This paper focuses on age restrictions on access to infertility treatments and eligibility for their public reimbursement, exploring their relevancy in contexts of rising late birth rates (40+). I explore how age‐based reimbursement policies for in vitro fertilization treatments have responded to these fertility trends in 27 high‐income countries and in which regulatory frameworks for medically assisted reproduction (MAR) very late births (45+) have particularly increased. First, I show that while age limits for treatment reimbursement are well aligned with the prevalence of late fertility in some national contexts, in most countries, strict age restrictions are lagging behind the rise in late births. In others, pronatalist policies have prompted permissive age criteria or law revisions, anticipating or adapting to rising trends in late births. Second, the rise in very late births has been limited in some contexts with strict age‐based rules. However, the analysis suggests that the impact of MAR on very late births may also be influenced by contextual factors other than regulations.

中文翻译：

---

对齐、预期、适应还是落后？辅助生殖和晚期生育能力中基于年龄的法规


本文重点介绍获得不孕症治疗的年龄限制及其公共报销资格，探讨它们在晚出生率上升 （40+） 背景下的相关性。我探讨了体外受精治疗的基于年龄的报销政策如何应对 27 个高收入国家的这些生育趋势，以及医疗辅助生殖 （MAR） 极晚出生 （45+） 的监管框架特别增加。首先，我表明，虽然治疗报销的年龄限制与某些国家背景下晚生育率的普遍性非常一致，但在大多数国家，严格的年龄限制落后于晚产率的上升。在另一些国家，生育主义政策促使了宽松的年龄标准或法律修订，以预测或适应晚产率的上升趋势。其次，在一些具有严格年龄规则的情况下，极晚出生率的增加受到限制。然而，分析表明，MAR 对极晚出生的影响也可能受到法规以外的环境因素的影响。