Infertility Treatment in Advanced Maternal Age: Balancing Success Rates and High-Risk Pregnancy Risks

South Korea’s public support for infertility treatments has reached a landmark milestone, with nearly 50,000 babies born last year through government-funded assisted reproductive programs—a 31% surge from 2024. The data, released by the Ministry of Health and Welfare on May 14, 2026, underscores the growing urgency of addressing infertility as marriage and childbirth ages rise across the country. While the policy has significantly boosted birth rates among couples facing fertility challenges, experts warn of rising risks associated with later-in-life pregnancies and the need for comprehensive preconception health measures.

In 2025 alone, 48,981 infants were born through the ‘Infertility Couple Treatment Cost Support Program’, accounting for 19.2% of all live births—a more than twofold increase since 2022, when such births represented just 9.3% of the national total. The program’s expansion reflects broader societal shifts: the average age of first marriage in South Korea now exceeds 33 for women and 35 for men, pushing many into their late 30s or early 40s before attempting pregnancy. For couples relying on assisted reproductive technology (ART), the stakes are high—success rates for in vitro fertilization (IVF) drop sharply after age 35, and procedures in older patients carry elevated risks of multiple pregnancies, preterm births, and neonatal complications.

“The dramatic rise in government-supported births is a testament to the program’s effectiveness, but it also highlights the complex trade-offs between fertility treatments and maternal/neonatal health,” said Dr. Lee Ji-won, a reproductive endocrinologist at Seoul National University Hospital. “While these policies are critical for addressing low birth rates, they must be paired with robust preconception counseling and early intervention strategies to mitigate risks.”

Key Takeaways

• Record-breaking impact: 48,981 babies born via public infertility support in 2025 (up 31% from 2024), now comprising 19.2% of all live births.
• Demographic drivers: Rising marriage ages (avg. 33 for women, 35 for men) delay parenthood, increasing reliance on ART.
• Health risks: 26% of supported births were multiples, and 10.8% resulted in preterm deliveries, per Ministry data.
• Policy gaps: Cold storage of eggs (oocyte cryopreservation) remains largely unsupported by public funds, despite growing demand.
• Future outlook: Experts project continued growth in ART-dependent births as fertility declines post-35.

How South Korea’s Infertility Support Program Works

The Ministry of Health and Welfare’s program covers a range of services, including:

• Fertility diagnostics: Subsidized preconception health screenings to assess ovarian reserve and sperm quality.
• ART procedures: Full or partial reimbursement for IVF cycles, intracytoplasmic sperm injection (ICSI), and other treatments.
• Psychosocial support: Counseling services for couples navigating infertility and its emotional toll.
• Emergency care: Coverage for high-risk pregnancies resulting from ART, including neonatal intensive care.

Eligibility is based on medical criteria (e.g., documented infertility after 12 months of unprotected intercourse) and age limits (typically up to age 44 for women, though exceptions exist for egg donation cycles). The program’s cost support has reduced out-of-pocket expenses for couples by an average of 70%, according to ministry estimates.

Rising Risks: The Dark Side of Later-Life Pregnancies

While the program’s success is undeniable, data reveals a troubling trend: 26% of babies born through public infertility support in 2025 were multiples—a rate nearly triple the national average. Multiple pregnancies are associated with higher risks of gestational diabetes, preeclampsia, and preterm labor. 10.8% of ART-supported births resulted in preterm deliveries, often linked to maternal age or ovarian stimulation protocols.

“The biological clock is real,” said Dr. Park Min-kyu, director of the Korean Society for Reproductive Medicine. “For women over 35, the risk of chromosomal abnormalities in embryos rises sharply, and the likelihood of live birth per IVF cycle drops from ~37% in the late 20s to ~10% by age 40. These statistics don’t just affect success rates—they impact the health of both mother, and child.”

Policy Gaps: Why Egg Freezing Remains Out of Reach for Most

Despite the program’s successes, a critical gap persists: public funding for oocyte cryopreservation (egg freezing) remains minimal. While some local governments offer limited subsidies, the procedure—typically costing $5,000–$10,000 per cycle—is largely a private expense. This disparity has sparked debates about whether the state should bear responsibility for “social egg freezing,” a practice increasingly adopted by career-focused women in their late 20s and early 30s.

“The current system treats infertility as a medical emergency but ignores the proactive steps women take to preserve fertility,” said Kim Hye-jin, a fertility law specialist at Yonsei University. “If we’re serious about supporting families, we need to move beyond reactive care and invest in preventive measures like egg freezing.”

“The current system treats infertility as a medical emergency but ignores the proactive steps women take to preserve fertility.”

What’s Next? Upcoming Policy Reviews and Public Health Initiatives

The Ministry of Health and Welfare is set to release a comprehensive fertility strategy report in Q3 2026, expected to address:

• Expansion of preconception health programs, including mandatory fertility screenings for couples planning pregnancy.
• Pilot projects for public egg freezing subsidies in select regions, pending cost-benefit analyses.
• Stricter regulations on multiple embryo transfers to reduce high-order multiple pregnancies.
• Integration of mental health support into infertility treatment pathways.

The next official update is scheduled for September 2026, when the ministry will announce adjustments to the 2027 budget allocation for reproductive health services. In the meantime, couples considering fertility treatments are advised to consult the Ministry’s ART support portal for updated eligibility criteria and regional variations in coverage.

Reader Q&A: Common Questions About South Korea’s Infertility Support

Q: How do I qualify for the public infertility support program?

A: Eligibility requires a diagnosis of infertility (e.g., unexplained infertility, tubal damage, male factor infertility) confirmed by a participating clinic. Age limits vary by procedure (typically up to age 44 for IVF, with exceptions for egg donation). Full guidelines here.

Q: Are there regional differences in coverage?

A: Yes. Seoul and metropolitan areas offer broader support, while rural regions may have longer waitlists for subsidized treatments. The National Health Insurance Service provides a search tool to check local clinic participation.

Q: What are the success rates for IVF in South Korea?

A: The national average for IVF success (live birth per embryo transfer) is ~37% for women under 35, dropping to ~10% by age 40. Success varies by clinic and patient-specific factors (e.g., cause of infertility). Society data shows top clinics achieve rates up to 50% for younger patients.

Q: Can I freeze my eggs with public funding?

A: Currently, no. While some local governments (e.g., Seoul) offer partial subsidies, the majority of costs remain out-of-pocket. Advocates are pushing for national-level support, citing equity concerns.

As South Korea grapples with one of the world’s lowest fertility rates (0.78 births per woman in 2025), the infertility support program stands as a rare bright spot. Yet the data also serves as a warning: without addressing the root causes—delayed parenthood, workplace pressures, and insufficient reproductive healthcare—the challenges will only grow more complex. For couples navigating this landscape, the message from experts is clear: plan early, seek support aggressively, and prioritize health at every stage.

What are your experiences with fertility support in South Korea? Share your stories in the comments below—or tag @WorldTodayJrnl to join the conversation.