And over the past several years you do see a general trend towards modestly increased fertility and modestly decreased mortality across the region.

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And, financially, having a child later in life, I reasoned, would allow me to build my earning potential more than if I took time off when I was younger (of course, I also ran the risk of increased costs in the event I needed fertility treatments).

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Twins, triplets and other multiple births also increased over the decade, partly due to fertility treatments.

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Dr Allan Pacey, senior lecturer at the University of Sheffield and secretary of the British Fertility Society, said some studies had shown an increased risk associated with some assisted reproductive techniques .

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Malawi increased modern contraceptive use from 17% of women in 1998 to 42% in 2010 but fertility fell only a bit, so something else must be going on.

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