Tenth in the order of changes that have occurred in the last quarter century is the change of lifestyle and its effect on both natural as well as assisted fertility (ivf). The pressures of modern life, work and the difficulty in balancing multiple roles (wife, mother, worker, pursuit of education & skills) have meant that women are delaying childbirth significantly.
As a woman ages, the number and quality of her eggs drops and so her ability to have children does the same too. So many women are doing this now, that Governments all over the world are beginning to worry about future population growth. Our neighbour down south is a good example of one such worried country. All we (and authorities) can do is to keep repeating the message: Have Children Early. Time cant be recovered. And while IVF can be a help, it does not overcome everything. Once a woman crosses the magic age of 40, it is even more dire.
The world smokes & drinks more, and obesity is now a common disease. The net effect is lower fertility for both men & women.
All of these factors have substantially increased the need for fertility services. Governments have also become more aware of infertility and made moves to offer fertility services in public hospitals, or pay for it under insurance cover. By comparision, in 1989, IVF was a niche service provided only by private centers. There was no such thing as government subsidy or insurance. Times have changed for the better.