What Merck Can Do: Engaging Stakeholders to Improve Access to Fertility Care in the Netherlands

Abstract

In the Netherlands, fewer and fewer children are being born. While this may seem like a personal matter, it has serious consequences for society. A continued low birth rate means there will be fewer people working in the future, while the number of elderly people in need of care and pensions continues to grow. This is expected to create growing pressure on the healthcare system, the economy, and social services in the coming decades, as fewer people are available to support an ageing population. This research explores how Merck can support better fertility care in the Netherlands by helping people understand the issue and by working with insurers and government organisations to make care more accessible. Merck is already active in developing fertility treatments, but the company also wants to play a broader role in influencing public understanding and policy on fertility. To investigate what barriers exist in the current system, interviews were conducted with fertility doctors and experts. A public survey was also held among highly educated women aged 20 to 29, and additional surveys were sent to politicians and health insurers. Although most political parties did not respond, useful insights were gathered from one insurer and existing policy documents. The results show that many young women overestimate their fertility at older ages. Over 70% believed that getting pregnant at age 35 is almost as easy as at 25, despite scientific evidence showing a sharp decline. Most said they would consider freezing their eggs, but only if the cost was covered. This points to a need for better education and earlier information. Merck could support this by making medically accurate knowledge more visible for example through awareness campaigns or partnerships with health professionals. Doctors also reported that fertility clinics differ in how they treat patients. Some clinics use modern approaches, while others still follow outdated steps that delay care. There is also concern about a lack of national coordination and legal restrictions that block innovation. The one responding insurer said fertility preservation is seen as a personal choice, not a medical necessity, though they did see the value of more public education. These findings show that both clinical care and reimbursement are fragmented. Merck could help by sharing expert knowledge in ways that are useful for decision-makers and by supporting better alignment between clinics. To truly improve access, Merck should focus on communication that builds understanding and trust. This means helping young people learn about fertility in time to act, but also helping policymakers and insurers see why change is needed. For example, Merck could organize expert meetings, support fact-based campaigns, or offer international examples. By working together with doctors, researchers, and other stakeholders, Merck can help build a more open and fair fertility care system not by promoting treatments, but by supporting informed choices and long-term solutions.