The country with the lowest birth rate in the world, but which has 'crowded' fertility clinics

When did you start IVF treatment? (IVF) in November last year, Kim Mi-ae knew it would be a grueling test of patience — something she had already faced when she conceived her first child three years ago.

But what shocked her this time were the "absurd" waits at the fertility clinic.

"When I went in January, it seemed like everyone had made the same New Year's resolution: to have a baby! Even with an appointment, I waited more than three hours," says the 36-year-old Seoul resident.

As South Korea continues to face some of the world's lowest birth rates, fertility clinics have seen increasing demand—a silver lining in the country's demographic crisis.

Between 2018 and 2022, the number of fertility treatments performed in South Korea increased by nearly 50%, reaching 200,000. Last year, one in six babies in Seoul was born with the help of fertility treatment.

Behind the boom , experts say, is a shift in attitudes toward family planning.

"We have a young generation... That is used to having control over their lives," says Sarah Harper, professor of gerontology at the University of Oxford in the United Kingdom. This control, she adds, can come in the form of single women freezing their eggs or couples trying in vitro fertilization when they are unable to conceive.

"Whereas in previous generations there was a greater acceptance that getting pregnant or not could be a bit random, now we have Korean women saying, 'I want to plan my life.'"

This is good news for the South Korean government, which is trying to pull the country out of a demographic crisis. Currently, one in five people in South Korea is 65 or older. There have never been so few babies relative to the country's total population.

The country has repeatedly broken its own record for the world's lowest birth rate: 0.98 babies per woman in 2018, 0.84 in 2020 and 0.72 in 2023. If this trend continues, experts warn the population of 50 million could halve in 60 years.

But recently, there's reason for cautious optimism: Instead of another record low, South Korea's birth rate rose slightly to 0.75 in 2024 — its first increase in nine years.

"It's a small increase, but still significant," says Seulki Choi, a professor at the Korea Development Institute's School of Public Policy and Management.

It's too early to tell whether this is the beginning of a much-needed reversal or just a small increase. The country's birth rate remains well below the global average of 2.2. But many, like Choi, are cautiously optimistic.

"If this trend continues, it could signal a long-term shift," Choi says. "We need to observe how young people's attitudes toward marriage and parenthood are changing."

For years, having children was the last thing on Park Soo-in's mind. She was always busy with her advertising work and often didn't return home until 4 a.m.

"I was in a company with endless overtime, so it wasn't something I could even realistically consider," says the 35-year-old.

Things started to change after she got married two years ago. She got a new job with lighter hours—and her friends started having kids.

"Seeing and interacting with their children made everything seem less overwhelming," she says. "And seeing my husband take the initiative, researching pregnancy and childbirth, and demonstrating genuine effort gave me confidence that we could do this."

When Park and her husband had trouble conceiving, they turned to fertility treatments. Many others are doing the same, reinforcing projections that the booming industry could be worth more than $2 billion by 2030.

"This is actually an important signal to policymakers that there are still some women who want to start a family but are facing... barriers to doing so," notes Jennifer Sciubba, president and CEO of the Population Reference Bureau, a nonprofit in Washington, D.C.

"More than anything, it's a sign that people are failing to fulfill their desire to have children."

The difficulty in conceiving is just a barrier.

At the root of South Korea's population problems is a series of social and financial pressures—from patriarchal norms that place most childcare responsibilities on women to long work hours and high education costs—that discourage many young people from having children.

For some, however, these dreams have merely been postponed. More than half of South Koreans say they want to have children but cannot afford them, according to a United Nations (UN) report. And when South Korean women have their first child, the average age is 33.6—one of the highest in the world.

"Looking back, maybe it would have been better to start earlier," Park says. "But realistically... now seems like the right time. In my late 20s, I simply didn't have the financial capacity to think about marriage or children."

The same goes for Kim, who spent three years saving for her wedding, and another four to have a child.

"People spend their youth studying, looking for jobs, and spending money to prepare for life. And by the time they're ready to settle down, it's usually too late," she says. "The longer you wait, the harder it becomes [to get pregnant], physically and emotionally."

For those who opt for in vitro fertilization, the process of trying to get pregnant also becomes much more expensive.

"It's hard to say exactly how much IVF costs because it varies so much from person to person and cycle to cycle," says Kim. "It's a huge, unpredictable expense that can really affect your finances."

As part of efforts to increase the birth rate, the South Korean government has expanded its support for fertility treatments. Seoul now subsidizes up to 2 million Korean won (US$8,100) for egg freezing, and 1.1 million won (US$4,400) for each in vitro fertilization treatment.

But even with government subsidies, Kim says she spent more than 2 million won ($8,100) in January on IVF — mostly on items not covered by the subsidies, such as supplements and additional tests.

And since less than half of IVF cycles are successful, costs can add up quickly.

This was the case for Jang Sae-ryeon in Jeolla Province, southwestern Korea. The 37-year-old began fertility treatment two years ago and has already undergone five IVF cycles, each costing her about 1.5 million won (US$1,000).

"I wish things would work out after just one or two tries, but for most people, that's not the case," she says. "Without money, you just can't move forward. That's the reality. And I think that's the most frustrating part."

Equally challenging, women say, are the pressures they face in the workplace when committing to a demanding IVF schedule.

Although South Korean companies offer several days of leave for fertility treatment, women say it's difficult to actually utilize this benefit. Kim says she underwent IVF for her first child without taking leave. Jang, for her part, reveals that her colleagues urged her to postpone treatment.

"This made me feel like IVF and a full-time job just don't mix," Jang says. "So I quit. But once I left, I faced financial difficulties. This prompted me to look for work again."

These financial and cultural pressures may have dashed many South Korean women's dreams of having children, but not Jang's. She still gets emotional when she recalls two pregnancies early in her marriage—both of which ended in miscarriages.

"You know how they say that when you have a child, you feel boundless love?" she says. "I think having a child who looks like us and raising a family together is one of the greatest forms of happiness a person can feel."