therapy can also treat infertility by repairing reproductive tissue, while new minimally invasive surgeries can treat damaging conditions such as endometriosis, a potential barrier to healthy pregnancies.

Dr Rohit Kumar, medical director and specialist general surgeon at International Modern Hospital, said a declining birth rate could have a significant impact on the economic landscape, with a shrinking population of younger people of working age.

“Tackling the issue of falling birth rates demands a comprehensive approach, and focus on the broader societal impacts,” he said.

“By incorporating family support initiatives and innovative healthcare solutions, the implications of an ageing population can be managed.”

Shrinking populations

The World Health Organisation’s Department of Sexual and Reproductive Health and Research states that in order to maintain stable populations, nations require a total fertility rate of 2.1 children per woman.

When fertility drops below this replacement level benchmark, populations begin to shrink.

In 2021, almost half of countries fell below that number.

Japan, a country with a population of about 125 million, is facing a significant challenge in how to address plummeting birth rates.

Pedestrians in Harajuku, central Tokyo. Official data for 2023 in Japan showed that births fell to an all-time low of 730,000, while there were 1.58 million deaths. AFP

The nation’s population reduced in size for the 15th consecutive year in 2023, with the number of registered Japanese citizens falling by a record 861,000.

Births fell to an all-time low of 730,000, while there were 1.58 million deaths.

To encourage population growth, the Japanese government has increased a one-off childbirth payment to around 500,600 yen (Dh12,000), with monthly assistance grants elevated to 29,000 yen for each child in families with three or more children.

Dr Diana Kayal, a specialist at the IVF International Clinic in Barsha, Dubai and founding member of Bourn Hall Fertility Clinic, said infertility affects approximately one in seven couples worldwide and is more common in the Arabian Gulf population, affecting one in six.

“Factors contributing to this are largely social and associated with rapid urbanisation,” she said.

“They include increased age at marriage, obesity, high tobacco use, lack of physical activity, and chronic conditions like diabetes.

“This reality poses potential challenges for future workforce sustainability and economic growth, particularly in high-income countries facing ageing populations and shrinking labour forces.

“To address the low fertility rates, the UAE has implemented several progressive changes.”

Reproductive technology

Egg freezing is one of the fastest-growing fertility treatments, enabling women to preserve their eggs for future use and offering more control over reproductive choices.

Dr Diana Kayal, a medical director of obstetrics, gynaecology and reproductive medicine and founding member of Bourn Hall Fertility Clinic, said infertility affects approximately one in seven couples worldwide and is more common in the Arabian Gulf population, affecting one in six. Photo: Dr Diana Kayal

After changes to UAE law, women are allowed to freeze their eggs for five years, extendable upon request.

Fertility services have surged in demand since, Dr Kayal said.

“Since the UAE legalised the procedure for both married and unmarried women in 2021, clinics in Dubai have seen a 2,000 per cent increase in egg freezing,” said Dr Kayal.

“This is testament to not only the increasing demand for fertility treatment, but to the effectiveness of progressive regulations and advancements in reproductive health care.

“By offering women the option to freeze their eggs, the UAE is empowering them to make informed decisions about their reproductive futures, further contributing to the overall growth and development of fertility treatments in the region.”