Across East Asia, societies are becoming richer, healthier and more educated, yet fewer people feel able or willing to have families and raise children. Low fertility plagues high-income societies, particularly in East Asia, where the total fertility rate (TFR) has fallen below one birth per woman, well under the replacement level of 2.1 births. While many countries have dedicated considerable resources and effort to reversing this trend, the results have been somewhat disappointing.

The pairing of “low fertility” and “human development” is central to the discussion. Fertility trends are not merely demographic outcomes; they reflect how people experience work, relationships, caregiving, inequality, security and hope for the future. Child-rearing has slipped down the priority list for young couples, with the heavy burden of responsibility cited alongside financial strain as a major barrier.

Few current demographic trends are as consequential as persistently low fertility. In East Asia, including Singapore, fertility rates in some countries hover near or below one child per woman, raising grave concerns about future population and socioeconomic sustainability. Hong Kong witnessed a historic low of 31,100 births in 2025, with a TFR of 0.73, one of the lowest among all economies in the region.

Other societies have seen deaths outnumber births since 2020. This shortfall has been mitigated by migration in some places – such as Singapore and Hong Kong – but less so in others, including South Korea and Japan. Consequently, ageing has become a pressing and pervasive problem. Japan, South Korea, Taiwan, Singapore and Hong Kong are now classified as super-aged societies as their proportion of adults aged 65 or over has surpassed 20 per cent.

These shifts are reshaping families, labour markets, caregiving systems, healthcare demand and fiscal sustainability. The working population is shrinking, and the rise in healthcare demand risks outpacing GDP growth, testing the sustainability of healthcare, pension and social welfare systems. Furthermore, these trends reshape how young adults imagine their futures and life chances, with “lying flat” and stagnant upward mobility becoming more prevalent in some societies.

Based on the Youth Sexuality Study of the Family Planning Association of Hong Kong, family formation aspirations among young adults have weakened. Our research suggests that declining and delayed marriage remain key proximate drivers of ultra-low fertility, themselves shaped by broader economic, cultural and institutional pressures. This is not likely to change in the near future.