Tunisia is experiencing a pronounced decline in its fertility rate, driven by a combination of economic, social, health, and environmental factors. According to recent data from the National Institute of Statistics, the average number of children per woman has decreased from 2.4 in 2016 to 1.5 in 2024. During the same period, the number of births declined from 219,441 to 126,401, and the birth rate fell from 19.4 to 10.6 per 1,000 people.
The decline in fertility was a key topic at the fifth edition of the Medical Days of the Tunisian Society of Gynecology-Obstetrics, held recently. Specialists emphasized that the decrease in fertility is not solely a medical issue but also reflects profound changes in Tunisian society. Factors contributing to this trend include the rise in age at marriage and first pregnancy, economic difficulties, and the increasing cost of starting a family. Additionally, more young people are choosing to emigrate, and new lifestyles are emerging, with a growing number of people opting for celibacy or choosing to have fewer or no children.
Age is a significant determinant of fertility, particularly for women. The chances of conception decrease gradually with age, and this decline accelerates after 35. This affects the success rates of assisted reproductive technologies. Moreover, fertility issues also concern men and can be linked to smoking, being overweight, a sedentary lifestyle, diet, stress, and environmental factors. Experts stress the importance of improving information on sexual and reproductive health, especially through school programs and pre-marital consultations, to prevent delayed consultations with specialists.
Tunisia has advanced expertise and technology in reproductive medicine, with the National Health Insurance Fund covering certain medications and, under specific conditions, up to three attempts at in vitro fertilization. The conference also discussed the use of artificial intelligence in reproductive medicine, from data analysis to the evaluation of sperm and embryos, subject to the final decision of the physician.
The Tunisian Society of Gynecology-Obstetrics has proposed revising Tunisian legislation to allow the cryopreservation of oocytes for women who wish to preserve their chances of having children. Currently, this option is mainly limited to specific medical indications, such as treatments that may impair fertility. Expanding this practice to other situations could provide an additional response to the decline in fertility, complementing awareness actions and existing support systems.
The decline in fertility in Tunisia has significant implications for the country's demographic and economic future. As the population ages, there may be a shrinking workforce and increased pressure on the pension system. The government and healthcare professionals are exploring ways to address these challenges, including improving access to reproductive healthcare and promoting healthy lifestyles.
The Medical Days of the Tunisian Society of Gynecology-Obstetrics highlighted the need for a comprehensive approach to address the decline in fertility. This includes not only medical interventions but also social and economic measures to support families and promote a culture of reproductive health. By working together, stakeholders aim to mitigate the effects of the declining fertility rate and ensure a healthier and more sustainable future for Tunisia.
Key points
- The fertility rate in Tunisia has declined significantly, from 2.4 children per woman in 2016 to 1.5 in 2024.
- The decline in fertility is driven by a combination of economic, social, health, and environmental factors, including the rise in age at marriage and first pregnancy, economic difficulties, and changing lifestyles.
- Experts propose revising Tunisian legislation to allow the cryopreservation of oocytes for women who wish to preserve their chances of having children.
