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Trend/1 → AGING Populations

Younger
for longer

Topic

“What one has wished for in youth, in old age one has in abundance.” More and more people can relate to this quote from Johann Wolfgang von Goethe as life expectancies steadily increase worldwide. Birth rates, meanwhile, are sinking. These developments are reflected in the portfolio of products and services from Merck – including those that treat infertility and further cancer research.

FERTILITY → BIRTH RATES AND DISTRIBUTION Worldwide by region

Source: United Nations, World Fertility Patterns 2013

On average, women are bearing fewer and fewer children.
In Asia, the fertility rate is likely to decline significantly.
Yet according to a forecast of the global distribution of births in 2030,
in absolute terms the majority of children will be born in Asia.

“Catch me if you can!” yells Lovis as he races across the playground. Little Henri runs behind his older brother, shouting. The two boys keep their parents on their toes. But for Silke (41) and Jens (44), achieving this happy family was a long and difficult process. “At around the age of 30, I felt ready to start a family. At the time, Jens was still in awe of the responsibility of having a family, but I was able to convince him. Then, however, I couldn’t get pregnant,” Silke explains. There was a medical reason for this. When she was 17 Silke suffered from pelvic inflammatory disease, which blocked her fallopian tubes. “Although I had suspected this, it still came as a shock,” Silke recalls. After numerous discussions, the couple decided to try artificial insemination. One frequently used method is in vitro fertilization (IVF), a procedure in which the egg is fertilized outside the body. After ovulation is induced, the egg cells are removed through the vagina and placed in a test tube with the sperm and then transferred back afterwards.

Filling of ready-to-use syringes → under cleanroom conditions at a Merck pharmaceutical production plant in Darmstadt, Germany.

“The treatment took three years; it was not an easy time for us,” says Jens. Silke agrees, “I put myself under tremendous pressure and suffered from mood swings. And the negative test results made me very sad.” Not until the seventh attempt did they suddenly hear the words, “Congratulations, you’re pregnant!” The elation over the birth of Lovis in February 2008 was followed by another shock. The baby had cerebral hemorrhaging. “After a difficult period, Lovis is a happy, normal boy today,” the parents report with relief. And he now has a younger brother to play with. Henri was born in summer 2011. This time, Silke became pregnant immediately after the first attempt. “Maybe it was because I was much more relaxed,” Silke says today. Silke and Jens experienced an “emotional rollercoaster” during their efforts to become parents. Artificial insemination was ultimately successful, however – twice in fact. “We wanted these children so very much,” the couple says with conviction, gazing with pride at their sons.

Fulfilling the desire for children through fertility treatment

What Silke and Jens went through is certainly no isolated case.

Roughly one in seven couples in Germany is unable to bear children due to fertility disorders. The yearning to have a baby of their own can quickly become a tale of woe. But many couples are able to fulfill their desire for a child through artificial insemination. The per-cycle success rate for in vitro fertilization is about 70%. Hormone therapy is of decisive importance in treating infertility. As the world leader in the fertility drug industry, Merck supplies hormones for each phase of the reproductive cycle – from developing the egg cell to the early stage of pregnancy. The company has also developed a wealth of products in this area, including a computerized test that improves the prospects of a successful pregnancy by identifying viable embryos. As a result of the intensive research and development efforts, around two million children have now been born thanks to products from Merck.

“There are many causes of fertility disorders. Half of cases are due to women, the other half to men. However, in many cases advanced age is the reason,” says Professor Dr. Heribert Kentenich from the Fertility Center Berlin. Particularly in modern industrial nations, career plans or individual fulfillment come first and many couples delay family planning – sometimes for too long. “By the age of 30, a woman’s probability of a successful pregnancy begins to decline, and at 40 the odds become very low,” Professor Kentenich explains. Despite this, the trend is clear: Fewer and fewer women are having their first child before the age of 30. Naturally, the topic of infertility is not confined to western industrialized nations. However, in many countries it is a taboo topic. For this reason, in 2014 Merck launched a widespread educational campaign in India in order to overcome the culturally driven obstacle of silence.

Silke and Jens → ASSISTED REPRODUCTIVE TECHNOLOGY HELPED SILKE AND JENS TO HAVE THEIR CHILDREN LOVIS (RIGHT) AND HENRI.

“By the age of 30, a woman’s probability of a successful pregnancy begins to decline, and at 40 the odds become very low.”

Prof. Dr. Heribert Kentenich → Fertility Center Berlin

Longer life expectancy thanks to medical advances

Birth rates continue to decline worldwide, especially in highly developed societies and in the emerging markets of Asia and Latin America. At the same time, life expectancy is increasing (see text on right) with growing numbers of people who are getting older and older. This development is giving rise to new challenges. This relates not only to typical age-related diseases such as neurodegenerative disorders that the medical world is aiming to fight. Therapies to treat chronic diseases can also help younger patients to remain active members of the workforce and society for longer. One of Merck’s goals is to help people with neurodegenerative disorders such as multiple sclerosis by offering therapies that substantially help to improve their quality of life. The same applies to cancer therapy. Thanks to highly specialized biopharmaceuticals, many tumors can now be cured through early detection and treatment. And the company continues to drive progress in cancer research with new approaches that focus primarily on harnessing the immune system to fight cancer. “In the field of immuno-oncology, we are testing treatment possibilities for our anti-PD-L1 antibody in several different pivotal clinical studies across multiple types of cancer, including non-small cell lung cancer and ovarian cancer, as well as Merkel cell carcinoma, a rare form of skin cancer,” said Luciano Rossetti, Head of Global Research and Development at Merck Serono. Through the broad range of innovative materials, reagents, test kits and equipment from its Merck Millipore Life Science business, Merck is also supporting medical progress. Diverse products from Merck make the development and manufacture of new medicines much easier – from filtration, sample preparation and cell biology instruments, products used in oncology and neurology, in molecular biology and stem cell research, or for infectious diseases and metabolic disorders.

Luciano Rossetti → Executive Vice President, Global Head of Research & Development Merck Serono

High quality of life in old age

Growing older does not necessarily mean becoming more ill. The vast majority of “new” senior citizens feel fitter for longer. They are active, like to travel and consume, and they take care of themselves. Merck is responding to the increasingly health-conscious older population with over-the-counter products for the self-treatment of minor complaints. In pharmacies around the globe, consumers can find products tailored to the varying requirements of older men and women – for example the Seven Seas Perfect7® range, a combination made from sources of natural fish oil rich in omega-3 fatty acids, with important vitamins and minerals. Products like these are helping a growing number of people enjoy a high quality of life in old age. In order to maintain their appearance, they can rely on cosmetic active ingredients from Merck, for example substances that offer protection from UV radiation, combat aging of the skin and regulate the skin’s moisture balance. If wrinkles persist, they can be covered with a skin-colored silicate powder.

→ Declining birth rates
In the early 1960s, the worldwide fertility rate averaged 4.9 children per woman. In 2012, the rate had fallen to 2.6 children overall, and in industrialized countries to 1.6. Women in Germany currently give birth to an average of just 1.4 children. When the birth rate falls below the replacement-level fertility rate of 2.1 children per woman, population numbers shrink. In a global comparison, the African continent has the highest fertility rate of 4.4 children per woman.

→ Life expectancy and world population are rising
Recent UN studies show that the world population will grow from the current 7 billion to 11 billion people by the year 2100. Africa’s population will show a particularly dynamic development. It is likely to increase between now and then from 1 billion to 4 billion people. Increasing life expectancy is the main driver of population growth worldwide. In 1900, life expectancy in Germany was approximately 45 years; today a girl born in Germany can expect to live to the age of 83, and a boy to the age of 78. Researchers believe life expectancies around the world will continue to increase at varying rates, depending on the region.

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