Break in case of emergency – obstacles to infertility treatment amidst South Korea’s fertility crisis

In the last 20 years the South Korean government has put a lot of effort and resources into encouraging South Koreans to have children and reverse the country’s trend of low birth rates to avoid a demographic breakdown. However these actions have unfortunately not caused much change. At the same time, unequal access to infertility treatment rooted in conservative customs within the medical industry poses an obstacle for single women and lesbian couples who want to have children – an obstacle that can be seen as unjustified considering the country’s demographic situation. 

South Korea has the lowest birthrates in the world of  6.69 per 1,000 population in 2026 which is a 0.37% decline from 2025. The South Korean fertility rate (looking at birth per woman in chilbearing age instead of the whole population) however  has increased since 2025 from 1.08 to 1.09. This however is still pretty far from the replacement level fertility of 2.1 required to maintain demographic stability. South Korea’s low birthrate has been declared a national emergency and a looming demographic crisis. Over the last 20 years the South Korean government has spent more than 360 trillion won (265 million USD) on policies aimed at solving the fertility rate issue. Some of the policies include economical compensation for households per child born (2 million won for each child born, 3 million won for those who have at least one child already and 5 million won for giving birth to twins). There is also monthly economical compensation for households having infants or small children. The paternity leave benefits have also been expanded. The Korean government also provides help with housing in some areas for newlyweds and new parents as well as encouraging dating by creating romantic outdoor spaces. However despite the Korean government having made a conscious effort to raise the fertility rate for the last 20 years the fertility rate has only increased minimally – in the last year. And it is also hard to say if the very small increase in fertility rate is a result of the policies or if it’s because of other factors. These policies offering economical and housing aid for people who have kids seem to have the goal of reassuring or convincing people debating on whether or not to have kids, to have kids. However, this strategy of trying to convince people to have children has proven to be rather tricky as shown by the absence of results followed by a very minimal increase in fertility rate, but with uncertain connections to the government’s policy. However, there is one demographic that needs no convincing in wanting to have children – and might prove a much more successful target for the South Korean government’s efforts to increase fertility rates. 

More children born through infertility treatments – But at what cost

In 2023 a survey found that 17,5 percent of the population experience infertility worldwide. According to WHO infertility is: “…a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.” Assuming that South Korea follows this trend means that about 9 million people of South Korea’s population of 51 million experience infertility; wanting and trying to have children but without being able to successfully conceive. And in South Korea in 2025 around 192,043 women and 108,358 men were found to have fertility issues — a number much lower than the expected total. Partly covering the cost for IVF treatments are already a part of South Korea’s efforts to increase the fertility rate with the state run insurance covering 70% of medical costs for infertility treatments since 2017 as well as making the allowed rounds of IVF very high. Subsequently the use of IVF in South Korea as well as the babies born from infertility treatment has risen. Statistics from South Korean Health Insurance Review and Assessment Service shows that there has been a 40 percent increase of infertility treatment in South Korea between 2019 and 2023 reaching around 200.000 in 2023. Among infertility treatments, IVF has seen a sharp increase of 55.4 percent during the four year period going from 100 000 cases to 170 000 cases in 2023, and IVF treatments have shown results, with 15.1 percent of all newborns in South Korea in 2024 conceived through IVF or artificial insemination, an increase from 8.7 percent in 2019. The babies born from infertility treatment also rose by 37 percent from 26,000 in 2019 to 36,000 in 2024. These statistics show that this investment from the government has been successful in enabling more babies to be born — thereby also raising the fertility rate. 

However, 30 percent of the costs for infertility treatment is still paid by the patient which still creates an economical obstacle for some aspiring parents. The personal costs of IVF can be hard to predict because they can vary a lot depending on the person and the amount of cycles needed for conceiving successfully. Even with government insurance covering the majority of the cost, one woman receiving IVF treatment in Korea reveals to have spent 1.5 million won (approximately 1000 USD) on each IVF cycle out of pocket. With the majority needing multiple IVF cycles to conceive successfully the costs add up. Although most companies offer their employees several days off from work to receive infertility treatments, these benefits are hard to make use of in reality due to workplace pressures. So despite government funding and successful statistics there are still obstacles for people looking for IVF treatments. But apart from high costs and difficulties getting time off there is also the issue of eligibility for infertility treatment which poses an obstacle for certain people in South Korea wanting to have children. 

Locked out – Single women and lesbian couples’ ineligibility to infertility treatments

Although the statistics above have shown an increase of infertility treatments and babies born as a result of them, these statistics and treatments are only taking into account the people who are eligible for infertility treatments in South Korea — which is only married women (more specifically women with husbands). However this is not due to any legal obstacles as South Korean Ministry of Health and Welfare had stated that receiving infertility treatment as a single woman isn’t illegal. Despite this, Korean Society of Obstetrics and Gynecology still states in its ethical guidelines that assisted reproductive procedures should only be given to married women. Although the National Human Rights Commission of Korea recommended the Korean Society of Obstetrics and Gynecology to change their guidelines,  the organization did not follow this recommendation claiming that their guideline of only offering infertility treatments to married women are grounded in the law — although it is not. In reality, it is almost impossible to find a doctor willing to give an assisted reproductive treatment to a woman without a husband. Also with Korean sperm banks being able to set their own requirements for patients they all require women to be married to receive their service. In Seoul single women are now eligible to receive fertility tests. However, those who want to receive reproductive treatment without a husband have nowhere to turn. 

These formal or informal rules for the eligibility of infertility treatment are all grounded in a very conservative view of how a family should look like. However in South Korea these attitudes around family are changing. A study from 2024 showed that in South Korea 42.8 percent think it is acceptable to have children outside of marriage. 

In South Korea there are circa 4 million households comprised of single (unmarried) women and with the total number of households in Korea being circa 23 million, that is 18% of all households. In other words 18% of all households in South Korea are excluded from access to infertility care and possibly having children through such care. Additionally in South Korea, 1 in 3 unmarried women or married women without children wants to have children. Statistically the current policies in South Korea around infertility treatments not being accessible to unmarried women might stop over one million women from having children although they might want to. 

Moreover the custom of only providing fertility treatments to married women also impacts women in same sex relationships as South Korea does not recognize same sex marriages. Statistics show that countries with equal accessibility to infertility treatment half of lesbian couples choose to have children. However, under Korea’s current custom around infertility treatments, people who want to receive reproductive treatments but aren’t eligible in South Korea for example unmarried women or lesbian couples,  have to go abroad to receive infertility treatment – something that is both very costly and inconvenient. In  2020 the Korean TV personality Fujita Sayuri, born in Japan, became a topic of discussion in Korea for having a child through intrauterine insemination (IUI) via sperm donation; a treatment she had to go back to Japan to receive, calling Korea’s unequal access to infertility treatment into question. Although lesbian couples and single women are a minority in society they still show a real intent to have children if they can. An intent that the South Korean government is currently neglecting despite being on the brink of a demographic breakdown. 

Break in case of emergency – equal access to infertility treatment in South Korea’s fertility crisis

Having spent 360 trillion won (265 million USD) in the last 20 years focusing on trying to convince people to have children, but with small, ambiguous, or no results, it might be more productive for the Korean government to to increase focus on people wanting children but failing to conceive. With infertility treatments in South Korea remaining inaccessible to a lot of people due to economical reasons and systemic exclusion, there is much that can be done to increase accessibility and thereby also the amount of children being born — contributing to increasing fertility rates and stabilising the country’s demographic trajectory. Although a wide range of actions are necessary to tackle South Korea’s birth rate crisis, putting a bigger focus on increasing accessibility to infertility treatments can be a secure and efficient part of it. Despite the absence of legal limitations, the cause of unequal access is rather in the customs of the industry, rooted in a very conservative view of family. Considering how equal access to infertility treatments are likely to lead directly into more children being born (unlike providing newlyweds with apartments) the South Korean government has everything to win by removing these obstacles considering the country’s demographic situation – if they find the situation dire enough yet to make them challenge the conservative forces keeping them in place.