This analysis examines reproductive governance and inequality in access to fertility services, suggesting reforms.
In this paper, we examine the governance of fertility services and situate our analysis in the broader context of reproductive ageing. Most countries restrict access to these services in reference to the age of people (especially women) who are unable to conceive and the causes of such inability. Despite the popularity of this approach, we argue that age- and cause-based restrictions actively rely on, and hence perpetuate, the constraints that hinder the realization of reproductive aspirations. To motivate this view, we provide an overview of the demographic trends that have reconfigured women's reproductive lifecourse. We then argue that the criteria governing access to publicly funded services are anachronistic, as they alienate policy from citizens' circumstances. In closing, we question the legitimacy of a reproductive governance that perpetuates existing inequality of opportunity, and propose the following changes: (1) de-responsibilizing (in)fertility; (2) reconsidering restrictions; (3) recognizing reproductive aspirations as a public good.
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Cavaliere et al. (2026) studied this question.
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