“You Can’t Beat Age”... Solutions Proposed for Korea’s Low Birthrate [Weekend Health]

[Financial News] “You can’t beat age. If you’re having difficulty starting a family, it’s important to begin treatment as soon as possible.”
Alexander Steinbach, head of Merck Healthcare’s global fertility and endocrinology business, emphasized the importance of fertility treatment amid Korea’s low birthrate.
Speaking at the Korea Science and Technology Center in Gangnam District, Seoul, on the 11th, he said, “Fertility treatment can help narrow the gap between the number of children people want and the number they are realistically able to have.” He explained that this “fertility gap” is also linked to low birthrates and population aging.
Steinbach identified Korea as a country where infertility is an especially pressing issue. Korea’s total fertility rate is 0.8, far below even that of developed European countries, where rates range from 1.25 to 1.5. He cited later marriage as the biggest factor. Korea has one of the world’s highest proportions of unmarried people in their 30s, among both men and women. In addition, most Asian countries, including Korea, tend to have children only after marriage.
“In Europe, unmarried women have children at a rate similar to that of married women,” he said, noting that “the fact that most births take place after marriage is a major difference between Korea and Europe.”
As people marry later, they are also having their first child later. The average age of mothers at the birth of their first child in Korea is 33.2, among the highest in the Organization for Economic Co-operation and Development (OECD), and far above the OECD average of about 30. Births to women aged 35 or older account for 37.5% of all births. Women aged 35 to 44 also make up nearly 60% of those receiving fertility treatment.
The number of births with medical assistance is also rising. In Korea, one in five newborns is born with government support for fertility treatment, giving the country the highest rate in the world. Japan ranks second. The rate is even higher among mothers aged 35 or older.

Steinbach’s repeated calls for early treatment reflect a persistent gap in awareness. According to a Merck survey of women’s awareness, many knew that age matters when it comes to pregnancy. But many were unaware that fertility drops sharply after age 35 and declines even more steeply after 40. Many also did not know about the ovarian age test (AMH, or anti-Müllerian hormone), which assesses ovarian reserve and can help estimate the chances of becoming pregnant.
He suggested, “Since people in Korea generally receive annual health checkups through their workplaces and elsewhere, including an ovarian reserve test as part of those checkups would be a great help.”
Merck has been active in fertility treatment since before the world’s first test-tube baby was born in 1978. More than 6 million people—about 50% of all IVF babies worldwide—were born with the help of Merck’s fertility drug portfolio. The company has also been active in Korea for more than 20 years.
Merck offers a product portfolio covering every stage of assisted reproductive treatment. The process begins by stimulating the development of as many follicles as possible in the patient, with a target of about 15. The timing is then managed to prevent premature ovulation before egg retrieval, while helping the follicles mature sufficiently by the time they are collected. After embryos created in vitro are transferred, medication is used to support implantation. Merck has treatments for every stage of the process.
The latest product is the Pergoveris Pen, launched in Korea two months ago and covered by National Health Insurance. Its autoinjector design makes it easy for patients to administer the medication themselves and allows for more precise dose adjustment. The company says that because it contains both follicle-stimulating hormone (FSH) and luteinizing hormone (LH), it can be especially helpful for older patients trying to become pregnant. Steinbach said, “With proper training and use, it can also greatly reduce the cost of treatment.”
Merck is also researching next-generation treatments that would provide FSH and LH as oral medicines rather than injections. The company is exploring their potential using artificial intelligence (AI) and technologies secured through acquisitions. Steinbach said, “It’s still at the preclinical stage, so development is unlikely in the near future, but we have high hopes,” adding, “For the next 8 to 10 years, we’ll continue making good use of our excellent products currently on the market.”

Beyond supplying treatments, Merck is also working to contribute to society. Its efforts fall into three main areas: working with policymakers, healthcare professionals and patient groups to help improve policies and systems; running public awareness campaigns; and setting an example as a family-friendly company.
The company runs an employee fertility treatment support program called “Fertility Benefit.” It is available regardless of gender, and male employees can receive support for their spouses. The company said the program has led to a considerable number of births.
Steinbach said fertility treatment has changed significantly over nearly the past 50 years. With a wider range of treatments now available, the chances of becoming pregnant through IVF have risen substantially, as long as patients are not too old. Procedures that once came close to being experimental are now becoming an established form of medical care covered by health insurance. Social attitudes have also changed. In the past, many patients struggled with stigma; now, fertility treatment is seen as something anyone can receive, and many patients get support from family and friends.
“As the saying goes, it takes a village to raise a child. Infertility is not something anyone can solve alone; it takes cooperation among many stakeholders,” he said. “That is especially true in Korea, which is grappling with low birthrates at the national level.” He added, “The government, patient groups and the medical community, as well as the industry, can do more than supply innovative treatments: they can help create an environment where anyone can start a family and receive fertility treatment without undue financial strain.”
[email protected] Jeong Myeong-jin, Medical Correspondent Reporter