Population Research and Policy Review 19: 301–315, 2000.
© 2000 Kluwer Academic Publishers. Printed in the Netherlands.
Demographic implications of reproductive technologies
ELIZABETH HERVEY STEPHEN
Georgetown University, Washington DC, USA
Abstract. Medical advances in the infertility ﬁeld are coming at a rapid pace. This paper ex-
amines four areas of demography that are being affected by the delivery of infertility services
in the United States, or have the potential to be affected. The greatest effects are currently
seen in the rapid increase in the rate of multiple deliveries, with smaller effects evident in
delayed childbearing. To date the sex ratio at birth in the United States has not been affected
by reproductive technologies. The experience from Asian countries such as Korea and China
indicates that massive societal change coupled with reproductive technologies could bring
about changes in the sex ratio at birth in the United States. The last area examined is the
intergenerational transmission of infertility which to date has not been largely affected by
reproductive technologies, but has the potential to affect a larger proportion of the population.
Keywords: Assisted reproductive technologies, Infertility
At the end of the 20th century, there were several reproductive stories that re-
ceived wide-spread news coverage. Considerable attention was given to sep-
tuplets and the following year, to octuplets, all of whom survived (Ackerman
1977; Washington Post 1998). Concerns were raised about post-menopausal
women having children when a 63-year old woman had a (healthy) child
(Weiss 1997a). Later in 1997, doctors in Georgia reported the ﬁrst births
(of twins) from frozen eggs (Weiss 1997b). A controversial study in 1998
reported that signiﬁcant amounts of DNA from two women’s eggs had been
reconstituted into one egg (Weiss 1998).
Reproductive technologies were responsible for all four ‘events’ described
above. The octuplets and septuplets were born as a result of their mother
taking a fertility drug; the 63-year old mother used a donor egg and an in
vitro fertilization procedure; the twins were also a result of donor egg, in vitro
fertilization, and a new process to freeze and thaw eggs; and for the last event,
the nucleus was removed from an infertile woman’s egg and was injected
into a donor’s egg whose nucleus had been removed prior to the procedure.
These were some of the most sensational human reproductive stories in the
waning years of the twentieth century, but what are we to make of them? Do