An ageing population is a bit like an octopus-its tentacles can reach into some very unusual spaces. One of those spaces is brought to our attention in the August 3, 2007 edition of The Economist magazine, in a column with the headline, "In vitro veritas: if a country wants to keep its population up, it should promote IVF."

And countries need to keep their populations up in order to be socially and economically sustainable.

IVF stands for in vitro fertilisation, that is, the manual fertilisation of a human egg in a laboratory or clinic, and the subsequent implantation of an early embryo into the woman's womb.

We know some couples need to utilise this medical technology to conceive a child, but what has changed so radically in modern life that a country should even consider supporting such a procedure en masse? Surely reproduction is a normal function of a woman's body, so why should a country support such a procedure through the public purse?

The answer lies with the impact of modern life on the reproductive health of men and women, and the feminist movement of the 1960s. While research shows that fertility is in decline in both women and men, women are also choosing to delay motherhood.

The feminist movement ensured accessible and affordable birth control, further education, and greater opportunities in the workplace for women. The unintended consequence is that women may now choose to defer childbearing until later in life and, when they do, they have fewer children or none at all. Women in their late twenties, thirties and forties who have been unable to conceive, or who have made the decision to defer motherhood, understand the impact of time and timing. In their twenties they might say, "My (biological) clock is ticking."

In their thirties they might say, "My clock is booming." By the time women are in their forties and they still want to start a family, the alarm bells are ringing, as opportunities for motherhood diminish with each decade and come to a natural end in mid-life.

Fortunately, women do have choices in the new millennium, and this is where IVF comes in. In Denmark, where The Economist reports that almost four percent of babies born in 2003 were the result of IVF, the government picks up the tab for a series of six treatments.

In Britain, where a woman might be funded for up to three treatments, the IVF birth rate is one and a half percent. Clearly there is a link between fertility and government subsidised treatment, but this is in countries where health care is nationalised. In the US a single treatment can cost $10,000 or more.

Yet, we have historically expected women to produce the next generation with little or no consideration of the cost to her health, freedom of choice, career opportunities, or lifetime earning power. Now that women are choosing to have their families later, have smaller families, or have no children at all, governments are trying to find ways of raising birth rates to at least replace their populations.

While IVF might be an extreme solution, several countries, including Australia, Canada, and the UK, are offering direct incentives such as a baby bonus, monthly child care payments, up to 12 months' maternity leave, and paid paternity leave.

Bermuda has a relatively high fertility rate compared to some developed countries at approximately 1.8, but it is still below the population replacement benchmark of 2.1 births per woman. Furthermore, the imminent retirement of Baby Boomers and fewer births in many parts of the world are fueling a global talent shortage.

This means that recruiting enough qualified workers, whether Bermudian or not, is now a major risk to our social and economic wellbeing, with the worldwide shortage of nurses being a prime example.

IVF may not be the answer to Bermuda's talent shortage, but finding innovative solutions to the impact of our ageing population as we compete on a global stage requires dialogue and a determination to think outside the box.

The octopus is an intelligent animal, and like the octopus we need to use our collective intelligence to find solutions to the impact of our rapidly changing demographics.

Marian Sherratt is Executive Director, Bermuda Council on Ageing. She writes on issues concerning ageing each fortnight in The Royal Gazette. Send email responses to info@bdaca.org.