PwC report indicates U.S. faces $162 billion GDP risk from falling birth rates (2025)

Northwell Health partnered with Stacker to explore the rising rate of preterm births in the U.S. using Centers for Disease Control and Prevention data. — Ratchat // Shutterstock

It has been widely reported that U.S. birth rates are falling. What is the likely impact? This is starting to look relatively bleak. A new report from PwC Strategy&, unveiled at the 11th International IVI RMA Congress, a gathering of more than 1,400 experts in fertility and related disciplines from over 58 countries, indicates the drastic economic impact of low birth rates and an ageing population in the U.S.

IVI RMA is the world’s largest fertility-focused medical group, combining scientific leadership, proprietary technology, and a human-centered care model. The group sees more than 115,000 patients per year, performing 180,000 annual treatments.

With fertility rates well below replacement levels and the average age of first-time parents rising, the report, “Shaping the Future: Socioeconomic Challenges and Opportunities in Aging Societies,” points to fertility medicine as a key lever for supporting social and economic sustainability.

This has an impact on Gross Domestic product (GDP), in relation to thetotal fertility ratewhich estimates the total number of births a woman would have, if she experienced the birth rates seen in women of each age group in one particular year across her childbearing years. This impacts GDP per capita, if it does not match economic predictions.

Indeed, many of the world’s richest economies will need to at least double productivity growth to maintain historical improvements in living standards amid sharp falls in their birth rates, according to the Financial Times.

U.S. birth trends of concern:

• Annual population growth is expected to decline significantly from 2 million in 2023 to 500,000 in 2100, leading to reduced economic growth and increased pressure on healthcare systems and pensions
• At 1.6 children per woman, fertility rates fall short of the 2.1 replacement level
• Since 1990, the average age of women at the birth of their first child has risen from 24 to 27, which will continue to put pressure on fertility rates as female fertility drops sharply with age
• By 2050, public expenditure on pensions and public health will rise by $751 billion (+3.8 percentage points of GDP), stressing the financial system

The report shows that 26 U.S. states could register negative GDP per capita growth as early as 2050, with cumulative impact reaching $162.3 billion between 2050 and 2100. In the U.S., just three percent of births currently result from ART, which encompasses a range of techniques including vitro fertilization (IVF).

A new hope?

The report, however, shows the promise of assisted reproductive technologies, like IVF, to counter and even reverse these demographic changes and support social and economic sustainability.If the U.S. reached utilization levels of reproductive technologies, such as IVF, comparable to other countries like Spain, this could boost births by 290,000/year.

“Reproductive medicine is no longer just a clinical discipline—it is a matter of social and demographic resilience and an essential demographic tool to reverse the decline in the birth rate,” Professor Antonio Pellicer, Executive Chairman of IVI RMA Global explains. “It is essential for public policies to incorporate fertility as a strategic priority, guaranteeing safe and agile access to reproductive medicine and promoting awareness and reproductive health education, to ensure future economic sustainability.”

Trump policy connection

Given President Trump’s somewhat weird support for a $5,000 “baby bonus,” the report, may unintentionally, be timely. On the campaign trail, Trump coined himself the “King of IVF,” and in March, he joked that he would be known as the “fertilization president.”

The Trumpian idea is far from becoming a reality, with a White House official telling CBS MoneyWatch that no final decision on such a plan has been made.The proposal would need to be approved by Congress, if it actually materialisises.