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When Kim Mi-ae began in vitro fertilization (IVF) last November, she anticipated a demanding test of patience, having already experienced this during her first pregnancy three years prior.
However, the unexpectedly long waits at the fertility clinic this time were a shock.
“When I visited in January, it seemed as though everyone had resolved to have a baby in the New Year! Despite having a reservation, I waited for over three hours,” the 36-year-old Seoul resident recounts.
As South Korea grapples with the world’s lowest birth rates, fertility clinics are experiencing growing demand, representing a notable trend amidst the country’s demographic challenges.
Between 2018 and 2022, the number of fertility treatments administered in the country increased by nearly 50%, reaching 200,000. Last year, one in six infants born in Seoul were conceived through fertility treatments.
Experts attribute this surge to evolving attitudes towards family planning.
“We are seeing a young generation… that values control over their life,” notes Sarah Harper CBE, professor in Gerontology at the University of Oxford. She suggests that this control manifests in single women freezing their eggs or couples pursuing IVF when natural conception proves difficult.
“Unlike previous generations that were more accepting of the unpredictable nature of conception, Korean women are now proactively planning their lives.”
This trend offers a positive sign for the South Korean government, which is actively working to address the demographic crisis. Currently, one in five South Koreans is 65 or older, and the proportion of babies relative to the total population is at an all-time low.
The country has repeatedly set new records for the world’s lowest birth rate: 0.98 babies per woman in 2018, 0.84 in 2020, and 0.72 in 2023. Experts caution that if this trajectory persists, the population of 50 million could be halved within 60 years.
However, recent data offers cautious optimism. In 2024, the birth rate slightly increased to 0.75, marking the first rise in nine years.
“While it’s a modest increase, it’s still significant,” observes Seulki Choi, a professor at the Korea Development Institute’s School of Public Policy and Management.
Whether this represents the beginning of a much-needed reversal or merely a temporary fluctuation remains to be seen. The country’s birth rate continues to fall below the global average of 2.2. Nonetheless, many, including Dr. Choi, express cautious optimism.
“If this trend continues, it could indicate a long-term shift,” Dr. Choi states. “It’s crucial to monitor how young people’s attitudes towards marriage and parenthood are evolving.”
For years, having children was far from Park Soo-in’s priorities. Her demanding advertising job often kept her at work until 04:00.
“My company demanded constant overtime, making it unrealistic to even consider having children,” the 35-year-old explains.
Her perspective began to shift after getting married two years ago. She secured a new job with more reasonable hours, and friends around her started having children.
“Seeing and interacting with their children made the prospect feel less daunting,” she says. “Furthermore, my husband’s proactive approach, researching pregnancy and childbirth and demonstrating genuine effort, instilled confidence that we could do this.”
When Ms. Park and her husband encountered difficulty conceiving, they turned to fertility treatments. Many others are following suit, contributing to projections that the burgeoning industry could be worth over $2 billion by 2030.
“This sends an important signal to policymakers that there are still women who desire to start families but face barriers in doing so,” says Jennifer Sciubba, president and CEO of the non-profit Population Reference Bureau in Washington, D.C.
“Above all, it highlights that people are unable to fulfill their aspirations to have children.”
Conceiving difficulties represents just one hurdle. At the core of South Korea’s population issues are a range of social and financial pressures, from patriarchal norms that disproportionately burden women with childcare responsibilities to long working hours and high education costs, discouraging many young people from starting families.
For some, however, these aspirations have simply been delayed. More than half of South Koreans express a desire to have children but cite affordability as a barrier, according to a UN report. Moreover, the average age at which South Korean women have their first child is 33.6, among the highest globally.
“Looking back, it might have been better to start earlier,” Ms. Park reflects. “But realistically… now feels like the right time. In my late 20s, I lacked the financial stability to consider marriage or children.”
Ms. Kim echoes this sentiment, having spent three years saving for marriage and another four for a child.
“People dedicate their youth to studying, job hunting, and accumulating the resources to prepare for life. By the time they are ready to settle down, it’s often late,” she observes. “But the later you wait, the harder it gets [to become pregnant], physically and emotionally.”
For those who choose IVF, the process of trying to conceive becomes considerably more expensive.
“It’s difficult to provide an exact figure for IVF costs due to significant variations based on the individual and the cycle,” Ms. Kim explains. “It’s a substantial and unpredictable expense that can significantly impact your finances.”
As part of its concerted efforts to increase the birth rate, the South Korean government has expanded its support for fertility treatments. Seoul now provides subsidies of up to 2 million Korean won ($1,460; £1,100) for egg-freezing and 1.1 million won for each IVF treatment.
Even with government subsidies, Ms. Kim reports spending over 2 million won in January for IVF, primarily on out-of-pocket items not covered by subsidies, such as supplements and additional tests.
And with less than half of IVF cycles resulting in successful pregnancies, the costs can rapidly accumulate.
This has been the experience for Jang Sae-ryeon in the southwestern Jeolla province. The 37-year-old began fertility treatment two years ago and has undergone five IVF cycles, each costing approximately 1.5 million won.
“I wish it worked out after just one or two tries, but that’s not the reality for most people,” she says. “Without financial resources, you simply can’t move forward. That’s the most frustrating aspect.”
Equally challenging, women report, are the workplace pressures they encounter when adhering to a demanding IVF schedule.
While South Korean companies offer several days of leave for fertility treatment, women say it’s often difficult to utilize them in practice. Ms. Kim recounts undergoing IVF for her first child without taking any leave. Ms. Jang, meanwhile, says her colleagues requested that she postpone her treatment.
“It made me feel like IVF and a full-time job are simply incompatible,” Ms. Jang says. “So I quit. But after leaving, I faced financial difficulties, leading to another cycle of quitting and job-hunting again.”
These financial and cultural pressures may have dampened many South Koreans’ dreams of having children, but not Ms. Jang’s. She still becomes emotional when recalling two pregnancies from early in her marriage, both of which ended in miscarriages.
“You know how they say when you have a child, you feel a love that’s limitless?” she says. “I believe that having a child who resembles both of us and creating a family together is one of the greatest sources of happiness a person can experience.”
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