Is Female Infertility the Cause of Iran's Low Birth Rate?

A few days ago Abu Douad pointed out an interesting article that appeared recently in Asia Times Online suggesting that Iran's low fertility was due at least in part to the country's very high level of infertility. The article is written by David Goldman at the London Center for Policy Research, which is in New York, not London--it is named after its president Herbert London. Anyway, Goldman suggests that recent sexual activity in Iran has increased the incidence of chlamydia and that helps keep the birth rate low. Does this make any sense?

First, it has be acknowledged that Iran has indeed experienced a genuinely stunning drop in fertility. I noted a few months ago that Iran shares with Cuba the distinction of responding to US-led economic embargoes by dramatically reducing childbearing. Economic uncertainty in a country characterized by increasing urbanization, high levels of literacy among both men and women, and a history of government-sponsored fertility control programs can almost certainly account for the rapid decline in fertility without resort to other explanations. Indeed, the idea that infertility is a key player in this is not well supported by the story upon which Goldman seems to rely. This is a paper published in the Journal of Reproduction and Infertility in 2009 reviewing three major studies in Iran. The important takeaway is that infertility--as defined in this particular article--was nearly as high in 1997 as it was in 2004-2005, and no more recent studies were cited. There is no evidence of a trend in infertility that would coincide with the trend in fertility rates. Perhaps even more important is the fact that I have not found any evidence of equivalently high levels of infertility in Turkey, whose fertility decline has closely mirrored Iran's. My view is that we can probably put the infertility theory in the category of maybe playing at most a very peripheral--and as yet unmeasured--role in Iran's fertility decline.