In 2024, the total fertility rate (TFR) in Okinawa Prefecture amounted to ****, the highest among the 47 prefectures of Japan. By comparison, Tokyo Prefecture recorded the lowest fertility rate of ****. That year, the overall total fertility rate in the country stood at ****.

The statistic shows the 20 countries with the lowest fertility rates in 2024. All figures are estimates. In 2024, the fertility rate in Taiwan was estimated to be at 1.11 children per woman, making it the lowest fertility rate worldwide. Fertility rate The fertility rate is the average number of children born per woman of child-bearing age in a country. Usually, a woman aged between 15 and 45 is considered to be in her child-bearing years. The fertility rate of a country provides an insight into its economic state, as well as the level of health and education of its population. Developing countries usually have a higher fertility rate due to lack of access to birth control and contraception, and to women usually foregoing a higher education, or even any education at all, in favor of taking care of housework. Many families in poorer countries also need their children to help provide for the family by starting to work early and/or as caretakers for their parents in old age. In developed countries, fertility rates and birth rates are usually much lower, as birth control is easier to obtain and women often choose a career before becoming a mother. Additionally, if the number of women of child-bearing age declines, so does the fertility rate of a country. As can be seen above, countries like Hong Kong are a good example for women leaving the patriarchal structures and focusing on their own career instead of becoming a mother at a young age, causing a decline of the country’s fertility rate. A look at the fertility rate per woman worldwide by income group also shows that women with a low income tend to have more children than those with a high income. The United States are neither among the countries with the lowest, nor among those with the highest fertility rate, by the way. At 2.08 children per woman, the fertility rate in the US has been continuously slightly below the global average of about 2.4 children per woman over the last decade.

Actual value and historical data chart for Japan Fertility Rate Total Births Per Woman

In 2023, Tokyo Prefecture recorded a 0.99 total fertility rate (TFR). The total fertility rate in the prefecture showed a steady decrease in recent years and fell below one for the first time in 2023.

Although fluctuating between 2000 and 2025, fertility rates generally decreased in all G7 countries in recent years. Italy and Japan were estimated to have the lowest fertility rates as of 2025, at *** children per woman of childbearing age. On the other hand, France had the highest rate at *** children. Interestingly, in Germany, the fertility rate was at the same level as Japan and Italy, but started to increase in 2013 and has remained slightly higher since. The fertility rate displays the average number of children a woman of child-bearing age in a country would have if she were to live to the end of her reproductive age.

Actual value and historical data chart for Japan Birth Rate Crude Per 1 000 People

Actual value and historical data chart for Japan Adolescent Fertility Rate Births Per 1 000 Women Ages 15 19

With 253,444 births, women aged 30 to 34 years were the leading age group giving birth in Japan in 2024. Overall, the number of live births in Japan added up to 686,173 in the year.

In 2024, there were around *** live births per 1,000 inhabitants in Japan, down from about *** in the previous year. The total number of live births in the nation amounted to approximately ******* in 2024. Japan’s super aging society Directly after the end of WWII, the live birth rate in Japan was over ** per 1,000 of population. The rate has constantly dropped in the last decades after the second baby boom (between 1971 and 1974). Meanwhile, the life expectancy of the Japanese people has increased, reaching about **** years for women and **** years for men in 2022. Due to the combination of both factors, Japan has developed into one of the most rapidly aging societies in the world. Almost ** percent of Japan’s population is currently aged 65 years and older, falling into the “super-aged nation” defined by international institutions and organizations.  Decreasing number of marriages In Japan, the number of births outside of marriage is small. The Japanese government, therefore, considers the decreasing number of marriages as the driving factor behind the country’s fertility decline. As of 2024, the number of marriages per 1,000 Japanese citizens was ****, less than half compared to that in the early 1970s. The average age of first marriage has also risen for both men and women. This trend can be partially attributed to the increasing number of employed and therefore financially and socially independent women in the past two decades. The employment rate of women in Japan exceeded ** percent for the first time in history in ****.

The average for 2022 based on 196 countries was 18.19 births per 1000 people. The highest value was in the Central African Republic: 45.42 births per 1000 people and the lowest value was in Hong Kong: 4.4 births per 1000 people. The indicator is available from 1960 to 2023. Below is a chart for all countries where data are available.

According to a survey conducted in September 2024, over ** percent of surveyed individuals identified the financial instability of young people and those in the child-rearing age as the root cause of the declining total fertility rate (TRF) in Japan. Almost ** percent considered it was due to the increasing number of people not wanting to get married.

The fertility rate of a country is the average number of children that women from that country will have throughout their reproductive years. From 1800 until 1865, Japan's fertility rate grew quite gradually, from 4.1 children per woman, to 4.8. From this point the fertility rate drops to 3.6 over the next ten years, as Japan became more industrialized. Towards the end of the nineteenth century, Japan's fertility rate grew again, and reached it's highest recorded point in the early 1920s, where it was 5.4 children per woman. Since this point it has been gradually decreasing until now, although it did experience slight increases after the Second World War, and in the early 1970s. In recent decades Japan's population has aged extensively, and today, Japan has the second oldest population and second highest life expectancy in the world (after Monaco). In contrast to this, Japan has a very low birth rate, and it's fertility rate is expected to fall below 1.4 children per woman in 2020.

Actual value and historical data chart for Japan Life Expectancy At Birth Total Years

For most of the past two centuries, falling birth rates have been associated with societal progress. During the demographic transition, where pre-industrial societies modernize in terms of fertility and mortality, falling death rates, especially among infants and children, are the first major change. In response, as more children survive into adulthood, women have fewer children as the need to compensate for child mortality declines. This transition has happened at different times across the world and is an ongoing process, with early industrial countries being the first to transition, and Sub-Saharan African countries being the most recent to do so. Additionally, some Asian countries (particularly China through government policy) have gone through their demographic transitions at a much faster pace than those deemed more developed. Today, in countries such as Japan, Italy, and Germany, birth rates have fallen well below death rates; this is no longer considered a positive demographic trend, as it leads to natural population decline, and may create an over-aged population that could place a burden on healthcare systems.

Japan JP: Sex Ratio at Birth: Male Births per Female Births data was reported at 1.056 Ratio in 2016. This stayed constant from the previous number of 1.056 Ratio for 2015. Japan JP: Sex Ratio at Birth: Male Births per Female Births data is updated yearly, averaging 1.056 Ratio from Dec 1962 (Median) to 2016, with 20 observations. The data reached an all-time high of 1.056 Ratio in 2016 and a record low of 1.056 Ratio in 2016. Japan JP: Sex Ratio at Birth: Male Births per Female Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Japan – Table JP.World Bank: Population and Urbanization Statistics. Sex ratio at birth refers to male births per female births. The data are 5 year averages.; ; United Nations Population Division. World Population Prospects: 2017 Revision.; Weighted average;

The statistic shows the total population in Japan from 2020 to 2024, with projections up until 2030. In 2024, the total population of Japan amounted to around 123.9 million inhabitants. See the figures for the population of South Korea for comparison. Total population in Japan From steadily low fertility rates to a growing elderly population, it is no secret that Japan’s population is shrinking. Population growth rates jump around a little, but are currently following a declining trend. The post-war baby boom generation is now in the 65-and-over age group, and the percentage of the population in that category is expected to keep growing, as is indicated by a high median age and high life expectancy. Japan already has the highest percentage of its population over 65 in the world, and the aging population puts some pressure on the Japanese government to provide welfare services for more people as rising numbers leave the workforce. However, the amount of jobs opened up for the younger generations by the older generations leaving the workforce means that unemployment is kept to a minimum. Despite a jump in unemployment after the global recession hit in 2008, rates were almost back to pre-recession rates by 2013. Another factor affecting Japan is the number of emigrants to other countries. The United States absorbs a number of emigrants worldwide, so despite a stagnating birth rate, the U.S. has seen a steady rise in population.

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Fertility Services Market Size 2025-2029

The fertility services market size is forecast to increase by USD 9.53 billion, at a CAGR of 7.8% between 2024 and 2029.

The market is a continually evolving landscape, driven by various factors that shape its dynamics. One significant trend is the increasing demand for fertility treatments due to the rising prevalence of late parenthood. According to recent studies, the number of women giving birth over the age of 35 has increased by 23.3% in the last decade. This demographic shift has led to a surge in demand for assisted reproductive technologies, including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Moreover, the market is also influenced by the growing incidence of prostate cancer, which can impact male fertility. According to the American Cancer Society, there will be approximately 193,000 new cases of prostate cancer diagnosed in the US in 2022.
This statistic underscores the importance of fertility services in addressing the reproductive health needs of cancer survivors. Despite these growth opportunities, the market faces challenges, including high complication rates associated with fertility treatments. For instance, the risk of multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) are significant concerns. These complications can lead to increased healthcare costs and potential long-term health risks for patients. The market is a complex and dynamic industry, shaped by demographic trends, health concerns, and technological advancements. As the demand for fertility treatments continues to rise, stakeholders must navigate the challenges and opportunities that come with this evolving landscape.

Major Market Trends & Insights

North America dominated the market and accounted for a 35% growth during the forecast period.
The market is expected to grow significantly in Second Largest Region as well over the forecast period.
By the Service, the Treatment services sub-segment was valued at USD 6.65 billion in 2023
By the End-user, the Fertility clinics sub-segment accounted for the largest market revenue share in 2023

Market Size & Forecast

Market Opportunities: USD 89.23 billion
Future Opportunities: USD USD 9.53 billion 
CAGR : 7.8%
North America: Largest market in 2023

What will be the Size of the Fertility Services Market during the forecast period?

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Fertility services encompass a range of medical interventions and technologies designed to help individuals and couples achieve pregnancy. One significant area within this market is the use of fertility medications, which play a crucial role in assisted reproductive technology (ART). According to recent reports, approximately 12% of women in the United States have used some form of fertility medication. ART involves various techniques, including artificial insemination, ovulation predictor kits, and ovarian stimulation protocols, among others. Cervical mucus plays a vital role in the natural process of conception, but ART may bypass this step through the use of intrauterine insemination (IUI) or in vitro fertilization (IVF).
In IUI, semen cryopreservation is essential for the success of the procedure. Ovarian stimulation protocols, such as ovulation induction, are commonly used in ART to increase the number of mature follicles and improve the chances of successful pregnancy. Ovulation predictor kits help individuals monitor their menstrual cycle and identify the most fertile days for conception. Despite the advancements in fertility services, challenges persist. Miscarriage rates remain a concern, with approximately 10-20% of known pregnancies ending in miscarriage. Blastocyst development is a critical factor in the success of ART, with implantation rate and pregnancy rate being essential indicators of treatment efficacy.
Reproductive endocrinology, a subspecialty of obstetrics and gynecology, focuses on the diagnosis and treatment of infertility. Donor insemination and ectopic pregnancy are other areas of fertility services that have gained increasing attention. Embryo culture media and ultrasound imaging are essential tools used in the field to monitor the development of embryos and assess the progress of pregnancies. Looking ahead, the market is expected to grow substantially. According to market reports, the global ART market is projected to expand at a significant rate, with an increase of around 15% in the number of ART cycles performed annually.
This growth is driven by factors such as rising infertility rates, increasing awareness, and advancements in technology. Comparing the growth rates of different regions, Asia Pacific is expected to witness the fastest growth in the ART market due to factors such as increasing disposable income, changing social norms, and government initiatives to promote fertility treatments

Japan assisted reproductive technology market size reached USD 3,524.7 Million in 2024. Looking forward, IMARC Group expects the market to reach USD 6,329.0 Million by 2033, exhibiting a growth rate (CAGR) of 6.7% during 2025-2033. The increasing prevalence of infertility in Japan, introduction of supportive measures by the government, recent technological advancements in ART, and rising awareness and societal acceptance of infertility treatment represent some of the key factors driving the market.

IMARC Group provides an analysis of the key trends in each segment of the market, along with forecasts at the country level for 2025-2033. Our report has categorized the market based on product, type, and end use.

In 2023, the total fertility rate in children per woman in Japan stood at 1.2. Between 1960 and 2023, the figure dropped by 0.8, though the decline followed an uneven course rather than a steady trajectory.

With an average of *** births per woman, Afghanistan had the highest fertility rate throughout the Asia-Pacific region in 2025. Pakistan and Papua New Guinea followed with the second- and third-highest fertility rates, respectively. In contrast, South Korea and Macao had the lowest fertility rates across the region. Contraception usage Fertility rates among women in the Asia-Pacific region have fallen throughout recent years. A likely reason is an increase in contraception use. However, contraception usage varies greatly throughout the Asia-Pacific region. Although contraception prevalence is set to increase across South Asia by 2030, women in both East Asia and Southeast Asia had higher contraception usage compared to South Asia in 2019. Women in APAC With the rise of feminism and the advancement of human rights, attitudes towards the role of women have changed in the Asia-Pacific region. Achieving gender equality has become a vital necessity for both men and women throughout the region. Alongside changes in traditional gender roles, women in certain Asia-Pacific countries, such as New Zealand, have become more inclined to marry later in life. Furthermore, the focus for younger women appears to be on having stability in their lives and securing an enjoyable job. This was displayed when female high school students in Japan were questioned about their future life aspirations.