VOLUME 116, ISSUE 6, P1455-1456
Michael L. Eisenberg, M.D.
Eat. Survive. Reproduce. These are the fundamental functions of all species, including humans. More specifically, we eat to survive, and we survive to reproduce and spread our DNA. However, there exist data that suggest that human reproduction is in peril. The total fertility rates (defined as births per woman over her lifetime) continue to decline and are projected to decline further worldwide (1, 2). Such declines have a profound impact on society because a birth rate of 2.1 is required for a nation to maintain a stable population. If the fertility rate were to fall below such a value (as it has for many countries in the developed world), the economic implications are enormous in terms of the workforce and ultimately tax base for social programs (which are compounded as lifespans increase). Thus, in addition to an academic question, a declining fertility rate has existential implications for a society.