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Nancarrow L, Fernando A, Hampton L, Murray C, Hapangama DK, Tempest N. What Do the General Public Know about Infertility and Its Treatment? Eur J Investig Health Psychol Educ 2024; 14:2116-2125. [PMID: 39194935 DOI: 10.3390/ejihpe14080141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 08/29/2024] Open
Abstract
Rates of infertility are rising, and informed decision making is an essential part of reproductive life planning with the knowledge that ART success decreases dramatically while a woman's age increases and that high costs can often be incurred during fertility treatment. We aimed to determine the current knowledge of infertility and its treatments in the general public through an online survey. We received 360 complete responses. The average age of respondents was 35 years with most respondents being female (90%), heterosexual (88%), white (85%) and university educated (79%). Of the total, 49% had children and 23% had a condition that affects their fertility; 41% had concerns about future fertility and 78% knew someone who had had fertility treatment. Participants' understanding of basic reproductive biology and causes of infertility varied with correct responses to questions ranging from 44% to 93%. Understanding of IVF outcomes was poorer with only 32% to 55% of responses being correct, and 76% of respondents felt that their education in fertility was inadequate. This survey highlights the inconsistencies in the general public's understanding of infertility in this relatively educated population. With increasing demands on fertility services and limited public funds, better education is essential to ensure patients are fully informed with regard to their reproductive life planning.
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Affiliation(s)
- Lewis Nancarrow
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK
- Hewitt Centre for Reproductive Medicine, Liverpool Women's NHS Foundation Trust, Liverpool L8 7SS, UK
- Liverpool Women's NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool L8 7SS, UK
| | - Anuthi Fernando
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK
| | - Lucy Hampton
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK
| | - Courtney Murray
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK
| | - Dharani K Hapangama
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK
- Liverpool Women's NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool L8 7SS, UK
| | - Nicola Tempest
- Department of Women's and Children's Health, Centre for Women's Health Research, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK
- Hewitt Centre for Reproductive Medicine, Liverpool Women's NHS Foundation Trust, Liverpool L8 7SS, UK
- Liverpool Women's NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool L8 7SS, UK
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Adamczyk A, Suh B, Lerner L. Analysis of the relationship between religion, abortion, and assisted reproductive technology: Insights into cross-national public opinion. SOCIAL SCIENCE RESEARCH 2024; 120:103012. [PMID: 38763544 DOI: 10.1016/j.ssresearch.2024.103012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 03/13/2024] [Accepted: 03/23/2024] [Indexed: 05/21/2024]
Abstract
With advancement in reproductive technologies, public opinion regarding these procedures varies considerably across the world. While prominent public debates have focused on abortion, we know less about the factors shaping feelings regarding Assisted Reproductive Technologies (ART). Both procedures challenge the idea that human life starts with conception - with the fertilization of an embryo. Using European Values Survey data and multilevel modeling, we compare how religion and other personal and country-level factors shape disapproval toward abortion and ART. Conservative Protestants and people who are more engaged with their religion and live in a more religious country are more likely to disapprove of abortion and ART. More supportive polices and attitudes regarding ART, but not abortion, are correlated. Additionally, economic development moderates the relationship between personal religiosity and abortion, but not ART. This finding provides important insight into why abortion has remained such a controversial issue, even in richer nations.
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Affiliation(s)
- Amy Adamczyk
- The Graduate Center, City University of New York (CUNY), United States; John Jay College of Criminal Justice, CUNY, United States.
| | - Brittany Suh
- The Graduate Center, City University of New York (CUNY), United States.
| | - Lindsay Lerner
- The Graduate Center, City University of New York (CUNY), United States; John Jay College of Criminal Justice, CUNY, United States.
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Malina A. The social infertility cycle model. HEALTH PSYCHOLOGY REPORT 2023; 12:183-196. [PMID: 39234021 PMCID: PMC11370734 DOI: 10.5114/hpr/170986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/24/2023] [Accepted: 08/12/2023] [Indexed: 09/06/2024] Open
Abstract
Infertility poses an immense challenge to contemporary society. Around one in six people worldwide trying to conceive a child are facing infertility. This situation exists in an age of great technological developments where advances in medicine have made infertility treatment widely available and increasingly effective. In this article, a model will be presented that aims to explain the individual and social functioning of individuals and couples undergoing infertility treatment using assisted reproductive methods. The model was developed on the basis of a series of studies carried out by the author and colleagues during 2015-2021. The social infertility cycle model was proposed as the outcome of further research steps that were taken. The model takes into consideration the factors and behaviours of couples with infertility that determine the quality of their everyday functioning as well as the effectiveness of infertility treatment. The successive steps of the research process will be outlined in the article along with a presentation of the developed model.
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Affiliation(s)
- Alicja Malina
- Department of Social Psychology, Faculty of Psychology, Kazimierz Wielki University, Bydgoszcz, Poland
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Public attitudes in the United States toward insurance coverage for in vitro fertilization and the provision of infertility services to lower income patients. F S Rep 2022; 3:122-129. [PMID: 35937442 PMCID: PMC9349243 DOI: 10.1016/j.xfre.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 11/20/2022] Open
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Disparities in access to effective treatment for infertility in the United States: an Ethics Committee opinion. Fertil Steril 2021; 116:54-63. [PMID: 34148590 DOI: 10.1016/j.fertnstert.2021.02.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 11/15/2022]
Abstract
In the United States, economic, racial, ethnic, geographic, and other disparities prevent access to fertility treatment and affect treatment outcomes. This opinion examines the factors that contribute to these disparities, proposes actions to address them, and replaces the document of the same name, last published in 2015.
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Affiliation(s)
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- American Society for Reproductive Medicine, Birmingham, Alabama
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Szalma I, Bitó T. Knowledge and attitudes about assisted reproductive technology: Findings from a Hungarian online survey. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2021; 13:75-84. [PMID: 34381884 PMCID: PMC8340049 DOI: 10.1016/j.rbms.2021.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 04/23/2021] [Accepted: 06/08/2021] [Indexed: 05/19/2023]
Abstract
This study aimed to evaluate the general knowledge and attitudes about assisted reproductive technology (ART) and the influence of sociodemographic features on knowledge and attitudes in a large sample of men and women of reproductive age in Hungary. A cross-sectional online survey study was conducted among 1370 men and women between 18 and 50 years of age in Hungary. The questionnaire included questions about self-rated knowledge, an attitude item, and eight questions concerning general knowledge about ART. In addition, participants were asked sociodemographic background questions. The results show that approximately half of the respondents (49.3%) rated themselves as fairly knowledgeable about ART. However, 56% of the respondents answered just three of the eight knowledge questions correctly. Both men and women had limited knowledge about the success rate of ART, the costs of ART and the age limit to access ART. The greatest lack of knowledge about ART was about its risks: the majority of respondents did not know that in-vitro fertilization poses health risks for women and conceived children. Regarding attitudes, the majority of respondents had a very positive attitude towards ART. Only those respondents who were religious were less supportive of ART. These data suggest that men and women of reproductive age overestimate their ART-related knowledge. As most men and women would like to have biological children in Hungary, there is a critical need for public education.
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Affiliation(s)
- Ivett Szalma
- Centre for Social Sciences, Hungarian Academy of Sciences Centre of Excellence, Budapest, Hungary
- Corvinus University of Budapest, Budapest, Hungary
- Corresponding author at: Centre for Social Sciences, Hungarian Academy of Sciences Centre of Excellence, Budapest, Hungary.
| | - Tamás Bitó
- Department of Obstetrics and Gynaecology, University of Szeged, Szeged, Hungary
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Condition, disease, disability: how the label used to describe infertility may affect public support for fertility treatment coverage. J Assist Reprod Genet 2021; 38:2109-2119. [PMID: 34036457 PMCID: PMC8149289 DOI: 10.1007/s10815-021-02231-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/11/2021] [Indexed: 11/14/2022] Open
Abstract
Purpose To assess public attitudes towards fertility treatment coverage and whether attitudes are influenced by infertility labels. Methods Cross-sectional, web survey-based experiment using a national sample of 1226 United States adults. Participants read identical descriptions about infertility, with the exception of random assignment to infertility being labeled as a “condition,” “disease,” or “disability.” Participants then responded to questions measuring their beliefs and attitudes towards policies related to the diagnosis and treatment of infertility. We measured public support for infertility policies, public preference for infertility labels, and whether support differed by the randomly assigned label used. We also queried associations between demographic data and support for infertility policies. Results Support was higher for insurance coverage of infertility treatments (p=.014) and fertility preservation (p=.017), and infertility public assistance programs (p=.036) when infertility was described as a “disease” or “disability” compared to “condition.” Participants who were younger, were planning or trying to conceive, had a family member or friend with infertility, and/or had a more liberal political outlook were more likely to support infertility policies. A majority of participants (78%) felt the term “condition” was the best label to describe infertility, followed by “disability” (12%). The least popular label was “disease” (10%). Those preferring “condition” were older (p<.001), more likely to be non-Hispanic White (p=.046), and less likely to have an infertility diagnosis (p<.001). Conclusion While less commonly identified as the best descriptors of infertility, labeling infertility as a “disease” or “disability” may increase support for policies that improve access to infertility care Supplementary Information The online version contains supplementary material available at 10.1007/s10815-021-02231-z.
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DI Pietro ML, Zaçe D, Poscia A, Marana R. Perceived knowledge, coping and diagnostic-therapeutic pathways of infertile couples trying to conceive: an Italian survey. Minerva Obstet Gynecol 2021; 74:279-287. [PMID: 33944525 DOI: 10.23736/s2724-606x.21.04800-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The last decades' increasing infertility risk factors have brought to a growing number of infertile couples. Knowledge regarding infertility and possible treatments ishowever-poor, leading to difficulty in coping and understanding. Knowing infertile couples' perceptions and needs may help clinicians develop services that better address these needs. METHODS This study aimed at assessing perceived knowledge, coping mechanisms and diagnostic-therapeutic pathways concerning infertility and Assisted Reproductive Technology (ART) in a sample of Italian infertile couples trying to conceive. In this cross-sectional study, 199 subjects aged 25-55 years old who had difficulties conceiving were asked to fill a questionnaire regarding infertility and ART perceived knowledge, coping and diagnostic-therapeutic pathways they had been through. RESULTS The perceived knowledge score was 42.5%. Couples had difficulties understanding ART's success rate and the potential risks for the woman and foetus. Subjects from North of Italy, who were previously engaged in an ART procedure, those who had signed a written informed consent and were offered a specific counselling session had significantly higher mean score of perceived knowledge. Couples were handling the situation in a satisfactory way, supported also by their family, but the procedures, clinical examinations, therapies, medications, were considered complex and stressful by 66.5% of the respondents. CONCLUSIONS Healthcare providers should consider the couples' previous experience with infertility, the important role of informed consent and personalized counselling sessions. Counselling for infertile couples should have a broader, comprehensive approach, integrating psychological, social, ethical support, as well as health literacy, taking into consideration the infertile couples' preferences and needs.
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Affiliation(s)
- Maria Luisa DI Pietro
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Drieda Zaçe
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy -
| | - Andrea Poscia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Marana
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Quaas AM, Manoj M. Infertility: still a largely uncovered and undertreated disease. J Assist Reprod Genet 2021; 38:1069-1070. [PMID: 33909177 PMCID: PMC8079517 DOI: 10.1007/s10815-021-02205-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Alexander M Quaas
- Division of Reproductive Endocrinology and Infertility, University of California, San Diego, CA, USA.
- Reproductive Partners San Diego, 9850 Genesee Avenue, Suite # 800, La Jolla, San Diego, CA, 92037, USA.
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Husain W, Imran M. Infertility as seen by the infertile couples from a collectivistic culture. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:354-360. [PMID: 33131049 DOI: 10.1002/jcop.22463] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/09/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
Infertility in collectivistic cultures is usually regarded as a matter of social stigmatization instead of a biomedical problem. It has adverse sociocultural consequences, especially for the female spouse. The current study, by involving 20 infertile couples, was a qualitative research focusing on the sociocultural experiences of the infertile couples about the nature, causes, and consequences of infertility. The findings of the current study clearly depicted the sociocultural factors involved in interpreting infertility as a matter of shame and bad reputation for the couple and its family. The study has filled a significant knowledge gap and will be useful in identifying and addressing the cultural barriers in the treatment of infertility.
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Affiliation(s)
- Waqar Husain
- Department of Humanities, COMSATS University, Islamabad, Pakistan
| | - Mibarrah Imran
- Department of Humanities, COMSATS University, Islamabad, Pakistan
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Chronopoulou E, Seifalian A, Stephenson J, Serhal P, Saab W, Seshadri S. Preconceptual care for couples seeking fertility treatment, an evidence-based approach. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.xfnr.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Sahakian JPKK, El Helou E, Azoury J, Salameh L, Abou Jaoude I, Sleilaty G. Infertility within the Lebanese population: beliefs and realities. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2020. [DOI: 10.1186/s43043-020-00037-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Infertility affects almost one in five couples but is still poorly understood by the general public. Although the socio-cultural aspect of infertility has already been covered in some countries, there is currently no study concerning the Lebanese population’s view on this topic. This study aims to examine the knowledge and perception of the Lebanese population regarding infertility. The findings of this study could inform the creation of appropriate awareness campaigns aiming to rectify existing ideas based on myths and Lebanese folklore and establish a scientific understanding of infertility.
Results
Six hundred and nine participants were interviewed, and the responses recorded were statistically significant and correlated with p values < 0.05 with the participants’ personal data, in particular their gender and academic level. Men were twice as likely as women to believe that couple infertility is a valid reason for a divorce or a second marriage. In addition, most men said that they would first consult a gynecologist in the event of couple infertility, which highlights the fact that the general population assumes the cause of infertility is of female origin, even though both sexes are frequently affected. In addition, men are twice as likely as women to refuse to live with an infertile spouse and the most educated respondents tend to be more aware and open to the idea of adopting a child or to use in vitro fertilization.
Conclusion
This study is the first to examine the socio-cultural beliefs and habits regarding infertility in Lebanon, with a focus on society’s attribution of infertility to women. More studies are needed to understand how a personal experience of infertility can affect one’s understanding and perceptions regarding infertility. Furthermore, Lebanese physicians should adopt a more multidisciplinary approach when managing couple infertility.
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King R, Nagy A, Dempsey M, Rice A. “That which is crooked can be made straight”: Challenges and opportunities of Assistive Reproductive Technologies (ART) in Ireland in the 21st century. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2019.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Harzif AK, Santawi VPA, Wijaya S. Discrepancy in perception of infertility and attitude towards treatment options: Indonesian urban and rural area. Reprod Health 2019; 16:126. [PMID: 31426818 PMCID: PMC6700767 DOI: 10.1186/s12978-019-0792-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/13/2019] [Indexed: 11/25/2022] Open
Abstract
Background In Indonesia infertility affects 10–15% of reproductive-age couples. In addition to medical problem, infertility in Indonesia poses significant social problem. Childlessness is often stigmatized as a failure which victimizes couples, moreover the females. Despite the high prevalence, there is no fertility awareness education which further passes down the common myth, misperception, and negative attitude towards infertility treatment in Indonesian society. Objective This study aims to reveal the knowledge, myth, and attitude towards infertility, likewise acceptance towards infertility treatment options. Method Cross-sectional study using standardized questionnaire was done to 272 individuals consisted of two parallel groups: Jakarta and Sumba representing urban and rural population respectively. Participants were all outpatients above 18 years old who visited the healthcare centers from February 2017 to June 2017. Results Knowledge on biological and lifestyle risk factors of infertility among Jakarta and Sumba groups were comparable. However, belief in supernatural causes of infertility is remarkable in Sumba population. There is a common misconception on the use of contraception as risk factors of infertility in both groups. Half respondents from both groups think infertility is a disease. In Jakarta 93.4% respondents consider both female and male should be investigated for infertility; in Sumba only 55.4% agree while 33.1% consider only female should be investigated. Infertility is an acceptable reason for polygamy for 41.3% respondents in Sumba, with 34.7% blaming maternal side for childlessness. Most respondents from both groups accept the use of Assisted Reproductive Technology and fertility enhancing drugs as treatment options. Conclusion Lack of understanding, misleading myths, and negative attitude towards infertility have been illustrated in the sample population.
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Affiliation(s)
- Achmad Kemal Harzif
- Department of Obstetrics and Gynecology, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jl. Pangeran Diponegoro no. 71. Kenari, Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta, Jakarta, 10430, Indonesia
| | - Victor Prana Andika Santawi
- Department of Obstetrics and Gynecology, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jl. Pangeran Diponegoro no. 71. Kenari, Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta, Jakarta, 10430, Indonesia.
| | - Stephanie Wijaya
- Department of Obstetrics and Gynecology, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jl. Pangeran Diponegoro no. 71. Kenari, Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta, Jakarta, 10430, Indonesia
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Sutherland JM, Frost ER, Ford EA, Peters AE, Reed NL, Seldon AN, Mihalas BP, Russel DL, Dunning KR, McLaughlin EA. Janus kinase JAK1 maintains the ovarian reserve of primordial follicles in the mouse ovary. Mol Hum Reprod 2019; 24:533-542. [PMID: 30247637 DOI: 10.1093/molehr/gay041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 09/24/2018] [Indexed: 01/13/2023] Open
Abstract
STUDY QUESTION Is the Janus kinase and signal transducer and activator of transcription (JAK-STAT) signalling pathway involved in ovarian follicle development and primordial follicle activation? SUMMARY ANSWER JAK1 is a key factor involved in the regulation of primordial follicle activation and maintenance of the ovarian reserve. WHAT IS KNOWN ALREADY A series of integrated, intrinsic signalling pathways (including PI3K/AKT, mTOR and KITL) are responsible for regulating the ovarian reserve of non-growing primordial follicles and ultimately female fertility. The JAK-STAT signal transduction pathway is highly conserved with established roles in cell division and differentiation. Key pathway members (specifically JAK1, STAT3 and SOCS4) have been previously implicated in early follicle development. STUDY DESIGN, SIZE, DURATION A laboratory animal study was undertaken using the C57Bl/6 inbred mouse strain as a model for human ovarian follicle development. To determine which Jak genes were most abundantly expressed during primordial follicle activation, mRNA expression was analysed across a developmental time-course, with ovaries collected from female mice at post-natal days 1 (PND1), 4 (PND4), 8 (PND8), as well as at 6 weeks (6WK) and 7 months (7MTH) (n ≥ 4). Functional analysis of JAK1 was performed on PND2 mouse ovaries subjected to in vitro explant culture treated with 12.5 μM Ruxolitinib (JAK inhibitor) or vehicle control (DMSO) for 48 h prior to histological assessment (n ≥ 4). PARTICIPANTS/MATERIALS, SETTING, METHODS The expression and localization of the JAK family during ovarian follicle development in the C57Bl/6 inbred mouse strain were evaluated using quantitative PCR, immunoblotting and immunolocalisation. Functional studies were undertaken using the JAK inhibitor Ruxolitinib to investigate the underpinning cellular mechanisms via biochemical in vitro inhibition and histological assessment of intact neonate ovaries. All experiments were replicated at least three times using tissue from different mice unless otherwise stated. MAIN RESULTS AND THE ROLE OF CHANCE Jak1 is the predominant Jak mRNA expressed in the C57Bl/6 mouse ovary across all developmental time-points assessed (P ≤ 0.05). Forty-eight hour inhibition of JAK1 with Ruxolitinib of PND2 ovaries in vitro demonstrated concomitant acceleration of primordial follicle activation and apoptosis (P ≤ 0.001) and upregulation of downstream JAK-STAT pathway members STAT3 and suppressors of cytokine signalling 4 (SOCS4). LARGE-SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION Results are shown in one species, the C57Bl/6 mouse strain as an established model of human ovary development. Ruxolitinib also inhibits JAK2, with decreased efficacy. However, Jak2 mRNA had limited expression in the mouse ovary, particularly at the neonatal stages of follicle development, thus any effect of Ruxolitinib on primordial follicle activation was unlikely to be mediated via this isoform. WIDER IMPLICATIONS OF THE FINDINGS This study supports a key role for JAK1 in the maintenance and activation of primordial follicles, with potential for targeting the JAK-STAT pathway as a method of regulating the ovarian reserve and female fertility. STUDY FUNDING AND COMPETING INTEREST(S) This project has been funded by the Australian National Health and Medical Research Council (G1600095) and The Hunter Medical Research Institute Bob and Terry Kennedy Children's Research Project Grant in Pregnancy & Reproduction (G1501433). All authors declare no conflict of interests.
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Affiliation(s)
- Jessie M Sutherland
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Emily R Frost
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Emmalee A Ford
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Alexandra E Peters
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Natalie L Reed
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Alexandra N Seldon
- School of Biomedical Science & Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Bettina P Mihalas
- School of Environmental and Life Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Darryl L Russel
- Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Kylie R Dunning
- Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia.,Australian Research Council, Centre of Excellence for Nanoscale BioPhotonics
| | - Eileen A McLaughlin
- School of Environmental and Life Sciences, University of Newcastle, Callaghan, NSW, Australia.,School of Biological Sciences, University of Auckland, Auckland, New Zealand
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Nasab S, Shah JS, Nurudeen K, Jooya ND, Abdallah ME, Sibai BM. Physicians' attitudes towards using elective oocyte cryopreservation to accommodate the demands of their career. J Assist Reprod Genet 2019; 36:1935-1947. [PMID: 31376103 DOI: 10.1007/s10815-019-01541-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/23/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Among medical professionals, there appears to be a significant lack of knowledge about oocyte cryopreservation. Medical professionals may be potential candidates for elective oocyte cryopreservation due to the demands and commitments of medical training. There is a paucity of data on this topic among medical professionals. The aim of this study was to assess knowledge, understanding, and beliefs towards elective egg freezing among medical professionals to assess whether they are potential candidates for elective egg freezing. METHODS This is a cross-sectional descriptive study in a university-based training program. All medical students, residents, fellows, and faculty were included. An online survey was emailed to potential participants. It included demographic questions regarding childbearing decision-making factors, fertility knowledge, and attitudes towards using elective oocyte cryopreservation. RESULTS A total of 1000 emails were sent. Of those, 350 completed surveys were received. On average, 33% of responders provided a correct answer to each fertility knowledge question. The duration of training and the heavy workload with long duty hours were the most common influencing factors when deciding the timing of childbearing. Overall, 65% of the male and female responders were concerned about their future fertility. Among those women who had future fertility concerns, 8% were not aware of egg freezing as a fertility option and wished they had had an opportunity to freeze their eggs at an earlier time. CONCLUSIONS Physicians' childbearing decisions can be affected by the demands of their careers. Elective oocyte cryopreservation could be considered an option for family planning. Educational sessions and awareness programs are needed to provide information about available fertility preservation options, which can potentially decrease the rate of regret.
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Affiliation(s)
- Susan Nasab
- McGovern Medical School, Department of Obstetrics and Gynecology, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 3.214, Houston, TX, 77030, USA.
| | - Jaimin S Shah
- McGovern Medical School, Department of Obstetrics and Gynecology, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 3.214, Houston, TX, 77030, USA
| | - Kemi Nurudeen
- Houston Fertility Institute, 6400 Fannin Street, Suite 2000, Houston, TX, 77030, USA
| | - Neda D Jooya
- McGovern Medical School, Department of Obstetrics and Gynecology, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 3.214, Houston, TX, 77030, USA
| | - Mazen E Abdallah
- Houston Fertility Institute, 6400 Fannin Street, Suite 2000, Houston, TX, 77030, USA
| | - Baha M Sibai
- McGovern Medical School, Department of Obstetrics and Gynecology, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 3.214, Houston, TX, 77030, USA
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Beliefs, attitudes and funding of assisted reproductive technology: Public perception of over 6,000 respondents from 6 European countries. PLoS One 2019; 14:e0211150. [PMID: 30682152 PMCID: PMC6347360 DOI: 10.1371/journal.pone.0211150] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 01/08/2019] [Indexed: 12/17/2022] Open
Abstract
Background Fertility rates in Europe are among the lowest in the world, which may be attributed to both biological and lifestyle factors. Cost and reimbursement of fertility treatments vary across Europe, although its citizens enjoy wide access to fertility care. Since few regional studies evaluating public support for fertility treatment exist, we conducted the Listening IVF and Fertility in Europe (LIFE) survey to ascertain public perception of in vitro fertilization (IVF) and gamete donation as a treatment for infertility among European men and women. Methods and findings This survey was distributed via an online questionnaire to 8,682 individuals who were voluntary participants in an online research panel residing in France, Germany, Italy, Spain, Sweden, or the UK. The survey covered items to determine respondents’ beliefs regarding IVF and its success, the need for public funding, the use of IVF among modern families with different lifestyles, and the support for gamete donation. Results were analyzed by age, country of origin, sex, and sexual orientation. A total of 6,110 (70% of total) men and women responded. Among all respondents, 10% had undergone IVF treatment and 48% had considered or would consider IVF in case of infertility. Respondents estimated IVF mean success rate to be 47% and over half of respondents believed that availability of IVF would encourage people to delay conception. Although 93% of respondents believed that IVF treatment should be publicly funded to some extent, a majority believed that secondary infertility or use of fertility treatments allowing to delay parenthood should be financed privately. Survey respondents believed that the mean number of stimulated IVF cycles funded publicly should be limited 2 to 3 (average 2.4). 79% of respondents were willing to pay for IVF if needed with a mean amount of 5,400 € for a child brought to life through IVF. According to respondents, mean minimum and maximum ages for IVF should be 29 and 42 years old, respectively. The current survey showed support for egg and sperm donation (78%), for IVF in single women (61%) and for same-sex female couples (64%). When analyzing the results per group (i.e., sex, age, sexual orientation, and countries), youngest age groups, homosexuals, bisexuals, German respondents, and men had similar overall positive attitudes and beliefs toward IVF and opinions on public funding. Perceived limits to availability were stronger in women. Conclusion Overall, the survey results demonstrate a positive attitude among respondents in an online panel toward IVF, gamete donation, and support for public funding for fertility treatment. These findings could potentially drive discussions between patients and prescribers to explore IVF treatment and among legislators and payers to support public funding for these procedures.
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Fritz R, Jindal S. Reproductive aging and elective fertility preservation. J Ovarian Res 2018; 11:66. [PMID: 30098598 PMCID: PMC6087539 DOI: 10.1186/s13048-018-0438-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/02/2018] [Indexed: 01/05/2023] Open
Abstract
Reproductive aging is a natural process that occurs in all women, eventually leading to reproductive senescence and menopause. Over the past half century there has been a trend towards delayed motherhood. Postponing reproduction can increase the chance of a woman remaining involuntarily childless as well as an increase in pregnancy complications in those that do achieve pregnancy at advanced maternal age. Despite the well-documented decrease in fecundity that occurs as a woman ages, reproductive aged women frequently overestimate the age at which a significant decline in fertility occurs and overestimate the success of assisted reproductive technologies (ART) to circumvent infertility. Oocyte cryopreservation enables women to achieve genetically related offspring in the event that they desire to postpone their childbearing to an age after which a significant decline in fertility occurs or in circumstances in which their reproductive potential is compromised due to medical pathology. Available success rates and safety data following oocyte cryopreservation have been reassuring and is not considered experimental according to the American Society for Reproductive Medicine and the European Society for Human Reproduction and Embryology. This review article will focus on an evidence-based discussion relating to reproductive aging and oocyte cryopreservation.
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Affiliation(s)
- Rani Fritz
- Department of Obstetrics, Gynecology & Women’s Health, Albert Einstein College of Medicine/Montefiore Medical Center, Minneapolis, USA
| | - Sangita Jindal
- Department of Obstetrics, Gynecology & Women’s Health, Albert Einstein College of Medicine/Montefiore Medical Center, Minneapolis, USA
- Montefiore’s Institute for Reproductive Medicine and Health, New York, USA
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Pedro J, Brandão T, Schmidt L, Costa ME, Martins MV. What do people know about fertility? A systematic review on fertility awareness and its associated factors. Ups J Med Sci 2018; 123:71-81. [PMID: 29957086 PMCID: PMC6055749 DOI: 10.1080/03009734.2018.1480186] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 06/01/2017] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Recent evidence indicates that reproductive-age people have inadequate fertility awareness (FA) concerning fertility, infertility risk factors, and consequences of delaying childbearing. However, no study has tried to summarize these studies and to clarify the variables associated with FA, namely the role of gender, age, education, and reproductive status on FA. METHODS A literature search up to February 2017 was conducted using the EBSCO, Web of Science, Scielo, and Scopus electronic databases with combinations of keywords and MeSH terms (e.g. 'awareness' OR 'health knowledge, attitudes, practice' AND 'fertility'; 'fertile period'; 'assisted reprod*'). RESULTS Seventy-one articles met the eligibility criteria and were included. The main results showed that participants report low-to-moderate FA. Higher levels of FA were shown by women, highly educated individuals, people who reported difficulties with conceiving, and those who had planned their pregnancies. Having or desiring to have children was not related to FA level. An inconsistent association between study participant age and FA was observed, with some studies indicating that older participants had higher FA, but others found an opposite result or did not find any association. CONCLUSION The current findings suggest that interventions to increase FA are warranted, especially those targeting men, people with low education, and in family planning settings. Interventions and campaigns should be customized to meet individuals' needs regarding FA. Because of the high heterogeneity regarding the assessment of FA, these conclusions must be interpreted with caution.
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Affiliation(s)
- Juliana Pedro
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Tânia Brandão
- Centre for Research in Psychology (CIP-UAL), Universidade Autónoma de Lisboa, Lisboa, Portugal
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Maria E. Costa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Mariana V. Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
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Favre-Inhofer A, Rafii A, Carbonnel M, Revaux A, Ayoubi JM. Uterine transplantation: Review in human research. J Gynecol Obstet Hum Reprod 2018; 47:213-221. [PMID: 29574054 DOI: 10.1016/j.jogoh.2018.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 03/16/2018] [Accepted: 03/20/2018] [Indexed: 12/18/2022]
Abstract
Uterine transplantation is the solution to treat absolute uterine fertility. In this review, we present the historical, medical, technical, psychological and ethical perspectives in human uterine transplantation research. We reviewed the PubMed database following PRISMA guidelines and added data presented by several research teams during the first international congress on uterine transplantation.
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Affiliation(s)
- A Favre-Inhofer
- Department of Gynecology and Obstetrics, Hospital Foch, Suresnes, France
| | - A Rafii
- Department of Gynecology and Obstetrics, Hospital Foch, Suresnes, France
| | - M Carbonnel
- Department of Gynecology and Obstetrics, Hospital Foch, Suresnes, France
| | - A Revaux
- Department of Gynecology and Obstetrics, Hospital Foch, Suresnes, France
| | - J M Ayoubi
- Department of Gynecology and Obstetrics, Hospital Foch, Suresnes, France.
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Goldman RH, Kaser DJ, Missmer SA, Farland LV, Scout, Ashby RK, Ginsburg ES. Fertility treatment for the transgender community: a public opinion study. J Assist Reprod Genet 2017; 34:1457-1467. [PMID: 28900753 DOI: 10.1007/s10815-017-1035-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 08/23/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The purposes of this study were to evaluate public opinion regarding fertility treatment and gamete cryopreservation for transgender individuals and identify how support varies by demographic characteristics. METHODS This is a cross-sectional web-based survey study completed by a representative sample of 1111 US residents aged 18-75 years. Logistic regression was used to calculate odd ratios (ORs) and 95% confidence intervals (CIs) of support for/opposition to fertility treatments for transgender people by demographic characteristics, adjusting a priori for age, gender, race, and having a biological child. RESULTS Of 1336 people recruited, 1111 (83.2%) agreed to participate, and 986 (88.7%) completed the survey. Most respondents (76.2%) agreed that "Doctors should be able to help transgender people have biological children." Atheists/agnostics were more likely to be in support (88.5%) than Christian-Protestants (72.4%; OR = 3.10, CI = 1.37-7.02), as were younger respondents, sexual minorities, those divorced/widowed, Democrats, and non-parents. Respondents who did not know a gay person (10.0%; OR = 0.20, CI = 0.09-0.42) or only knew a gay person without children (41.4%; OR = 0.29, CI = 0.17-0.50) were more often opposed than those who knew a gay parent (48.7%). No differences in gender, geography, education, or income were observed. A smaller majority of respondents supported doctors helping transgender minors preserve gametes before transitioning (60.6%) or helping transgender men carry pregnancies (60.1%). CONCLUSIONS Most respondents who support assisted and third-party reproduction also support such interventions to help transgender people have children.
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Affiliation(s)
- Randi H Goldman
- Center for Infertility and Reproductive Surgery, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
| | - Daniel J Kaser
- Reproductive Medicine Associates of New Jersey, Basking Ridge, NJ, 07920, USA
| | - Stacey A Missmer
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, 49503, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.,Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Leslie V Farland
- Center for Infertility and Reproductive Surgery, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Scout
- The Torvus Group, Beverly Hills, CA, 09212, USA
| | - Rachel K Ashby
- Center for Infertility and Reproductive Surgery, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Elizabeth S Ginsburg
- Center for Infertility and Reproductive Surgery, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
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Stevenson EL, McEleny KR. Male subfertility as a chronic illness: the role of adaptive challenges. HUM FERTIL 2017; 20:148-154. [PMID: 28330414 DOI: 10.1080/14647273.2017.1303198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Male factor infertility (MFI) is extremely common, often with several associated chronic health conditions. Because a man's fertility assessment may be their first contact with health services, the health care team has a responsibility to act as male health advocates to ensure comprehensive care. The diagnosis of subfertility allows a broader view of these men as patients with a chronic illness who have complex health needs. Because of the associated complexity of care following evaluation, there needs to be new approach in how men affected by MFI should be managed long term. In this commentary, we propose that the Adaptive Leadership Framework model for Chronic Illness is a suitable vehicle to use for management of the MFI patient's journey towards optimized health.
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Affiliation(s)
- Eleanor L Stevenson
- a Division of Health for Women, Children and Families , Duke University School of Nursing , Durham , NC , USA
| | - Kevin R McEleny
- b Newcastle Fertility Centre , The Newcastle-upon-Tyne Hospitals NHS Trust , Newcastle , UK
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Alosaimi FD, Bukhari M, Altuwirqi M, Habous M, Madbouly K, Abotalib Z, Binsaleh S. Gender differences in perception of psychosocial distress and coping mechanisms among infertile men and women in Saudi Arabia. HUM FERTIL 2016; 20:55-63. [PMID: 27778521 DOI: 10.1080/14647273.2016.1245448] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The objective of the study was to evaluate the differences in psychosocial distress and coping mechanisms among infertile men and women in Saudi Arabia (SA). We performed a cross-sectional study of infertile patients (206 women and 200 men) attending infertility clinics in three referral hospitals in Riyadh, SA. A semi-structured questionnaire was developed to assess socio-demographic, clinical and psychosocial variables. Infertility-related psychosocial pressures were reported in 79 (39.7%) male and 97 (47.3%) female participants (p = 0.123). Males suffered more from intrusive questions and pressure to conceive, remarry or get divorced, while females were stressed more from psychological and emotional exhaustion, marital discord, attitudes of mothers-in-law or society, and persistent desire by the husband to have children. To cope with infertility, females engaged more in religious activities (p < 0.001) and spoke more to someone regarding their problems (p < 0.001). To solve their infertility problems, 50% tried to find solutions via the internet, and 38.5% of males and 51% of females reported using alternative medicines (p = 0.012). The patients with infertility in SA face multiple psychosocial stressors related to their infertility, and cope differently based on the gender and culture-specific knowledge of infertility. The female participants were significantly more affected from psychosocial stressors and the persistent desire by their spouse to have children.
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Affiliation(s)
- Fahad D Alosaimi
- a Department of Psychiatry , King Saud University , Riyadh , Saudi Arabia
| | - Mujahid Bukhari
- b Department of Obstetrics and Gynaecology , King Saud University , Riyadh , Saudi Arabia
| | - Maram Altuwirqi
- a Department of Psychiatry , King Saud University , Riyadh , Saudi Arabia
| | - Mohamad Habous
- c Urology Department , Elaj Medical Group , Jeddah , Saudi Arabia
| | - Khaled Madbouly
- d Department of Urology , Prince Mohammed Bin Abdulaziz Hospital , Riyadh , Saudi Arabia
| | - Zeinab Abotalib
- b Department of Obstetrics and Gynaecology , King Saud University , Riyadh , Saudi Arabia
| | - Saleh Binsaleh
- e Division of Urology, Department of Surgery , King Saud University , Riyadh , Saudi Arabia
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Rossi BV, Bressler LH, Correia KF, Lipskind S, Hornstein MD, Missmer SA. Lifestyle and in vitro fertilization: what do patients believe? FERTILITY RESEARCH AND PRACTICE 2016; 2:11. [PMID: 28620538 PMCID: PMC5424337 DOI: 10.1186/s40738-016-0026-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 09/16/2016] [Indexed: 11/22/2022]
Abstract
Background Patients have many beliefs regarding lifestyle factors and IVF outcomes. Methods Observational study of 208 IVF patients at an academic infertility center. Main outcome measures were perceived influence of various lifestyle factors assessed by multivariable logistic regression and p-value tests for linear trend (Pt). Results A majority of participants believed that there were many women’s lifestyle choices that were influential, compared to fewer male factors (cessation of tobacco (72 %), alcohol (69 %), caffeine (62 %), and use of vitamins (88 %)). Compared to participants with less education, participants with a higher education level were less likely to believe vitamins were helpful and some alcohol use was not harmful. As income decreased, participants were less likely to consider dietary factors contributory to IVF success, such as women (p-trend, p = 0.02) and men (p-trend, p = 0.009) consuming a full-fat dairy diet. Participants’ beliefs were most commonly influenced by physicians (84 %) and the internet (71 %). Conclusions Patients believed many lifestyle factors are associated with IVF success. Understanding patients’ assumptions regarding the effect of lifestyle factors on IVF success may better allow physicians to counsel patients about IVF outcomes. Electronic supplementary material The online version of this article (doi:10.1186/s40738-016-0026-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Brooke V Rossi
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA.,University Hospitals Fertility Center, Kathy Risman Pavilion, Suite 310, 1000 Auburn Dr, Beachwood, OH 44122 USA
| | - Leah Hawkins Bressler
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA
| | - Katharine F Correia
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA
| | - Shane Lipskind
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA
| | - Mark D Hornstein
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA
| | - Stacey A Missmer
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA USA.,Department of Epidemiology, Harvard School of Public Health, Boston, MA USA
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Place JMS, Bireley M. Exploring Infertility from the Cultural Context of Latino College Students: Results from a Preliminary Focus Group. J Racial Ethn Health Disparities 2016; 4:10.1007/s40615-016-0282-4. [PMID: 27586031 DOI: 10.1007/s40615-016-0282-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/29/2016] [Accepted: 08/17/2016] [Indexed: 10/21/2022]
Abstract
Despite a racial/ethnic disparity, little research has examined minority group perceptions of infertility. After developing a 15-question English-language focus group guide, 13 Latino college students (ages 19-22) at a Midwestern university were recruited to participate in a focus group to discuss their perceptions of infertility in the context of their family and culture. The focus group was audio recorded, professionally transcribed, and analyzed according to the constructed Grounded Theory approach. Three major themes were identified: 1) infertility is not considered when looking towards the future; 2) infertility is not discussed due to shame; and 3) infertility does not require a medical resolution. College students have the opportunity to make lifestyle modifications that can optimize fertility, but intention to change behavior is contingent on accurate fertility knowledge, which is often influenced by cultural norms. Our results suggest that these Latino students do not consider infertility a risk in their future lives nor is infertility something they consider should be explicitly discussed. Importantly, they do not perceive the need for medical interventions when addressing infertility, which carries implications for treatment seeking. When creating educational interventions for infertility, it is important to take into account the cultural lens through which infertility is understood.
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Affiliation(s)
- Jean Marie S Place
- Department of Nutrition and Health Science, Ball State University, Cooper CL, 326F, Muncie, IN, 47306, USA.
| | - McKenna Bireley
- Department of Nutrition and Health Science, Ball State University, Cooper CL, 326F, Muncie, IN, 47306, USA
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Wilkinson S, Williams NJ. Should uterus transplants be publicly funded? JOURNAL OF MEDICAL ETHICS 2016; 42:559-65. [PMID: 26670671 PMCID: PMC5013100 DOI: 10.1136/medethics-2015-102999] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 11/12/2015] [Indexed: 05/14/2023]
Abstract
Since 2000, 11 human uterine transplantation procedures (UTx) have been performed across Europe and Asia. Five of these have, to date, resulted in pregnancy and four live births have now been recorded. The most significant obstacles to the availability of UTx are presently scientific and technical, relating to the safety and efficacy of the procedure itself. However, if and when such obstacles are overcome, the most likely barriers to its availability will be social and financial in nature, relating in particular to the ability and willingness of patients, insurers or the state to pay. Thus, publicly funded healthcare systems such as the UK's National Health Service (NHS) will eventually have to decide whether UTx should be funded. With this in mind, we seek to provide an answer to the question of whether there exist any compelling reasons for the state not to fund UTx. The paper proceeds as follows. It assumes, at least for the sake of argument, that UTx will become sufficiently safe and cost-effective to be a candidate for funding and then asks, given that, what objections to funding there might be. Three main arguments are considered and ultimately rejected as providing insufficient reason to withhold funding for UTx. The first two are broad in their scope and offer an opportunity to reflect on wider issues about funding for infertility treatment in general. The third is narrower in scope and could, in certain forms, apply to UTx but not other assisted reproductive technologies (ARTs). The first argument suggests that UTx should not be publicly funded because doing so would be inconsistent with governments' obligations to prevent climate change and environmental pollution. The second claims that UTx does not treat a disorder and is not medically necessary. Finally, the third asserts that funding for UTx should be denied because of the availability of alternatives such as adoption and surrogacy.
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Affiliation(s)
- Stephen Wilkinson
- Department of Politics, Philosophy and Religion, Lancaster University, Lancaster, UK
| | - Nicola Jane Williams
- Department of Politics, Philosophy and Religion, Lancaster University, Lancaster, UK
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Muñoz Sastre MT, Sorum PC, Mullet E. The acceptability of assisted reproductive technology among French lay people. J Reprod Infant Psychol 2016. [DOI: 10.1080/02646838.2016.1188279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Paul Clay Sorum
- Department of Pediatrics, Albany Medical College , Albany, NY, USA
| | - Etienne Mullet
- Department of Ethics, Institute of Advanced Studies (EPHE) , Paris, France
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Hendriks S, Hessel M, Mochtar MH, Meissner A, van der Veen F, Repping S, Dancet EAF. Couples with non-obstructive azoospermia are interested in future treatments with artificial gametes. Hum Reprod 2016; 31:1738-48. [PMID: 27130613 DOI: 10.1093/humrep/dew095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 03/23/2016] [Indexed: 12/26/2022] Open
Abstract
STUDY QUESTION Would couples diagnosed with non-obstructive azoospermia (NOA) consider two future treatments with artificial gametes (AGs) as alternatives for testicular sperm extraction followed by ICSI (TESE-ICSI)? SUMMARY ANSWER Most couples with NOA (89%) would opt for treatment with AGs before attempting TESE-ICSI and/or after failed TESE-ICSI. WHAT IS KNOWN ALREADY Couples with NOA who undergo TESE-ICSI have a 25% chance of conceiving a child. Two future treatments that are being developed are 'ICSI with artificial sperm formed from somatic cells' (ICSI with AGs) and 'natural conception after autotransplantation of in vitro proliferated spermatogonial stem cells' (natural conception with AGs). It is unknown what treatment preferences patients have. STUDY DESIGN, SIZE, DURATION A cross-sectional survey conducted in 2012-2013, addressing all 921 couples diagnosed with NOA and treated with TESE-ICSI in Dutch fertility clinics between 2007 and 2012. The coded questionnaires were sent by mail and followed up with two reminders. PARTICIPANTS/MATERIALS, SETTING, METHODS We developed the questionnaire based on a literature review and previous qualitative interviews, and included treatment preference and the valuation of nine treatment characteristics. We assessed reliability of the questionnaires and calculated mean importance scores (MISs: 0-10) of each treatment characteristic. We assessed which patient and treatment characteristics were associated with a couple's hypothetical treatment preference using binominal regression. MAIN RESULTS AND THE ROLE OF CHANCE The vast majority (89%) of the 494 responding couples (response rate: 54%) would potentially opt for AGs as a first and/or a last resort treatment option. More specifically, as a first treatment couples were likely (67%) to prefer natural conception with AGs over TESE-ICSI and less likely to prefer ICSI with AGs over TESE-ICSI (34%). After failed TESE-ICSI, the majority of couples (75%) would want to attempt ICSI with AGs as a last resort option. The most important characteristics of treatment were safety for children (MIS: 8.2), pregnancy rates (MIS: 7.7) and curing infertility (MIS: 6.8). Costs, burden, naturalness and technological sophistication were of about equal importance (MIS: 3.1-4.0). The majority of patients rated conception at home and moral acceptability as not important (MIS: 1.7 and 0.8, respectively), but the importance attributed to these variables did still affect patients' likeliness to opt for AGs. LIMITATIONS AND REASONS FOR CAUTION Couples with NOA not opting for TESE-ICSI were not included and might have other perspectives. Couples' hypothetical choices for AGs might differ from their actual choices once data on the costs, safety and pregnancy rates become available from these new treatment options. WIDER IMPLICATIONS OF THE FINDINGS The interest of couples with NOA in potential future treatments with AGs encourages further pre-clinical research. Priority setting for research and future decision-making on clinical application of AGs should take all characteristics important to patients into account. STUDY FUNDING/COMPETING INTERESTS The authors report no financial or other conflict of interest relevant to the subject of this article.
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Affiliation(s)
- S Hendriks
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M Hessel
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M H Mochtar
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A Meissner
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - F van der Veen
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - S Repping
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - E A F Dancet
- Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands KU Leuven, Department of Development and Regeneration, Leuven University Fertility Clinic, Leuven, Belgium
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Fortin C, Abele S. Increased Length of Awareness of Assisted Reproductive Technologies Fosters Positive Attitudes and Acceptance among Women. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2015; 9:452-64. [PMID: 27110326 PMCID: PMC4841309 DOI: 10.22074/ijfs.2015.4603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 06/18/2014] [Indexed: 11/09/2022]
Abstract
Background The field of infertility medicine has witnessed a surge of scientific developments in
recent years, but research on public attitudes towards infertility treatments has
remained minimal. This study examined the social and demographic factors that affect
women’s attitudes towards assisted reproductive technology (ART) in general, as well as
their opinions of specific issues related to ART. Materials and Methods This cross-sectional study was conducted from March 2011 to April 2011 by means of an
online survey administered to a sample of 287 women. Results Women with a longer length of awareness of ART had significantly greater attitudinal
favorability towards ART. Political affiliation was also significantly related to
general attitudes, as well as several specific aspects of ART issues. Conclusion The results of this study suggest that several factors influence attitudes that women
hold in regards to ART. Identifying some of these factors serves as a crucial starting
point for devising strategies to increase public acceptance of ART.
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Affiliation(s)
- Chelsea Fortin
- Department of Psychology, Miami University, Oxford, OH, USA; Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA
| | - Susanne Abele
- Department of Psychology, Miami University, Oxford, OH, USA
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Disparities in access to effective treatment for infertility in the United States: an Ethics Committee opinion. Fertil Steril 2015; 104:1104-10. [DOI: 10.1016/j.fertnstert.2015.07.1139] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 07/17/2015] [Indexed: 11/18/2022]
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Childress KJ, Lawson AK, Ghant MS, Mendoza G, Cardozo ER, Confino E, Marsh EE. First contact: the intersection of demographics, knowledge, and appraisal of treatment at the initial infertility visit. Fertil Steril 2015; 104:180-7. [PMID: 26003271 DOI: 10.1016/j.fertnstert.2015.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/01/2015] [Accepted: 04/02/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine the impact of the initial infertility visit on treatment-related knowledge, patient anxiety, and appraisals of treatment. DESIGN Prospective survey. SETTING Academic medical center. PATIENT(S) Two hundred thirty-four English-speaking women aged 18-50 years attending their first infertility visit. INTERVENTION(S) Participants completed a survey assessing health literacy, knowledge, anxiety, and appraisals of the treatment process before and after their infertility visit. MAIN OUTCOME MEASURE(S) Knowledge of infertility and treatment and anxiety and appraisal scores. RESULT(S) Most participants were white and earned >$100,000/year and had at least a college education. Baseline knowledge of reproductive anatomy, assisted reproductive technology (ART), and fertility factors was modest but improved after the initial visit. Factors associated with higher knowledge included higher education and income, white or Asian ethnicity, and English as a primary language. Patient appraisals of treatment represented by the positive (Challenge) and negative (Threat and Loss) subscale scores on the Appraisal of Life Events (ALE) scale changed over time Negative appraisals of treatment and anxiety scores decreased and positive appraisals of treatment increased after the initial visit. Lower knowledge was associated with higher positive appraisal scores; lower health literacy was associated with higher anxiety and appraisal scores (positive and negative) after the visit. Black women had higher Challenge scores compared with white and Asian women. Hispanic women had higher anxiety scores than non-Hispanic women. CONCLUSION(S) Infertility patients have modest baseline knowledge of fertility and infertility treatment. The initial infertility visit can improve this knowledge and decrease both negative appraisals of treatment and anxiety levels. Differences in knowledge and appraisal were seen across ethnic groups and other demographic variables. Physicians should individualize patient counseling to improve patients' knowledge and provide realistic treatment expectations while also reducing patient anxiety.
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Affiliation(s)
- Krista J Childress
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Angela K Lawson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Marissa S Ghant
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Gricelda Mendoza
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Eden R Cardozo
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts
| | - Edmond Confino
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Erica E Marsh
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
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Cumulative incidence of infertility in a New Zealand birth cohort to age 38 by sex and the relationship with family formation. Fertil Steril 2015; 103:1053-1058.e2. [DOI: 10.1016/j.fertnstert.2014.12.121] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/18/2014] [Accepted: 12/18/2014] [Indexed: 11/21/2022]
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Daniluk JC, Koert E. Fertility awareness online: the efficacy of a fertility education website in increasing knowledge and changing fertility beliefs. Hum Reprod 2015; 30:353-63. [PMID: 25480922 PMCID: PMC4287305 DOI: 10.1093/humrep/deu328] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 11/05/2014] [Accepted: 11/17/2014] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION How effective is online education in increasing knowledge of fertility and assisted reproductive technologies (ART), and changing beliefs about the timing of parenthood? SUMMARY ANSWER Exposure to an online educational intervention resulted in immediate changes in participants' beliefs about the ideal timing of parenthood, and a significant increase in their knowledge of fertility and ART treatments and options; most of these changes were not sustained over time, particularly for men. WHAT IS KNOWN ALREADY Research has identified significant gaps in men's and women's knowledge of fertility and ART, contributing to the trend to delay childbearing. Effective educational programs need to be developed, to support informed fertility and child-timing decisions. STUDY DESIGN, SIZE, DURATION Pre-post intervention study of 199 currently childless men and women, and a 6-month follow-up of 110 of these participants. PARTICIPANTS/MATERIALS, SETTING, METHODS One hundred and ninety-nine childless participants between the ages of 18 and 35 were asked to complete 4 beliefs and 22 knowledge questions prior to, and immediately after, reading 10 online posts related to: fertility testing and preservation, fertility history and lifespan, the effects of health and fitness on fertility, and assisted reproduction. Six months later, 110 of the original sample repeated the 26-item survey. MAIN RESULTS AND THE ROLE OF CHANCE Participants' fertility and ART knowledge scores increased significantly immediately after the intervention, as did their confidence in their fertility and ART knowledge. Participants' beliefs about the ideal and latest age a woman or man should consider producing a child decreased. However, 6 months later, participants' beliefs and knowledge levels largely returned to their pre-intervention levels, particularly for the men in the study. LIMITATIONS, REASONS FOR CAUTION The sample size and the recruitment methods may limit the generalizability of these findings. WIDER IMPLICATIONS OF THE FINDINGS Previous studies have demonstrated the short-term efficacy of online educational approaches to increase fertility knowledge and support informed family planning decisions. Web-based approaches have the benefit of being easily and conveniently accessed by individuals worldwide. However, the findings of the current study call into question the long-term efficacy of online fertility education, and suggest that variables such as gender and relevance need to be considered in assessing the efficacy of online fertility education strategies.
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Affiliation(s)
- J C Daniluk
- Department of Educational and Counselling Psychology, University of British Columbia, Vancouver, BC, Canada
| | - E Koert
- Department of Educational and Counselling Psychology, University of British Columbia, Vancouver, BC, Canada
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Bazarganipour F, Ziaei S, Montazeri A, Foroozanfard F, Kazemnejad A, Faghihzadeh S. Health‐Related Quality of Life in Patients with Polycystic Ovary Syndrome (PCOS): A Model‐Based Study of Predictive Factors. J Sex Med 2014; 11:1023-1032. [DOI: 10.1111/jsm.12405] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fulford B, Bunting L, Tsibulsky I, Boivin J. The role of knowledge and perceived susceptibility in intentions to optimize fertility: findings from the International Fertility Decision-Making Study (IFDMS). Hum Reprod 2013; 28:3253-62. [PMID: 24105825 DOI: 10.1093/humrep/det373] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is the role of knowledge, perceived vulnerability and level of risk of infertility in women's intentions to take action to improve their chance of becoming pregnant (i.e. by seeking medical and/or non-medical help and making lifestyle changes)? SUMMARY ANSWER Women younger than age 35 were more likely to intend to take measures to improve their chance of conceiving when they were knowledgeable about fertility and felt susceptible to infertility; however, there was no such association in older women. WHAT IS KNOWN ALREADY The majority of young adults wish to become parents but many are jeopardizing their chances by engaging in behaviours that decrease fertility (e.g. smoking, not seeking timely medical advice when faced with problems conceiving). Research is needed to establish what motivates people to take steps to optimize their chances of pregnancy. The Health Belief Model (HBM) postulates that knowledge and beliefs about susceptibility to infertility are critical in whether people will engage in fertility-optimizing behaviours. STUDY DESIGN, SIZE AND DURATION This cross-sectional survey included 1345 childless women (trying to conceive and having never engaged in fertility medical treatment) from the International Fertility Decision-Making Study (IFDMS). PARTICIPANTS/MATERIALS, SETTING, METHODS Infertility risk factors were determined using the FertiSTAT. The Cardiff Fertility Knowledge Scale (CFKS) assessed fertility knowledge. Perceived susceptibility was defined as whether a fertility problem was suspected. The outcome measure was intentions to optimize one's fertility by making lifestyle changes and/or seeking help. MAIN RESULTS AND THE ROLE OF CHANCE In this study, 75.5% of women had an infertility risk factor and 60.3% suspected a fertility problem. The average correct score on the CFKS was 51.9%. Intentions to optimize fertility were lower among women who were heavy smokers (P < 0.05) and who had been trying to conceive for a year or over (P < 0.01), while intentions to optimize fertility were greater among those with a higher body mass index or greater knowledge and those who suspected a fertility problem (all P < 0.001). These overall effects were qualified in some subgroups. Heavy smokers were more likely to intend to seek medical help when they had greater knowledge (P < 0.001) and women having difficulty conceiving were more likely to intend to seek medical help if they felt susceptible to infertility (P < 0.001). Heavy smokers who were knowledgeable intended to change their lifestyle only when they felt they had a fertility problem (P < 0.01). Intentions to change were not dependent on knowledge and perceived susceptibility in older women. LIMITATIONS, REASONS FOR CAUTION The data were cross-sectional and thus we cannot infer causality. The results may have been affected by the sample profile, which was biased towards high levels of perceived susceptibility and low levels of knowledge. WIDER IMPLICATIONS OF THE FINDINGS To maximize impact, educational campaigns should take into account the presence and type of infertility risk factors in the target audience. STUDY FUNDING/COMPETING INTERESTS Merck-Serono S. A. Geneva-Switzerland (an affiliate of Merck KGaA Darmstadt, Germany) and the Economic and Social Research Council (ESRC, UK) funded this project (RES-355-25-0038, 'Fertility Pathways Network'). L.B. is funded by a postdoctoral fellowship from the Medical Research Council (MRC) and the ESRC (PTA-037-27-0192). B.F. is funded by an interdisciplinary PhD studentship from the ESRC/MRC (ES/1031790/1). I.T. is an employee of Merck-Serono S.A. Geneva-Switzerland (an affiliate of Merck KGaA Darmstadt, Germany).
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Affiliation(s)
- B Fulford
- School of Psychology, Cardiff University, Tower Building, Park Place, Cardiff CF10 3AT, UK
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Sabarre KA, Khan Z, Whitten AN, Remes O, Phillips KP. A qualitative study of Ottawa university students' awareness, knowledge and perceptions of infertility, infertility risk factors and assisted reproductive technologies (ART). Reprod Health 2013; 10:41. [PMID: 23962162 PMCID: PMC3751831 DOI: 10.1186/1742-4755-10-41] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 08/15/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Awareness of infertility risk factors is an essential first step to safeguard future fertility. Whereas several studies have examined university students' awareness of female fertility and related risk factors, the topic of male infertility has not been well examined. The objective of this study was to assess young men and women's awareness, knowledge and perceptions of infertility, male and female infertility risk factors and assisted reproductive technologies (ART). METHODS Semi-structured interviews were conducted in 2008 with a multi-ethnic sample of sixteen male and twenty-three female Ottawa university students, followed by qualitative data analysis to identify major themes. Interview topics included awareness of male and female infertility risk factors, infertility diagnosis/treatments and personal options in the event of future infertility. RESULTS Participants were generally familiar with infertility as a biomedical health problem, could identify sex-specific risk factors but overestimated fertility of women in their thirties and ART success rates. Reproductive health knowledge gaps and confusion of the physiological life-stage of menopause with infertility were apparent. Most participants would pursue in vitro fertilization or international adoption in the event of personal infertility. Some participants wished to use a 'natural' approach and were concerned with potential side effects of ART-related medications. CONCLUSIONS The general awareness of infertility in young adults is promising and supports the potential uptake for health promotion of fertility preservation. This study underscores the continued need for comprehensive sexual and reproductive health education and promotion for adolescents and young adults.
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Affiliation(s)
- Kelley-Anne Sabarre
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Zainab Khan
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Amanda N Whitten
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Olivia Remes
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Karen P Phillips
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Institute of Population Health, University of Ottawa, Ottawa, ON, Canada
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Abolfotouh MA, Alabdrabalnabi AA, Albacker RB, Al-Jughaiman UA, Hassan SN. Knowledge, attitude, and practices of infertility among Saudi couples. Int J Gen Med 2013; 6:563-73. [PMID: 23874117 PMCID: PMC3711755 DOI: 10.2147/ijgm.s46884] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction Infertility places a huge psychological burden on infertile couples, especially for women. Greater knowledge of the factors affecting fertility may help to decrease the incidence of infertility by allowing couples to avoid certain risk factors. The aim of our study was (1) to assess the knowledge and attitudes of infertile and fertile Saudi participants on infertility, possible risk factors, and social consequences; and (2) to determine the practices of infertile Saudi couples to promote their fertility before having them attend an in vitro fertilization (IVF) clinic. Methods and materials We conducted a cross-sectional study on 277 fertile participants from outpatient clinics and 104 infertile patients from the IVF clinic at King Abdulaziz Medical City between June 24, 2012 and July 4, 2012, using a previously validated interview questionnaire. Descriptive and analytical statistics were applied with a significance threshold of P ≤ 0.05. Results A generally poor level of knowledge (59%) and a neutral attitude (76%) toward infertility were reported by participants. Mistaken beliefs commonly held by the study participants regarding the causes of infertility were Djinns and supernatural causes (58.8%), black magic (67.5%), intrauterine devices (71.3%), and contraceptive pills (42.9%). The healer/Sheikh was reported as the primary and secondary preference for infertility treatment by 6.7% and 44.2% of IVF patients, respectively. Compared with fertile patients, IVF patients were significantly less likely to favor divorce (38.5% versus 57.6%; P = 0.001) or marriage to a second wife (62.5% versus 86.2%; P < 0.001), if the woman could not have a baby. The patients with infertility had more favorable attitudes toward fertility drugs (87.5% versus 68.4%; P = 0.003) and having a test tube baby (92.4% versus 70.3%; P < 0.001). Child adoption was accepted as an option for treatment by the majority of IVF patients (60.6%) and fertile outpatients (71.5%). Alternative treatments previously practiced by the IVF patients to improve fertility include practicing Ruqia (61%), using alternative medicine (42%), engaging in physical exercise (39%), eating certain foods (22%), and quitting smoking (12%). Conclusion These findings have implications for health care providers regarding the reluctance that couples experiencing fertility problems may have, at least initially, to accept some interventions required for the couple to conceive.
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Affiliation(s)
- Mostafa A Abolfotouh
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Wojcieszek AM, Thompson R. Conceiving of change: a brief intervention increases young adults' knowledge of fertility and the effectiveness of in vitro fertilization. Fertil Steril 2013; 100:523-9. [PMID: 23628107 DOI: 10.1016/j.fertnstert.2013.03.050] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 03/07/2013] [Accepted: 03/29/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the effectiveness of an educational intervention in increasing knowledge of fertility and the effectiveness of IVF among university students in Australia. DESIGN Two-group, pretest-posttest design. SETTING A large metropolitan university in Queensland, Australia. PATIENT(S) One hundred thirty-seven male and female undergraduate students. INTERVENTION(S) Online information brochure on fertility (intervention group), or an online information brochure on home ownership (control group). MAIN OUTCOME MEASURE(S) Knowledge of fertility, knowledge of IVF effectiveness, and desired age at commencement and completion of childbearing, assessed immediately before and after exposure to the brochure. RESULT(S) Exposure to the brochure resulted in significant increases in knowledge of fertility and knowledge of IVF effectiveness in the intervention group and significant decreases in desired age at commencement and completion of childbearing. No changes were observed in the control group. CONCLUSION(S) Educational intervention is a worthwhile endeavor that can increase knowledge of fertility and IVF effectiveness in the short-term. Further research is needed to evaluate whether increased knowledge persists and affects intentions in the longer-term. Because the determinants of timing of childbearing are highly multifactorial, fertility education should be paired with policies and practices that support men and women to make informed decisions about the timing of childbearing.
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Affiliation(s)
- Aleena M Wojcieszek
- Mater Medical Research Institute, Mater Health Services, South Brisbane, Queensland, Australia.
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Everywoman J. Cassandra's prophecy: why we need to tell the women of the future about age-related fertility decline and 'delayed' childbearing. Reprod Biomed Online 2013; 27:4-10. [PMID: 23673191 DOI: 10.1016/j.rbmo.2013.03.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 03/07/2013] [Indexed: 10/26/2022]
Abstract
This anonymized paper describes the author's experience of age-related infertility and unintended childlessness. It outlines her journey from diagnosis to treatment success and clinical pregnancy through assisted reproduction using oocyte donation, followed by subsequent early miscarriage. It makes subjective observations about treatment she received and presents her impressions of how discourses of knowledge dissemination, communication and care were constructed in the organizations she encountered. It sets her own reflections alongside broader observations on the challenges facing women today when planning a family and draws attention to what she perceives to be the misleading myths and misunderstandings concerning reproduction that these women are now subject to. In the light of this, it offers some suggestions for modified public health messages and new approaches to sex education and health screening that may consequently help to empower tomorrow's women (and men) to take full control over their reproductive lives in the 21st century. The paper takes as its mascot the figure of Cassandra, daughter of King Priam and Queen Hecuba. She was loved by Apollo, but resisted him. In consequence, he rendered useless the gift of prophecy that he had bestowed on her by causing her predictions never to be believed.
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Affiliation(s)
- Jane Everywoman
- C/O Duck End Farm, Park Lane, Dry Drayton, Cambridge CB23 8DB, UK.
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Menuz V, Hurlimann T, Godard B. Is human enhancement also a personal matter? SCIENCE AND ENGINEERING ETHICS 2013; 19:161-177. [PMID: 21786000 DOI: 10.1007/s11948-011-9294-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 07/05/2011] [Indexed: 05/28/2023]
Abstract
Emerging technologies are increasingly used in an attempt to "enhance the human body and/or mind" beyond the contemporary standards that characterize human beings. Yet, such standards are deeply controversial and it is not an easy task to determine whether the application of a given technology to an individual and its outcome can be defined as a human enhancement or not. Despite much debate on its potential or actual ethical and social impacts, human enhancement is not subject to any consensual definition. This paper proposes a timely and much needed examination of the various definitions found in the literature. We classify these definitions into four main categories: the implicit approach, the therapy-enhancement distinction, the improvement of general human capacities and the increase of well-being. After commenting on these different approaches and their limitations, we propose a definition of human enhancement that focuses on individual perceptions. While acknowledging that a definition that mainly depends on personal and subjective individual perceptions raises many challenges, we suggest that a comprehensive approach to define human enhancement could constitute a useful premise to appropriately address the complexity of the ethical and social issues it generates.
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Affiliation(s)
- Vincent Menuz
- Department of Social and Preventive Medicine, Bioethics Programs, University of Montreal, Montreal, Canada.
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Hostiuc S. Conventional vs unconventional assisted reproductive technologies: Opinions of young physicians. J OBSTET GYNAECOL 2012; 33:67-70. [DOI: 10.3109/01443615.2012.721817] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mac Dougall K, Beyene Y, Nachtigall RD. Age shock: misperceptions of the impact of age on fertility before and after IVF in women who conceived after age 40. Hum Reprod 2012. [PMID: 23203214 DOI: 10.1093/humrep/des409] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What do older women understand of the relationship between age and fertility prior and subsequent to delivering their first child? SUMMARY ANSWER Women who were first-time parents over the age of 40 did not accurately perceive the relationship between age and fertility prior to conceiving with IVF. WHAT IS KNOWN ALREADY While increases in women's age at their first birth have been most pronounced in relatively older women, the rapidity of fertility decline is not appreciated by most non-infertility specialist physicians, the general public or men and women who are delaying childbearing. STUDY DESIGN, SIZE AND DURATION Qualitative retrospective interviews were conducted from 2009 to 2011 with 61 self-selected women who were patients in one of two fertility clinics in the USA. PARTICIPANTS/MATERIALS, SETTING, METHODS All participants had delivered their first child following IVF when the woman was 40 years or older. The data include women's responses to the semi-structured and open-ended interview questions 'What information did you have about fertility and age before you started trying to get pregnant?' and 'What did you learn once you proceeded with fertility treatment?' MAIN RESULTS AND THE ROLE OF CHANCE Of the women, 30% expected their fertility to decline gradually until menopause at around 50 years and 31% reported that they expected to get pregnant without difficulty at the age of 40. Reasons for a mistaken belief in robust fertility included recollections of persistent and ongoing messaging about pregnancy prevention starting in adolescence (23%), healthy lifestyle and family history of fertility (26%), and incorrect information from friends, physicians or misleading media reports of pregnancies in older celebrity women (28%). Participants had not anticipated the possibility that they would need IVF to conceive with 44% reporting being 'shocked' and 'alarmed' to discover that their understanding of the rapidity of age-related reproductive decline was inaccurate'. In retrospect, their belated recognition of the effect of age on fertility led 72% of the women to state that they felt 'lucky' or had 'beaten the odds' in successfully conceiving after IVF. Of the women, 28% advocated better fertility education earlier in life and 23% indicated that with more information about declining fertility, they might have attempted conception at an earlier age. Yet 46% of women acknowledged that even if they had possessed better information, their life circumstances would not have permitted them to begin childbearing earlier. LIMITATIONS AND REASONS FOR CAUTION Both the self-selected nature of recruitment and the retrospective design can result in biases due to memory limitations or participant assimilation and/or contrast of past events with current moods. The cohort did not reflect broad homogeneity in that the participants were much more likely to be highly educated, Caucasian and better able to pay for treatment than national population norms. As attitudes of older women who were unsuccessful after attempting IVF in their late 30s or early 40s are not represented, it is possible (if not likely) that the recollections of women who did not conceive after IVF would have been more strongly influenced by feelings of regret or efforts to deflect blame for their inability to conceive. WIDER IMPLICATIONS OF THE FINDINGS While the failure to appreciate the true biological relationship between aging and fertility may be common and may reflect inaccessibility or misinterpretation of information, it is not sufficient to explain the decades-long socio-demographic phenomenon of delayed childbearing.
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Affiliation(s)
- K Mac Dougall
- Institute for Health & Aging, University of California, San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, USA
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Bunting L, Tsibulsky I, Boivin J. Fertility knowledge and beliefs about fertility treatment: findings from the International Fertility Decision-making Study. Hum Reprod 2012. [PMID: 23184181 DOI: 10.1093/humrep/des402] [Citation(s) in RCA: 146] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION How good is fertility knowledge and what are treatment beliefs in an international sample of men and women currently trying to conceive? SUMMARY ANSWER The study population had a modest level of fertility knowledge and held positive and negative views of treatment. WHAT IS KNOWN ALREADY Few studies have examined general fertility treatment attitudes but studies of specific interventions show that attitudes are related to characteristics of the patient, doctor and context. Further, research shows that fertility knowledge is poor. However, the majority of these studies have examined the prevalence of infertility, the optimal fertile period and/or age-related infertility in women, in university students and/or people from high-resource countries making it difficult to generalize findings. STUDY DESIGN, SIZE, DURATION A cross-sectional sample completed the International Fertility Decision-making Study (IFDMS) over a 9-month period, online or via social research panels and in fertility clinics. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were 10 045 people (8355 women, 1690 men) who were on average 31.8 years old, had been trying to conceive for 2.8 years with 53.9% university educated. From a total of 79 countries, sample size was >100 in 18 countries. All 79 countries were assigned to either a very high Human Development Index (VH HDI) or a not very high HDI (NVH HDI). The IFDMS was a 45-min, 64-item English survey translated into 12 languages. The inclusion criteria were the age between 18 and 50 years and currently trying to conceive for at least 6 months. Fertility knowledge was assessed using a 13-item correct/incorrect scale concerned with risk factors, misconceptions and basic fertility facts (range: 0-100% correct). Treatment beliefs were assessed with positive and negative statements about fertility treatment rated on a five-point agree/disagree response scale. MAIN RESULTS AND THE ROLE OF CHANCE Average correct score for Fertility Knowledge was 56.9%, with greater knowledge significantly related to female gender, university education, paid employment, VH HDI and prior medical consultation for infertility (all P < 0.001). The mean agreement scores for treatment beliefs showed that agreement for positive items (safety, efficacy) was correlated with agreement for negative items (short/long-term physical/emotional effects) (P > 0.001). People who had given birth/fathered a child, been trying to conceive for less than 12 months, who had never consulted for a fertility problem and who lived in a country with an NVH HDI agreed less with negative beliefs. HDI, duration of trying to conceive and help-seeking were also correlates of higher positive beliefs, alongside younger age, living in an urban area and having stepchildren. Greater fertility knowledge was associated with stronger agreement on negative treatment beliefs items (P < 0.001) but was unrelated to positive treatment beliefs items. LIMITATIONS, REASONS FOR CAUTION There was volunteer bias insofar as more women, people of higher education and people with fertility problems (i.e. met criteria for infertility, had consulted a medical doctor, had conceived with fertility treatment) participated and this was true in VH and NVH HDI countries. The bias may mean that people in this sample had better fertility knowledge and less favourable treatment beliefs than is the case in the general population. WIDER IMPLICATIONS OF THE FINDINGS Educational interventions should be directed at improving knowledge of fertility health. Future prospective research should be aimed at investigating how fertility knowledge and treatment beliefs affect childbearing and help-seeking decision-making.
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Affiliation(s)
- Laura Bunting
- Economic and Social Research Council, Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Tower Building, Park Place, Cardiff, Wales CF10 3AT, UK
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The other side of the fertility coin: a comparison of childless men's and women's knowledge of fertility and assisted reproductive technology. Fertil Steril 2012; 99:839-46. [PMID: 23148926 DOI: 10.1016/j.fertnstert.2012.10.033] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 10/15/2012] [Accepted: 10/17/2012] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine childless men's knowledge about fertility and assisted reproductive technology (ART) treatments and family building options, compared to knowledge of a sample of childless women. DESIGN Self-report questionnaire comprising 2 self-ratings and 20 knowledge questions related to later childbearing and ART. SETTING Online survey. PATIENT(S) A total of 599 presumed fertile, childless men between the ages of 20 and 50 years. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Knowledge of fertility and ART as measured by the male version of the Fertility Awareness Survey. RESULT(S) The majority of participants rated themselves as having some knowledge or being fairly knowledgeable about fertility and ART. However, on the 20 knowledge questions, overall knowledge was limited, with more than 50% of the sample answering correctly only 4 of 20 knowledge questions. The men demonstrated even less knowledge of fertility and ART than childless women. CONCLUSION(S) Given that the childless men in our study had no coherent body of knowledge regarding age-related fertility and ART treatment and family-building options, men may be contributing to the trend to delay childbearing. If they are to be effective in supporting informed fertility and childbearing decisions, education programs must target both women and men.
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Prevalence and risk factors of the female sexual dysfunction in a sample of infertile Iranian women. Arch Gynecol Obstet 2012; 286:1589-96. [DOI: 10.1007/s00404-012-2489-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 07/19/2012] [Indexed: 10/28/2022]
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Daniluk JC, Koert E. Childless Canadian men's and women's childbearing intentions, attitudes towards and willingness to use assisted human reproduction. Hum Reprod 2012; 27:2405-12. [PMID: 22684907 DOI: 10.1093/humrep/des190] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What are the childbearing intentions of currently childless men and women? What is their attitude towards, and willingness to use, assisted human reproduction (AHR) treatments and family-building options should they be faced with fertility challenges in the future? SUMMARY ANSWER Men and women expect to become parents significantly later in life than they believe is ideal. If faced with future fertility challenges, respondents were open to using IVF, but were not positively predisposed to third-party family-building options. WHAT IS KNOWN ALREADY Delayed childbearing is an increasing worldwide phenomenon that has considerable health and fertility-related implications. Research to date has focused primarily on women, and indicates a lack of knowledge about the fertility life span and the limitations of AHR in fully compensating for age-related fertility declines. STUDY DESIGN, SIZE, DURATION Cross-sectional study of 2000 childless women and 599 childless men, conducted between April 2010 and May 2011. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 2599 childless, presumed fertile individuals between the ages of 20 and 50 years. An online questionnaire assessed fertility beliefs and intentions and willingness to use AHR. MAIN RESULTS AND THE ROLE OF CHANCE The findings indicate that men and women expect to become parents significantly later in life than they believe is ideal. If faced with fertility challenges in the future, both men and women were open to using IVF. Men were significantly more willing to consider using donated eggs and embryos, gestational surrogacy and fertility preservation. Women were significantly more willing to consider using home fertility testing, IVF, ICSI and donor sperm. Overall, the childless respondents were not positively predisposed to third party-family-building options. LIMITATIONS The geographic specificity of the sample, the online format and recruitment methods may limit the generalizability of these findings. WIDER IMPLICATIONS OF THE FINDINGS Given the worldwide trend towards delayed childbearing, and the widespread availability of AHR, it is likely that these findings could extend to the wider North American, European and Australasia populations of English- and French-speaking childless men and women. However, it should be noted that international differences exist, especially concerning regulations governing the funding of AHR and payment for gametes and surrogacy. It is significant that women and men in this study indicated a lack of willingness to consider the use of third third-party treatments--the very options they may need to use in building their families, if the increasing trend towards delayed childbearing continues. STUDY FUNDING/COMPETING INTERESTS This research was funded by a grant from the Canadian Institutes of Health Research and Assisted Human Reproduction Canada #PAH-103594, 2009/10. No competing interests.
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Affiliation(s)
- J C Daniluk
- Department of Educational and Counselling Psychology, University of British Columbia, 2125 Main Mall, Vancouver, BC, Canada V6T 1Z4.
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Söderberg M, Christensson K, Lundgren I. A project for future life-Swedish women's thoughts on childbearing lacking experience of giving birth and parenthood. Int J Qual Stud Health Well-being 2012; 7:QHW-7-17318. [PMID: 22567038 PMCID: PMC3346159 DOI: 10.3402/qhw.v7i0.17318] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2012] [Indexed: 11/14/2022] Open
Abstract
A lifeworld hermeneutic approach was used in order to understand Swedish women's thoughts on childbearing. Nine women were interviewed, and they ranged in age from 22 to 28 years and represented diverse socioeconomic, educational, sexual, and fertility backgrounds. All women were similar in that they lacked experience of giving birth and parenthood. The analysis showed that childbearing includes dimensions of both immanence and transcendence. Immanence, as childbearing is seen as stagnant to women's freedom in present life. Transcendence, as childbearing is thought of as a project for future life, a part of female identity, and a conscious standpoint for which the woman wants to be prepared and for which she wants to create the best conditions.
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Affiliation(s)
- Malin Söderberg
- Institution of Reproductive Health, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Peterson BD, Pirritano M, Tucker L, Lampic C. Fertility awareness and parenting attitudes among American male and female undergraduate university students. Hum Reprod 2012; 27:1375-82. [DOI: 10.1093/humrep/des011] [Citation(s) in RCA: 177] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Daniluk JC, Koert E, Cheung A. Childless women's knowledge of fertility and assisted human reproduction: identifying the gaps. Fertil Steril 2011; 97:420-6. [PMID: 22192349 DOI: 10.1016/j.fertnstert.2011.11.046] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 11/27/2011] [Accepted: 11/30/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To determine the knowledge about fertility and assisted human reproduction (AHR) treatments of a large sample of childless women. DESIGN Self-report questionnaire comprising two self-ratings of current fertility and AHR knowledge, and 16 knowledge questions related to fertility and AHR. SETTING Online. PATIENT(S) A total of 3,345 childless women between the ages of 20 and 50. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Knowledge of fertility and AHR. RESULT(S) The majority of participants rated themselves as having some knowledge or being fairly knowledgeable about fertility and AHR. However, on the 16 knowledge questions, overall knowledge was low, with 50% or more of the sample answering only 6 of 16 questions correctly. CONCLUSION(S) The data suggest that the women in the study have no coherent body of knowledge regarding age-related fertility and AHR treatment options. With an increasing number of women electing to delay childbearing, there is a critical need for public education regarding age-related fertility declines and the availability, costs, and limitations of AHR. This study offers important mental health contributions to infertility prevention and public health education efforts.
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Affiliation(s)
- Judith C Daniluk
- Department of Educational and Counselling Psychology, University of British Columbia, Vancouver, British Columbia, Canada.
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