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Steenberg M, Koert E, Schmidt L, Bogstad J, Sylvest R. Single mothers by choice - experiences of single women seeking treatment at a public fertility clinic in Denmark: A pilot study. Midwifery 2024; 134:104013. [PMID: 38663056 DOI: 10.1016/j.midw.2024.104013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 04/02/2024] [Accepted: 04/16/2024] [Indexed: 06/17/2024]
Abstract
PROBLEM There has been an increase in the number of single women deciding to have children through the use of medically assisted reproduction (MAR). These women are referred to as 'single mothers by choice' (SMC). BACKGROUND Previous studies have shown how SMC can feel stigmatised. AIM Explore if single women seeking fertility treatment in Denmark feel stigmatised. METHODS Six single women undergoing MAR at a public fertility clinic in Denmark were interviewed. The interviews were audiotaped, anonymised, and transcribed in full, after provided written consent by the participants to take part in the study. Data were analysed using qualitative content analysis. FINDINGS The women would have preferred to have a child in a relationship with a partner. Despite their dream of the nuclear family meaning a family group consisting of two parents and their children (one or more), the women choose to become SMC because motherhood was of such importance, and they feared they would otherwise become too old to have children. The participants did not experience stigma or negative responses to their decision, but they all had an awareness of the prejudices other people might have towards SMC. CONCLUSION This study contributes to the understanding of the experiences of single women seeking fertility treatment in a welfare state where there are no differences in the possibilities for different social classes to seek MAR.
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Affiliation(s)
- Michala Steenberg
- Department of Public Health, Faculty of Medical and Health Sciences, University of Copenhagen, 5 Oester Farimagsgade, PO Box 2099, DK, 1014, Copenhagen K, Denmark
| | - Emily Koert
- Department of Public Health, Faculty of Medical and Health Sciences, University of Copenhagen, 5 Oester Farimagsgade, PO Box 2099, DK, 1014, Copenhagen K, Denmark
| | - Lone Schmidt
- Department of Public Health, Faculty of Medical and Health Sciences, University of Copenhagen, 5 Oester Farimagsgade, PO Box 2099, DK, 1014, Copenhagen K, Denmark
| | - Jeanette Bogstad
- Fertility Department, Copenhagen University Hospital, Rigshospitalet, 9 Blegdamsvej, DK, 2100, Copenhagen Ø, Denmark
| | - Randi Sylvest
- Department of Public Health, Faculty of Medical and Health Sciences, University of Copenhagen, 5 Oester Farimagsgade, PO Box 2099, DK, 1014, Copenhagen K, Denmark; Fertility Department, Copenhagen University Hospital, Rigshospitalet, 9 Blegdamsvej, DK, 2100, Copenhagen Ø, Denmark.
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Delbaere I, De Vos M, Somers S, Condorelli M, Pening D, Bogaerts A, Vandepitte H, Stoop D, Harper J, Mertes H. 'Do I want children later in life?' Reproductive intentions of 1700 adolescents. EUR J CONTRACEP REPR 2024; 29:85-92. [PMID: 38683752 DOI: 10.1080/13625187.2024.2335651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/19/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE In the past decades, a positive attitude towards having children has been reported in young people. The current generation of adolescents is increasingly concerned about environmental cataclysm which may have an impact on their desire for children. The purpose of this study is to depict the current attitudes in Flemish adolescents towards having children. MATERIALS AND METHODS All secondary schools in Flanders (Belgium) were invited to distribute an anonymous online survey among their pupils in the last two years of secondary education. In total, 1700 adolescents participated and provided quantitative and qualitative data on their reproductive intentions. RESULTS Most pupils expressed a desire for children (60.2%), 24.7% were undecided and 10.8% were not willing to have children. Significantly more boys than girls would like to have children (67.0% versus 61.7%, p < 0.01). Adolescents who were uncertain about having children or not interested, reported financial reasons and loss of freedom as most important reasons. CONCLUSIONS While most adolescents would like to have children in the future, one in four adolescents is undecided and one in ten indicates a wish to remain childless; reasons for wanting children are rather personal, reasons for not wanting children are rather pragmatic.
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Affiliation(s)
- Ilse Delbaere
- VIVES University of Applied Sciences, Kortrijk, Belgium
| | - Michel De Vos
- Free University Brussels and Brussels IVF, UZ Brussel, Brussels, Belgium
| | - Sara Somers
- Department of Reproductive Medicine, Ghent University Hospital, Ghent, Belgium
| | - Margherita Condorelli
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), CUB Hôpital Erasme, Clinique de Fertilité, Brussels, Belgium
| | - David Pening
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), CUB Hôpital Erasme, Clinique de Fertilité, Brussels, Belgium
| | - Annick Bogaerts
- REALIFE, Department of Development & Regeneration, Women & Child, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | | | - Dominic Stoop
- Department of Reproductive Medicine, Ghent University Hospital, Ghent, Belgium
| | - Joyce Harper
- Institute for Women's Health, University College London, London, UK
| | - Heidi Mertes
- Department of Philosophy and Moral Sciences and Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Yao Y. Research on influencing factors of college teachers' second child fertility intentions--Taking Jinan as an example. PLoS One 2024; 19:e0299838. [PMID: 38771815 PMCID: PMC11108140 DOI: 10.1371/journal.pone.0299838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/16/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Fertility intentions, as a direct driver of fertility behavior, play an important role in the implementation of national fertility policy and population development. This study explored the influencing factors of college teachers' second child fertility intentions in Jinan, China on the basis of TPB. METHODOLOGY/PRINCIPAL FINDINGS Based on the theory of planned behavior, this paper employs basic characteristics analysis, difference analysis, and factor analysis related to the fertility intentions of the participants. Analysis found participants between 31 and 40 years old had the highest second child fertility intentions, and participants with a college-age first child had the lowest second child fertility intentions. Attitude and subjective norms had a positive impact on second child fertility intentions, and policy awareness had a positive impact on attitude, which indirectly affected second child fertility intentions. Subjective norms had the greatest influence on second child fertility intentions, followed by attitude, and policy awareness had the least influence on second child fertility intentions. SIGNIFICANCE/FUTURE RESEARCH The findings of this paper can enrich the theoretical research on fertility intentions, and also provide more optimal practical references for the formulation and propagation of China's fertility policy as well as the improvement of the division of family roles in China. Future research can further explore the impact of fertility policy on the fertility intentions of other groups.
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Affiliation(s)
- Yanling Yao
- School of Information Engineering, Shandong Management University, Jinan, Shandong, China
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Kasaven LS, Mitra A, Ostrysz P, Theodorou E, Murugesu S, Yazbek J, Bracewell-Milnes T, Ben Nagi J, Jones BP, Saso S. Exploring the knowledge, attitudes, and perceptions of women of reproductive age towards fertility and elective oocyte cryopreservation for age-related fertility decline in the UK: a cross-sectional survey. Hum Reprod 2023; 38:2478-2488. [PMID: 37816663 PMCID: PMC10694402 DOI: 10.1093/humrep/dead200] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/07/2023] [Indexed: 10/12/2023] Open
Abstract
STUDY QUESTION What are the knowledge, perceptions and attitudes towards fertility and elective oocyte cryopreservation (OC) for age-related fertility decline (ARFD) in women in the UK? SUMMARY ANSWER Awareness of OC for ARFD has reportedly improved compared to studies carried out almost a decade ago, but inconsistencies in knowledge remain regarding the rate of miscarriage amongst specific age groups, the financial costs and optimal age to undergo OC for ARFD. WHAT IS KNOWN ALREADY The age of first-time motherhood has increased amongst western societies, with many women of reproductive age underestimating the impact of age on fertility. Further understanding of women's awareness of their fertility, the options available to preserve it and the barriers for seeking treatment earlier are required in order to prevent the risk of involuntary childlessness. STUDY DESIGN, SIZE, DURATION A hyperlink to a cross-sectional survey was posted on social media (Instagram) between 25 February 2021 and 11 March 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS Women from the general population aged 18-50 years were invited to complete the survey. MAIN RESULTS AND THE ROLE OF CHANCE In total, 5482 women fulfilled the inclusion criteria and completed the survey. The mean age of participants was 35.0 years (SD 10.25; range 16-52). Three quarters (74.1%; n = 4055) disagreed or strongly disagreed they felt well informed regarding the options available to preserve their fertility, in case of a health-related problem or ARFD. The majority overestimated the risk of miscarriage in women aged ≥30 years old, with 14.5% correctly answering 20%, but underestimated the risks in women ≥40, as 20.1% correctly answered 40-50%. Three quarters (73.2%; n = 4007) reported an awareness of OC for ARFD and 65.8% (n = 3605) reported that they would consider undergoing the procedure. The number of women who considered OC for ARFD across age groups were as follows: 18-25 (8.3%; n = 300), 26-30 (35.8%; n = 1289), 31-35 (45.9%; n = 1654), 36-40 (9.6%; n = 347), 41-45 (0.3%; n = 13), and 46-50 (0.1%; n = 2). The majority of women (81.3%; n = 4443) underestimated the cost of a single cycle of OC for ARFD (<£5000). Furthermore, 10.4% (n = 566) believed a single cycle would be adequate enough to retrieve sufficient oocytes for cryopreservation. Approximately 11.0% (n = 599) believed OC for ARFD may pose significant health risks and affect future fertility. Less than half agreed or strongly agreed that the lack of awareness regarding OC for ARFD has impacted the likelihood of pursuing this method of fertility preservation further (41.4%; n = 2259). LIMITATIONS, REASONS FOR CAUTION Results from cross-sectional studies are limited as interpretations made are merely associations and not of causal relationships. The online nature of participant recruitment is subject to selection bias, considering women with access to social media are often from higher socioeconomic and education backgrounds, thus limiting generalizability of the findings. WIDER IMPLICATIONS OF THE FINDINGS Further education regarding the financial costs and optimal age to undergo elective OC to increase the chances of successful livebirth are required. Clinicians should encourage earlier fertility counselling to ensure that OC is deemed a preventative measure of ARFD, rather than an ultimate recourse to saving declining fertility. STUDY FUNDING/COMPETING INTEREST(S) No funding was required for this article. There are no conflicts of interests to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- L S Kasaven
- Department of Gynaecological Oncology, Queen Charlotte’s and Chelsea Hospital, London, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Cutrale Perioperative and Ageing Group, Imperial College London, London, UK
| | - A Mitra
- Department of Gynaecological Oncology, Queen Charlotte’s and Chelsea Hospital, London, UK
| | - P Ostrysz
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - E Theodorou
- Department of Reproductive Medicine, Centre for Reproductive and Genetic Health, London, UK
| | - S Murugesu
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - J Yazbek
- Department of Gynaecological Oncology, Queen Charlotte’s and Chelsea Hospital, London, UK
| | - T Bracewell-Milnes
- Department of Gynaecology and Reproductive Medicine, Lister Fertility Clinic, The Lister Hospital, London, UK
| | - J Ben Nagi
- Department of Reproductive Medicine, Centre for Reproductive and Genetic Health, London, UK
| | - B P Jones
- Department of Gynaecological Oncology, Queen Charlotte’s and Chelsea Hospital, London, UK
| | - S Saso
- Department of Gynaecological Oncology, Queen Charlotte’s and Chelsea Hospital, London, UK
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Tuominen A, Saavalainen L, Niinimäki M, Gissler M, But A, Härkki P, Heikinheimo O. First live birth before surgical verification of endometriosis-a nationwide register study of 18 324 women. Hum Reprod 2023; 38:1520-1528. [PMID: 37403272 PMCID: PMC10391315 DOI: 10.1093/humrep/dead120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/22/2023] [Indexed: 07/06/2023] Open
Abstract
STUDY QUESTION Do women with endometriosis have lower first live birth rate before surgical diagnosis than women without verified endometriosis? SUMMARY ANSWER Compared to reference women, the incidence of first live birth was lower in women prior to surgical verification of endometriosis irrespective of the type of endometriosis. WHAT IS KNOWN ALREADY Endometriosis is associated with pain and reduced fertility. The mechanism of infertility is partly explained by anatomical, endocrinological, and immunological changes. Over the past decades, the treatment of both endometriosis and infertility has evolved. Knowledge of fertility far before surgical diagnosis of endometriosis in large cohorts and of different types of endometriosis has been lacking. The diagnostic delay of endometriosis is long, 6-7 years. STUDY DESIGN, SIZE, DURATION Retrospective population-based cohort study focused on the time period before the surgical verification of endometriosis. All women with surgical verification of endometriosis in 1998-2012 were identified from the Finnish Hospital Discharge Register and the reference cohort from the Central Population Register. Data on deliveries, gynecological care, and sociodemographic factors before the surgical diagnosis were gathered from Finnish national registers maintained by the Finnish Institute for Health and Welfare, the Digital and Population Data Services Agency, and Statistics Finland. PARTICIPANTS/MATERIALS, SETTING, METHODS All women aged 15-49 years at the time of surgical verification of endometriosis (ICD-10: N80.1-N80.9) in Finland during 1998-2012 were identified (n = 21 620). Of them, we excluded women born in 1980-1999 due to the proximity of the surgical diagnosis (n = 3286) and women left without reference (n = 10) for the final endometriosis cohort of 18 324 women. From the final cohort, we selected sub-cohorts of women with isolated diagnosis of ovarian (n = 6384), peritoneal (n = 5789), and deep (n = 1267) endometriosis. Reference women were matched by age and residence and lacked registered clinical or surgical diagnosis of endometriosis (n = 35 793). The follow-up started at the age of 15 years and ended at the first birth, sterilization, bilateral oophorectomy, hysterectomy, or until the surgical diagnosis of endometriosis or corresponding index day-whichever came first. Incidence rate (IR) and the incidence rate ratio (IRR) of first live birth before the surgical verification of endometriosis with corresponding CIs were calculated. In addition, we reported the fertility rate of parous women (the number of all children divided by the number of parous women in the cohort) until the surgical verification of endometriosis. The trends in first births were analysed according to the women's birth cohort, type of endometriosis, and age. MAIN RESULTS AND THE ROLE OF CHANCE Surgical diagnosis of endometriosis was set at the median age of 35.0 years (IQR 30.0-41.4). Altogether 7363 women (40.2%) with endometriosis and 23 718 (66.3%) women without endometriosis delivered a live born infant before the index day (surgery). The IRs of the first live birth per 100 person-years were 2.64 (95% CI 2.58-2.70) in the endometriosis cohort and 5.21 (95% CI 5.15-5.28) in the reference cohort. Between the endometriosis sub-cohorts, the IRs were similar. The IRR of the first live birth was 0.51 (95% CI 0.49-0.52) between the endometriosis and reference cohorts. Fertility rate per parous woman before the surgical diagnosis was 1.93 (SD 1.00) and 2.16 (SD 1.15) in the endometriosis and reference cohorts (P < 0.01). The median age at the first live birth was 25.5 (IQR 22.3-28.9) and 25.5 (IQR 22.3-28.6) years (P = 0.01), respectively. Between the endometriosis sub-cohorts, women in the ovarian sub-cohort were the oldest at the time of surgical diagnosis with the median age of 37.2 years (IQR 31.4-43.3), (P < 0.001). Altogether 44.1% (2814) of the women with ovarian, 39.4% (2282) with peritoneal, and 40.8% (517) with deep endometriosis delivered a live born infant before the diagnosis. IRRs between the endometriosis sub-cohorts did not differ. Fertility rate per parous woman was lowest, 1.88 (SD 0.95), in the ovarian sub-cohort compared to 1.98 (SD 1.07) in the peritoneal and 2.04 (SD 0.96) in deep endometriosis (P < 0.001). Women with ovarian endometriosis were oldest at first live birth compared to women in other sub-cohorts with a median age of 25.8 years (IQR 22.6-29.1) (P < 0.001). Cumulative distributions of first live birth were presented according to age at first live birth and birth cohorts of the participants. LIMITATIONS, REASONS FOR CAUTION The increasing age at first live birth, increasing practice of clinical diagnostics, conservative treatment of endometriosis, a possible effect of coexisting adenomyosis, and use of artificial reproductive treatments should be considered when assessing the results. In addition, the study is limited due to possible confounding effects of socioeconomic factors, such as level of education. It should be noted that, in this study, we assessed parity only during the years preceding the surgical verification of endometriosis. WIDER IMPLICATIONS OF THE FINDINGS The need for early diagnosis and relevant treatment of endometriosis appears clear given the impairment of fertility prior to its surgical verification. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by the Hospital District of Helsinki and Uusimaa and by Finska Läkaresällskapet. The authors report no conflicts of interest. All authors have completed the ICMJE Disclosure form. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- A Tuominen
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Hyvinkää Hospital, Hyvinkää, Finland
| | - L Saavalainen
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - M Niinimäki
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu (MRC Oulu), University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostobothnia, Oulu, Finland
| | - M Gissler
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Academic Primary Health Care Center, Stockholm, Sweden
| | - A But
- Department of Biostatistics, University of Helsinki, Helsinki, Finland
| | - P Härkki
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - O Heikinheimo
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Ren Y, Xie Y, Xu Q, Long M, Zheng Y, Li L, Niu C. University students' fertility awareness and its influencing factors: a systematic review. Reprod Health 2023; 20:85. [PMID: 37280685 DOI: 10.1186/s12978-023-01628-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION In recent years, a growing number of researchers have begun to study fertility awareness (FA). Evidence suggests that college students in their reproductive years have a common understanding of fertility, risk factors for infertility, and assisted reproductive technologies. Therefore, this systematic review summarizes these studies and explores the factors affecting college students' fertility awareness. METHODS A systematic literature search of databases (PUBMED/MEDLINE, Cochrane, Web of Science, Embase, and EBSCO) was conducted from inception to September 2022. Studies that assessed the levels of fertility awareness and factors influencing college students were considered for the review. The qualities of the included studies were evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. This systematic review is reported according to the preferred reporting items for systematic review (PRISMA) guidelines. RESULTS Twenty-one articles met the eligibility criteria and were included. The preliminary results showed that participants reported low to moderate FA. Female medical students demonstrated higher levels of fertility awareness. The association between age, years of education, and FA was insufficient. CONCLUSION The results of the current study suggest that increased FA interventions are warranted, especially for the male, non-medical student population. Governments and educational institutions should strengthen education programs for young students on reproductive health to help them raise awareness about childbirth, and society should provide family support for young people.
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Affiliation(s)
- Yue Ren
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China
| | - Yue Xie
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China
| | - Qulian Xu
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China
| | - Miaochen Long
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China
| | - Ying Zheng
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China
| | - Lin Li
- Department of Obstetrics and Gynecology, Yangzhou University Affiliated Hospital, Yangzhou, China
| | - Changmin Niu
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China.
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Undergraduate students have low fertility knowledge and high anxiety regarding future fertility: An opportunity for education. Heliyon 2023; 9:e14623. [PMID: 36967893 PMCID: PMC10034448 DOI: 10.1016/j.heliyon.2023.e14623] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Objectives To assess childbearing intentions, concerns about future fertility, knowledge about the age-related decline in fertility, and interest in receiving fertility education among undergraduate students. Design From March to April 2021, a cross-sectional, web-based survey with 42 reproductive and fertility-related questions was administered to and completed by actively enrolled undergraduates at Northwestern University in the United States. Results The survey was completed by 291 students (mean age 20.2 years). Of all participants, 62.5% plan to have children and 68.3% intend to delay childbearing. Significantly more females than males (70.7% vs 40.9%, P = 0.004) and premedical students compared to non-premedical students (78.2% vs 60.1%, P = 0.002) reported planning to delay childbearing due to educational or career aspirations. Significantly more females than males (43.5% vs 4.5%, P < 0.001) and premedical compared to non-premedical students (50.4% vs 31.5%, P = 0.002) also reported having anxiety about future fertility due to career aspirations.When surveyed about fertility knowledge, 31.1% of participants reported that females are as fertile in their forties as they are in their thirties, and 25.4% stated that female fertility does not dramatically decline until age 40 or later. When asked to estimate the oldest age a woman has conceived using autologous oocytes, 83.3% reported age 48 or older. Of all participants, 72.3% were interested in learning about fertility. Conclusions The majority of surveyed undergraduates plan to delay childbearing, yet they have concerns about how career goals will impact future fertility. Notably, females and premedical students reported higher rates of anxiety when compared to their male and non-premedical counterparts. Knowledge about the age-related decline in fertility was limited, but students have a strong interest in learning about fertility, highlighting an opportunity for educational intervention at the undergraduate level. With education, students may be empowered to make informed decisions about future reproductive strategy earlier in time, potentially decreasing future anxiety.
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Brautsch LAS, Voss I, Schmidt L, Vassard D. Social disparities in the use of ART treatment: a national register-based cross-sectional study among women in Denmark. Hum Reprod 2023; 38:503-510. [PMID: 36370443 DOI: 10.1093/humrep/deac247] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/18/2022] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION How are educational level, labor market attachment and income associated with receiving a first ART treatment in either the public or private healthcare sector among women in Denmark? SUMMARY ANSWER Higher educational level and income as well as labor market attachment were associated with higher probability of initiating ART treatment at public and private fertility clinics among women in Denmark. WHAT IS KNOWN ALREADY Infertility is common in populations worldwide, and the approach to this issue differs between societies and healthcare systems. In the public Danish healthcare system, ART treatment is free of charge, and the direct cost for patients is therefore low. In the private healthcare sector in Denmark, ART treatment is self-financed. There is limited knowledge about the association between socioeconomic factors and seeking ART treatment, although previous studies have indicated that higher socioeconomic status is associated with seeking ART treatment. STUDY DESIGN, SIZE, DURATION Women undergoing ART treatment during 1994-2016 registered in the Danish IVF register were individually linked with data from sociodemographic population registers using the Danish Personal Identification number. The study population consisted of 69 018 women treated with ART and 670 713 age-matched comparison women from the background population with no previous history of ART treatment. PARTICIPANTS/MATERIALS, SETTING, METHODS The women included in the analyses were aged 18-45 years. The associations between attained educational level, labor market attachment and income and receiving a first ART treatment attempt were investigated for women either initiating treatment in the public sector or in the private sector, respectively. Information on age and origin was included as potential confounders, and odds ratios (ORs) were estimated in logistic regression models. In addition, analyses were stratified by age group to investigate potential differences across the age span. MAIN RESULTS AND THE ROLE OF CHANCE Adjusted results showed increased odds of receiving a first ART treatment in either the public or private sector among women with a higher educational level. Furthermore, women in employment were more likely to receive a first ART treatment in the public or private sector compared to women outside the workforce. The odds of receiving a first ART treatment increased with increasing income level. Surprisingly, income level had a greater impact on the odds of receiving a first ART treatment in the public sector than in the private sector. Women in the highest income group had 10 times higher odds of receiving a first ART treatment in the public sector (OR: 10.53 95% CI: 10.13, 10.95) compared to women in the lowest income group. Sub-analyses in different age groups showed significant associations between ART treatment and income level and labor market attachment in all age groups. LIMITATIONS, REASONS FOR CAUTION Our study does not include non-ART treatments, as the national IVF register did not register these types of fertility treatments before 2007. WIDER IMPLICATIONS OF THE FINDINGS In Denmark, there is equal access to medically assisted reproduction treatment in the publicly funded healthcare system, and since there is no social inequality in the prevalence of infertility, social inequality in the use of ART treatment would not be expected as such. However, our results show that social inequality is found for a first ART treatment attempt across publicly and privately funded ART treatment across the socioeconomic indicators, educational level, labor market attachment and income. STUDY FUNDING/COMPETING INTEREST(S) The funding for the establishment of the Danish National ART-Couple II Cohort (DANAC II Cohort) was obtained from the Rosa Ebba Hansen Foundation. The authors have no conflict of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
| | - Ida Voss
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen K, Denmark
| | - Lone Schmidt
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen K, Denmark
| | - Ditte Vassard
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen K, Denmark
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Farrelly C. Longevity Science and Women's Health and Wellbeing. JOURNAL OF POPULATION AGEING 2023:1-20. [PMID: 36741335 PMCID: PMC9885070 DOI: 10.1007/s12062-023-09411-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023]
Abstract
In most areas of the world women comprise the majority of older persons (especially at the most advanced ages), but the additional longevity (globally it is 4.8 years) women have often comes with poorer health status compared to age-matched men. This article draws attention to four distinct ways an applied gerontological intervention designed to increase the human healthspan via "rate (of ageing) control" could positively impact the health and wellbeing of women in today's ageing world. The four benefits examined are: (1) improving women's health in late life; (2) increasing reproductive longevity and improving maternal health, (3) reducing the financial vulnerability many women experience at advanced ages (especially in the developing world); and (4) reducing the caring burdens which typically fall, at least disproportionately, on daughters to care for their ageing parents. Highlighting these factors is important as is helps focus geroscience advocacy not only on the potential health dividend age retardation could confer on those in late life, but also the distributional effects on health throughout the lifespan (e.g. improving maternal health) and on helping to ameliorate other important inequalities (e.g. reducing the financial vulnerabilities of late life and easing the burdens on the care givers for ageing parents). By making vivid the benefits "rate (of ageing) control" could confer on women, especially in the developing world, the goal of retarding biological ageing can be rightly construed as a pressing public health priority for the 21st century.
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Affiliation(s)
- Colin Farrelly
- Department of Political Studies, Queen’s University, Kingston, Canada
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Grace B, Shawe J, Stephenson J. Exploring fertility knowledge amongst healthcare professional and lay population groups in the UK: a mixed methods study. HUM FERTIL 2023:1-10. [PMID: 36600193 DOI: 10.1080/14647273.2022.2153349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
As the average age of first-time parents continues to rise, there has been a concerted effort by educators, policy makers and several reproductive health groups to improve fertility awareness. This study explored fertility knowledge of lay men and women and healthcare professionals (HCPs) using the same test instrument, providing a new and unique perspective compared with previous studies. Results were obtained from 1082 survey respondents: 347 HCPs, 319 men and 413 women, 105 of whom were trying to conceive (TTC). A total of 35 interviewees were purposively sampled to include 9 HCPs, 13 men and 13 women from the reproductive age range and of varying ethnic and educational backgrounds. Interview data were transcribed and analysed using the framework method. The proportion of HCPs correctly answering the survey knowledge questions was 47.1 (95% CI = 41.7%, 52.5%) compared to 44.4% for women (95% CI = 38.9%, 50.1%); 49.9% (95% CI = 39.0, 59.9%) for women TTC; and 32.5% (95% CI = 27.1%, 37.9%) for men. HCPs were ranked as the most trusted source for seeking fertility information. Overall HCPs did not demonstrate better fertility knowledge than lay participants, with inconsistencies regarding where responsibility lies for providing the right information to patients. HCPs need to improve their knowledge about fertility to help improve patient's fertility awareness.
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Affiliation(s)
- Bola Grace
- Department of Sexual and Reproductive Health, Faculty of Population Health Sciences, UCL Institute for Women's Health, University College London, London, UK
| | - Jill Shawe
- Faculty of Health, University of Plymouth, Plymouth, UK.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Judith Stephenson
- Department of Sexual and Reproductive Health, Faculty of Population Health Sciences, UCL Institute for Women's Health, University College London, London, UK
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Costa RV, Marafona AS, Martins AO. [Advanced Maternal Age: A Perspective of the Portuguese Reality]. ACTA MEDICA PORT 2023; 36:69-70. [PMID: 36592484 DOI: 10.20344/amp.19115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/28/2022] [Indexed: 01/03/2023]
Affiliation(s)
- Rafaela Vieira Costa
- Unidade de Saúde Familiar Amadeo de Souza-Cardoso. Agrupamento de Centros de Saúde Baixo-Tâmega I. Amarante. Portugal
| | - Ana Sofia Marafona
- Unidade de Saúde Familiar Douro Vita. Agrupamento de Centros de Saúde Douro II - Douro Sul. Lamego. Grupo de Estudos de Saúde da Mulher. Associação Portuguesa de Medicina Geral e Familiar. Lisboa. Portugal
| | - Andreia Oliveira Martins
- Unidade de Saúde Familiar Terra e Mar. Agrupamento de Centros de Saúde Grande Porto IV. Póvoa de Varzim. Portugal
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Harper JC, Botero-Meneses JS. An online survey of UK women's attitudes to having children, the age they want children and the effect of the COVID-19 pandemic. Hum Reprod 2022; 37:2611-2622. [PMID: 36210721 PMCID: PMC9619608 DOI: 10.1093/humrep/deac209] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 09/01/2022] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What are women's views on having children, including the age they want to have them and other influences such as the coronavirus disease 2019 (COVID-19) pandemic? SUMMARY ANSWER Women's views on having children, at their preferred age of 30 years, included their maternal urge and concerns about their biological clock and stability, while 19% said COVID-19 had affected their views. WHAT IS KNOWN ALREADY Women globally are delaying the birth of their first child, with the average age of first birth approaching 32 years in some countries. The average age women have their first child in the UK is 30.7 years and over 50% of women aged 30 years are childless. The fertility rate stands at 1.3 in several European Union countries. Some people are not having their desired family size or are childless by circumstance. It is essential to understand people's attitudes to having children in different countries to identify trends so we can develop educational resources in an age-appropriate manner. STUDY DESIGN, SIZE, DURATION We conducted an anonymous, online survey of multiple choice and open-ended questions. The survey was live for 32 days from 15 May 2020 to 16 June 2020 and was promoted using social media. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 887 women from 44 countries participated in the survey. After filtering out women who did not consent, gave blank or incomplete responses, and those not in the UK, 411 responses remained. From the data, three areas of questioning were analysed: their views on having children, the ideal age they want to have children and the effects of the COVID-19 pandemic. Qualitative data were analysed by thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE The average age (±SD) of the women who completed the survey was 32.2 years (±5.9), and they were mainly heterosexual (90.8%) and 84.8% had a university education. One-third of women were married/in a civil partnership (37.7%) and 36.0% were cohabitating. In relation to their views on having children, the main themes identified were: the maternal urge, the ticking of the biological clock, why did no one teach us this?, the need for stability and balance in their life, pressure to start a family and considering other ways to have a family. When asked 'In an ideal world, at what age approximately would you like to have had or have children?' a normal distribution was observed with a mean age of 29.9 (±3.3) years. When asked 'What factors have led you to decide on that particular age?' the most frequent choice was 'I am developing my career'. Three themes emerged from the qualitative question on why they chose that age: the need for stability and balance in their life, the importance of finding the right time and life experiences. The majority of women felt that the COVID-19 pandemic had not affected their decision to have children (72.3%), but 19.1% said it had. The qualitative comments showed they had concerns about instability in their life, such as finances and careers, and delays in fertility treatment. LIMITATIONS, REASONS FOR CAUTION The survey was promoted on social media only and the women who answered the survey were highly educated. WIDER IMPLICATIONS OF THE FINDINGS The women surveyed ideally want children at age 30 years but there are obstacles in their way, such as the need to develop their career. Global tailored fertility education is essential to ensure people make informed reproductive choices. In addition, it is essential for supportive working environments and affordable childcare to be in place in every country. STUDY FUNDING/COMPETING INTEREST(S) J.C.H. is founder of www.globalwomenconnected.com and Reproductive Health at Work, and author of the book Your Fertile Years. This project was funded by the Institute for Women's Health, UCL. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Joyce C Harper
- EGA Institute for Women’s Health, University College London, London, UK
| | - Juan Sebastián Botero-Meneses
- EGA Institute for Women’s Health, University College London, London, UK
- Universidad del Rosario, School of Medicine and Health Sciences, Neuroscience Center Neurovitae-UR, Neuroscience Research Group NEUROS, Bogotá, Colombia
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Patra S, Unisa S. An exploration of treatment seeking behavior of women experienced infertility and need for services in rural India. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:978085. [PMID: 36303623 PMCID: PMC9580773 DOI: 10.3389/frph.2022.978085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo make informed decisions on fertility treatment, couples need to understand the treatment options available to them. A wide range of treatment options is available from the traditional and biomedical service providers in India. There is a dearth of research to find out factors that influence the treatment-seeking behavior of couples, particularly in rural areas.ObjectivesThe study aimed to document the treatment-seeking behavior of women for their infertility problems. Further, the research focused on the socio-economic determinants affecting allopathic treatment-seeking of women and the services needed for couples experiencing infertility in rural India.MethodsThe study is cross-sectional. Primary data were collected from the two high infertility prevalence districts. Complete mapping and listing were carried out to identify the eligible respondents. A total of 159 ever-married women (20–49 years) out of 172 identified women were interviewed. Bivariate and multivariate analyses were performed.ResultsAmong 159 interviewed women, only three did not seek any kind of treatment. Of the 156 women, 63, 65, and 28 women (mutually exclusive) received first, second and third-order treatment, respectively. The number of women decreased in the succeeding phases of infertility. Women aged above 35 years, were significantly less (OR = 0.310, p < 0.05) compared to women aged below 30 years to receive allopathic treatment. The use of allopathic treatment was significantly three times higher among women who were educated (OR = 3.712, p < 0.01) and two times higher among those who were exposed (OR = 2.217, p < 0.5) to media. Further, for those who had felt the treatment was necessary, about 30, 44, 10, and 19% mentioned that due to unaffordability, inaccessibility, or inconveniences they couldn't consult allopathic treatment.ConclusionsTimely diagnosis and appropriate treatment play important role in infertility management. Women who are more educated and are exposed to media tend to consult allopathic treatment. Similarly, time and money spent on care vary significantly and independently by type of treatment and socioeconomic factors. There is a need for mandatory insurance coverage for infertility treatment enacted by the state government. In addition to the public services, the private sector and the traditional healers are both important alternative sources of first help.
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Affiliation(s)
- Shraboni Patra
- Department of Population and Development, International Institute for Population Sciences (IIPS), Mumbai, India
- *Correspondence: Shraboni Patra
| | - Sayeed Unisa
- Department of Biostatistics and Epidemiology, International Institute for Population Sciences (IIPS), Mumbai, India
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Iino K, Fukuhara R, Yokota M, Yokoyama Y. Fertility awareness and subclinical infertility among women trying to get pregnant at home. BMC Womens Health 2022; 22:43. [PMID: 35184726 PMCID: PMC8859874 DOI: 10.1186/s12905-022-01626-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Recent studies on fertility awareness among the reproductive population have reported the lack of accurate knowledge about fertility and assisted reproductive technologies. However, there has been little information regarding women trying to get pregnant at home. The aim of this study was to explore the prevalence of subclinical infertility among women trying to get pregnant at home, and to evaluate awareness regarding infertility and reasons for not visiting infertility clinics among women who use pregnancy-assist mobile applications to help them conceive. Methods A total of 2084 Japanese women responded to this online survey. We selected 1541 women according to the study criteria. Based on the results of 61 questions, we evaluated knowledge regarding fertility, prevalence of subclinical infertility, and reasons for not visiting the clinic among the participants. Results Despite the desire to conceive, the participants had an apparent tendency to overestimate the age limit for childbearing. A total of 338 (21.9%) women answered that in general women aged > 45 years could get pregnant. Approximately 40% of the women had possible subclinical infertility and were unaware of the fact. Additionally, about 70% of the women considered themselves to have infertility problems. Women who were aware of the possibility of infertility hesitated to visit the clinic due to unfamiliarity with a gynecologist or clinic, and apprehensions about the gynecologic examination. Conclusions In our study, some women required treatment for infertility. Nonetheless, they hesitated to visit an infertility clinic. Sexual health education, together with proper accessibility to gynecology clinics, are necessary to reduce involuntary childlessness.
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Affiliation(s)
- Kaori Iino
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5 Zaifu Hirosaki, Hirosaki, Aomori, 036-8562, Japan. .,National Hospital Organization Hirosaki National Hospital, 1 Tominotyo, Hirosaki, Aomori, 036-8545, Japan.
| | - Rie Fukuhara
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5 Zaifu Hirosaki, Hirosaki, Aomori, 036-8562, Japan
| | - Megumi Yokota
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5 Zaifu Hirosaki, Hirosaki, Aomori, 036-8562, Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5 Zaifu Hirosaki, Hirosaki, Aomori, 036-8562, Japan
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Chan SL, Thumboo J, Boivin J, Saffari SE, Yin S, Yeo SR, Chan JKY, Ng KC, Chua KH, Yu SL. Effect of fertility health awareness strategies on fertility knowledge and childbearing in young married couples (FertStart): study protocol for an effectiveness-implementation hybrid type I multicentre three-arm parallel group open-label randomised clinical trial. BMJ Open 2022; 12:e051710. [PMID: 34980614 PMCID: PMC8724708 DOI: 10.1136/bmjopen-2021-051710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Birth rates have been declining in many advanced societies including Singapore. We designed two interventions with vastly different resource requirements, which include fertility education, personalised fertility information and a behavioural change component targeting modifiable psychological constructs to modify fertility awareness and childbearing intentions. We aim to evaluate the effect of these two interventions on knowledge, attitudes and practice around childbearing compared with a control group among young married couples in Singapore and understand the implementation factors in the setting of an effectiveness-implementation hybrid type 1 three-arm randomised trial. METHODS AND ANALYSIS We will randomise 1200 young married couples to no intervention (control), Fertility Health Screening group (FHS) or Fertility Awareness Tools (FAT) in a 7:5:5 ratio. Couples in FHS will undergo an anti-Mullerian hormone test and semen analysis, a doctor's consultation to explain the results and standardised reproductive counselling by a trained nurse. Couples in FAT will watch a standardised video, complete an adapted fertility status awareness (FertiSTAT) tool and receive an educational brochure. The attitudes, fertility knowledge and efforts to achieve pregnancy of all couples will be assessed at baseline and 6 months post-randomisation. Birth statistics will be tracked using administrative records at 2 and 3 years. The primary outcome is the change in the woman's self-reported intended age at first birth between baseline and 6 months post-randomisation. In addition, implementation outcomes and cost-effectiveness of the two interventions will be assessed. ETHICS AND DISSEMINATION This study has been reviewed and approved by the Centralized Institutional Review Board of SingHealth (2019/2095). Study results will be reported to the study funder and there are plans to disseminate them in scientific conferences and publications, where authorship will be determined by the International Committee of Medical Journal Editors guidelines. TRIAL REGISTRATION NUMBER NCT04647136; ClinicalTrails.gov Identifier.
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Affiliation(s)
- Sze Ling Chan
- Health Services Research Centre, Singhealth, Singapore
| | - Julian Thumboo
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore
| | - Jacky Boivin
- School of Psychology, Cardiff University, Cardiff, UK
| | | | - Shanqing Yin
- Chairman Medical Board Office, KK Women's and Children's Hospital, Singapore
| | - Samantha Rachel Yeo
- Division of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore
| | - Jerry Kok Yen Chan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - Kee Chong Ng
- Chairman Medical Board Office, KK Women's and Children's Hospital, Singapore
| | - Ka-Hee Chua
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - Su Ling Yu
- Department of Obstetrics & Gynaecology, Singapore General Hospital, Singapore
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Berthelsen ASN, Gamby ALN, Christensen U, Schmidt L, Koert E. How do young men want to receive information about fertility? Young men's attitudes towards a fertility campaign targeting men in Copenhagen, Denmark. Hum Reprod Open 2021; 2021:hoab027. [PMID: 34322604 PMCID: PMC8313403 DOI: 10.1093/hropen/hoab027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/22/2021] [Indexed: 11/24/2022] Open
Abstract
STUDY QUESTION What are young men’s attitudes towards the Danish fertility campaign ‘How’s your sperm?’ and how do they want to receive fertility information in the future? SUMMARY ANSWER The young men found that the campaign had limited impact because it was not relevant to their current life situation and they believed general fertility awareness should be a mandatory part of education, while more targeted information would be helpful through web-based venues when it was more relevant to their lives (e.g. when ready to have children). WHAT IS KNOWN ALREADY It is estimated that 16–26% of the Danish population who want children will experience infertility at some point in their lives. In Denmark, 25% of young healthy men have decreased sperm quality, and 20% of 50-year-old men are childless. Men play an important role in the fertility decision-making of couples, thus, it is important to target men and ensure that they have sufficient fertility knowledge. However, fertility awareness is limited among men and there have been few fertility awareness initiatives targeting men. In October 2018, the Municipality of Copenhagen launched the campaign ‘How’s your sperm?’ as a tool to increase fertility knowledge among men. To identify potential barriers for the effect of fertility campaigns targeting men, evaluations of such campaigns are needed. STUDY DESIGN, SIZE, DURATION This study was a cross-sectional, qualitative study of six focus groups including a total of 27 currently childless young men from the Capital Region of Copenhagen, Denmark. Data collection took place between April and October 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS The interviewed young men were currently childless and were all residents in the Capital Region of Copenhagen. They were between 23 and 32 years old with an average age of 26 years, and almost all were university students or had a university degree. The focus group discussions were audiotaped, anonymized and transcribed in full. Data were analyzed using qualitative content analysis. MAIN RESULTS AND THE ROLE OF CHANCE Overall, the campaign had limited influence on the young men because they believed the campaign was not relevant to their current life situation. Furthermore, the young men were confused about the aim and message of the campaign, as they thought it encouraged them to have their sperm quality tested. The young men also criticized the campaign for making a link between sperm quality and masculinity. They recognized the importance of knowledge about reproductive health but they wanted access to accurate information about fertility and risk factors for infertility. According to the young men, future initiatives should prioritize clear communication of accurate, reliable and understandable fertility information in web-based venues. In addition, the young men suggested that general fertility information should be a mandatory part of the (sexual) education curriculum in primary and secondary schools. LIMITATIONS, REASONS FOR CAUTIONS Participants were young and highly educated; thus the findings cannot be generalized to all men of a similar age group or to men at older ages. WIDER IMPLICATIONS OF THE FINDINGS Different strategies that are relevant to the lifespan are needed to increase fertility awareness in the male population. The young men’s responses underscored that any fertility awareness strategy or campaign must convey respect for the individual’s autonomy. The findings highlight that how information is communicated and the quality or type of information that is disseminated are both important in acceptability by target users. STUDY FUNDING/COMPETING INTEREST(S) No funding was received for this study. No conflicts were declared for all authors. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- A S N Berthelsen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen K, Denmark
| | - A L N Gamby
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen K, Denmark
| | - U Christensen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen K, Denmark
| | - L Schmidt
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen K, Denmark
| | - E Koert
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen K, Denmark
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Chen PL, Saman TN. A new model for evaluating the influence of social networks, social learning, and supportive policies on the desire of women for fertility. HUMAN SYSTEMS MANAGEMENT 2021. [DOI: 10.3233/hsm-190825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Nowadays, social networks become so famous and attract a lot of users. In recent eras, the increase of online social networks and the digitization of communication types have meant that online social networks have become a significant part of social network examination. OBJECTIVE: In this paper, we investigate the social networks to study the desire of women for fertility. The study has delivered new visions into the elements of reproductive behavior and has discussed the development of increasingly refined and realistic theories of fertility desire. METHODS: A questionnaire is intended for evaluating the elements of the model. Questionnaires were reviewed by experts with significant experiences in this domain. From 384 users of Telegram as an important social network in Iran, data are collected. For statistical examination, the SPSS 22 and SMART- PLS 3.2 software are also utilized. RESULTS: Results confirmed the validity of the model for assessing of the desire of women for fertility. The outcomes have indicated that the social network has a negative effect on the desire of women for fertility. Besides, the results have shown that the role of social networks on social learning is significant and positive. Furthermore, the role of social learning and supportive policies on the desire of women for fertility is positive and significant. CONCLUSIONS: According to findings, managers have enough precision in training women and daughters through social networks and social learning to enhance the desire for fertility. Finally, it is significant to note that since data are self-reported, they could be affected by rationalization and may not correlate with fertility behavior. In future studies, by gathering a comprehensive sample, other important elements can be considered that cause the desire of women for fertility.
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Affiliation(s)
- Pei-Lin Chen
- China University of Labor Relations, Beijing, China
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Whyte S, Brooks RC, Chan HF, Torgler B. Sex differences in sexual attraction for aesthetics, resources and personality across age. PLoS One 2021; 16:e0250151. [PMID: 34010298 PMCID: PMC8133465 DOI: 10.1371/journal.pone.0250151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 04/01/2021] [Indexed: 11/25/2022] Open
Abstract
Because sexual attraction is a key driver of human mate choice and reproduction, we descriptively assess relative sex differences in the level of attraction individuals expect in the aesthetic, resource, and personality characteristics of potential mates. As a novelty we explore how male and female sexual attractiveness preference changes across age, using a dataset comprising online survey data for over 7,000 respondents across a broad age distribution of individuals between 18 and 65 years. In general, we find that both males and females show similar distribution patterns in their preference responses, with statistically significant sex differences within most of the traits. On average, females rate age, education, intelligence, income, trust, and emotional connection around 9 to 14 points higher than males on our 0-100 scale range. Our relative importance analysis shows greater male priority for attractiveness and physical build, compared to females, relative to all other traits. Using multiple regression analysis, we find a consistent statistical sex difference (males relative to females) that decreases linearly with age for aesthetics, while the opposite is true for resources and personality, with females exhibiting a stronger relative preference, particularly in the younger aged cohort. Exploring non-linearity in sex difference with contour plots for intelligence and attractiveness across age (mediated by age) indicates that sex differences in attractiveness preferences are driven by the male cohort (particularly age 30 to 40) for those who care about the importance of age, while intelligence is driven by females caring relatively more about intelligence for those who see age as very important (age cohort 40 to 55). Overall, many of our results indicate distinct variations within sex at key life stages, which is consistent with theories of selection pressure. Moreover, results also align with theories of parental investment, the gender similarities hypothesis, and mutual mate choice-which speaks to the fact that the broader discipline of evolutionary mate choice research in humans still contains considerable scope for further inquiry towards a unified theory, particularly when exploring sex-difference across age.
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Affiliation(s)
- Stephen Whyte
- School of Economics and Finance & Centre for Behavioural Economics, Society & Technology (BEST), Queensland University of Technology, Gardens Point, Brisbane, QLD, Australia
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
| | - Robert C. Brooks
- Evolution & Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Ho Fai Chan
- School of Economics and Finance & Centre for Behavioural Economics, Society & Technology (BEST), Queensland University of Technology, Gardens Point, Brisbane, QLD, Australia
| | - Benno Torgler
- School of Economics and Finance & Centre for Behavioural Economics, Society & Technology (BEST), Queensland University of Technology, Gardens Point, Brisbane, QLD, Australia
- CREMA—Center for Research in Economics, Management and the Arts, Basel, Switzerland
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Delbaere I, Pitsillos T, Tydén T, Kerckhof L, Iliadis SI. Fertility awareness and parenthood intentions among medical students in three European countries. EUR J CONTRACEP REPR 2021; 26:312-322. [PMID: 33855916 DOI: 10.1080/13625187.2021.1901877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study was to investigate medical undergraduate students' fertility awareness and parenthood intentions in three European countries, as well as possible differences across genders and countries. MATERIALS AND METHODS A cross sectional survey among 656 medical students in Sweden, Belgium and Greece. The utilised questionnaire comprised 23 questions. RESULTS Three fourth of participants (n = 472/629) correctly stated that women are most fertile at 20-25 years of age. Approximately 91% correctly answered that women's fertility starts to significantly decline before the age of 35, which differed among countries of participation. Social oocyte or sperm freezing was considered by 67% of Belgians, 49% Greeks, and 16.5% Swedes (p < 0.001). Approximately 95% expressed a wish of having a child in the future and the median age was 29 years for the first and 35 years for the last child. CONCLUSIONS Knowledge about fertility among medical students was in general satisfactory, albeit varying by country and gender. Medical curricula and social policies for childbearing should be respectively updated in EU countries suffering population growth.
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Affiliation(s)
- Ilse Delbaere
- Department of Healthcare, VIVES University of Applied Sciences, Kortrijk, Belgium
| | - Tryfonas Pitsillos
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Tanja Tydén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Lisa Kerckhof
- Department of Healthcare, VIVES University of Applied Sciences, Kortrijk, Belgium
| | - Stavros I Iliadis
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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A Survey of Women Who Cryopreserved Oocytes for Non-medical Indications (Social Fertility Preservation). Reprod Sci 2021; 28:2216-2222. [PMID: 33449346 DOI: 10.1007/s43032-021-00460-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/06/2021] [Indexed: 10/22/2022]
Abstract
To evaluate the expectations, experiences, and fertility awareness status of women who underwent social oocyte cryopreservation. Cohort survey study was conducted at an academic medical center. All women who underwent social oocyte cryopreservation between January 2015 and June 2016 were recruited. One hundred thirty-three women were contacted by phone to participate in a survey. The questionnaire investigated the initial motivation towards freezing, intentions to use cryopreserved oocytes, treatment experience, awareness of fertility and knowledge about chances of having a live birth with their frozen oocytes. The mean age at the time of oocyte freezing was 38.5 ± 2.68 years. The average number of mature oocytes cryopreserved was 5.48 ± 6.6 (1-16). Two major motivations were absence of a male partner (40%) and an anticipated age-related fertility decline (42%). Almost 60% overestimated the chances of natural conception, as well as the success of IVF at the age of 40 years. Half of the oocyte bankers reported that fertility declined between ages 35 and 39, but only 28% of patients estimated the live birth rate per cryopreserved oocyte correctly. Overall 98.8% stated that they would recommend oocyte cryopresevation to a friend, and 72% felt more secure in terms of reproductive potential. Despite comprehensive personalized counseling prior to the start of ovarian stimulation, many women do not seem to have a realistic understanding of reproductive aging. Even though gamete cryopreservation provides some insurance, overestimating the effectiveness of oocyte cryopreservation can also lead to a false sense of security. Clinical Trial Registration: 2016.086.IRB1.006.
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Place JM, Peterson BD, Horton B, Sanchez M. Fertility awareness and parenting intentions among Mexican undergraduate and graduate university students. HUM FERTIL 2020; 25:397-406. [PMID: 32896180 DOI: 10.1080/14647273.2020.1817577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
An online, cross-sectional survey was carried out between November 2017 and January 2018 to assess fertility awareness among students attending the National Autonomous University of Mexico (UNAM) in Mexico City. A total of 371 students participated in the survey (n = 228 females, 143 males). 75% of females and 74% of males believed a woman's fertility begins to decline markedly after age 40. Over 75% of all participants overestimated the probability of couples having a live birth after undergoing one cycle of IVF. With regard to parenting intentions, only 48% of females wished to have children compared to 59% of males (p = 0.037) and men were more likely to have their first child at age 30 or later (71% men vs 55% women). In the event of infertility, participants had a higher preference not to have children or to pursue adoption rather than use in vitro fertilisation (IVF). In summary, university students in Mexico City demonstrated low levels of fertility awareness and a smaller proportion indicated a wish to have children than has been reported by young people elsewhere in the world.
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Affiliation(s)
- J M Place
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
| | - B D Peterson
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA, USA
| | - B Horton
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
| | - M Sanchez
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
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Hviid Malling GM, Schmidt L, Pitsillos T, Hammarberg K, Tydén T, Friberg B, Jensen I, Ziebe S. Taking fertility for granted - a qualitative exploration of fertility awareness among young, childless men in Denmark and Sweden. HUM FERTIL 2020; 25:1-12. [PMID: 32720536 DOI: 10.1080/14647273.2020.1798516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/18/2020] [Indexed: 12/12/2022]
Abstract
Most previous studies about fertility knowledge and attitudes among men have been based on quantitative methods using questionnaires with fixed-choice response options. The aims of this qualitative study were to explore childless young men's reflections on fertility and infertility through semi-structured interviews. Danish (n = 17) and Swedish (n = 12) young childless men aged between 20 and 30 years in their last year of education were interviewed. Data were analysed using qualitative content analysis. Few informants had considered their own fertility, and most were positive towards fertility treatment. The young men had inadequate knowledge about factors that can potentially impair male and female fertility. On average, the young men each mentioned three different factors they believed influence male and female fertility: (i) health behaviour; (ii) factors beyond personal control; and (iii) age. None mentioned sexual transmitted infections (STIs) but most appeared aware of the effect of increasing age on fertility. The results of this study highlight the need for educational strategies to improve young men's knowledge about fertility and the factors that influence it, particularly about the potential adverse effect of STIs on fertility.
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Affiliation(s)
- Gritt Marie Hviid Malling
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tryfonas Pitsillos
- Department of Women's and Children's Health, University Hospital Uppsala, Uppsala, Sweden
| | - Karin Hammarberg
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Victorian Assisted Reproductive Treatment Authority, Melbourne, Australia
| | - Tanja Tydén
- Department of Women's and Children's Health, University Hospital Uppsala, Uppsala, Sweden
| | - Britt Friberg
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Inez Jensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Søren Ziebe
- Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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23
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Hviid Malling GM, Pitsillos T, Tydén T, Hammarberg K, Ziebe S, Friberg B, Schmidt L. 'Doing it in the right order': childless men's intentions regarding family formation. HUM FERTIL 2020; 25:188-196. [PMID: 32567408 DOI: 10.1080/14647273.2020.1778803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In high-income countries, parental age at first birth has increased and this postponement increases the risk of involuntary childlessness or having fewer children than desired. This interview study was conducted in Denmark and Sweden among childless men (n = 29) in their last year of an education. The aim was to explore the role of individual and societal factors on fertility decision-making and men's reflections on barriers and enablers for earlier family formation. Data were analysed with thematic content analysis. Almost all participants wanted children in the future. Overall, there was a desire to follow the 'right chronology': get educated, having a stable relationship, employment and a good financial status before having children. While most men felt mature enough to have children, they were still not ready. Influences from within the inner social circle, societal expectations, the need for security and stability and being ready to give up freedom and individuality were factors that affected participants' preferred timing of parenthood. Most men did not have suggestions for how earlier family formation could be supported. Results suggest a gap between the ideal biological and ideal social age of family formation that may lead to unfulfilled parenthood aspirations.
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Affiliation(s)
- Gritt Marie Hviid Malling
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Fertility Clinic, Copenhagen University Hospital, Copenhagen, Denmark
| | - Tryfonas Pitsillos
- Department of Women's and Children's Health, University Hospital Uppsala, Uppsala, Sweden
| | - Tanja Tydén
- Department of Women's and Children's Health, University Hospital Uppsala, Uppsala, Sweden
| | - Karin Hammarberg
- Global and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Victorian Assisted Reproductive Treatment Authority, Melbourne, Australia
| | - Søren Ziebe
- Fertility Clinic, Copenhagen University Hospital, Copenhagen, Denmark
| | - Britt Friberg
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Abstract
Delayed childbearing is currently a major challenge in reproductive medicine as increased age has an important impact on successful conception, both in natural and in assisted reproduction. There is a lack of knowledge about the impact of age on fertility, even in highly educated populations. A number of initiatives have been taken to increase fertility awareness. Health care providers have been encouraged to talk with patients about their reproductive life plan (RLP) for almost a decade based on recommendations from the Centres for Disease Control and Prevention. This concept has been explored successfully in Swedish contraception counselling. A growing number of online interventions aim to raise fertility awareness. These websites or interactive tools provide relevant information for individuals and couples as they consider whether they want children, when they should have them, and how many they may wish to have. These interventions are important, because research depicts that knowledge helps people in their decision-making process. With new fertility preservations such as egg freezing now available, additional education is needed to be sure that women and couples are well informed about the cost and low success rates of this intervention.
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Affiliation(s)
- Ilse Delbaere
- Midwifery Education, VIVES University of Applied Sciences, Kortrijk, Belgium
- CONTACT Ilse Delbaere Midwifery Education, VIVES University of Applied Sciences, Doorniksesteenweg 145, Kortrijk, 8500, Belgium
| | - Sarah Verbiest
- Center for Maternal and Infant Health, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tanja Tydén
- Department of Women’s and Children’s Heath, Akademiska Sjukhuset Uppsala University, Uppsala, Sweden
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25
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Ford EA, Roman SD, McLaughlin EA, Beckett EL, Sutherland JM. The association between reproductive health smartphone applications and fertility knowledge of Australian women. BMC WOMENS HEALTH 2020; 20:45. [PMID: 32131809 PMCID: PMC7057638 DOI: 10.1186/s12905-020-00912-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/24/2020] [Indexed: 12/15/2022]
Abstract
Background Previous studies have identified that women living in developed countries have insufficient knowledge of factors which may be contributing to the increasingly high global infertility rates such as maternal age and assisted reproductive technologies. There is a large market of reproductive health smartphone applications, yet little is known about the advantages these apps may confer to users in regards to reproductive health knowledge. Methods An anonymous, online survey of women living in Australia aged 18 and above was open March–June 2018, until ≥200 responses were acquired for statistical power. Respondents answered questions regarding knowledge about general fertility and related factors (age, cyclic fertility, smoking, obesity, miscarriage rate, and success of assisted reproductive technologies). Fertility knowledge was compared in respondents who did or did not use apps relating to female reproductive health. Additionally the functions preferred in reproductive health apps was described by app using respondents. Sociodemographic information was also collected, and relevant data within the dataset was subject to multivariable modelling for the outcome of the fertility knowledge questions. Results Of the 673 respondents that completed the survey, 43.09% reported using mobile phone applications relating to female reproductive health. On average, respondents answered only three of the six fertility knowledge questions correctly. App using respondents were more likely to score better on one question, related to fertility during the menstrual cycle (p < 0.001). App users most commonly reported using the menstrual tracking function in apps (82.4%), which may account for the increased knowledge of cyclic fertility. Conclusions This data provides preliminary evidence toward the usefulness of smartphone applications as a medium for providing information about fertility to women. A limited understanding of one’s own fertility was demonstrated despite being essential for the decision-making of women throughout their reproductive years.
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Affiliation(s)
- Emmalee A Ford
- Priority Research Centre for Reproductive Science, Schools of Biomedical Science & Pharmacy and Environmental & Life Sciences, University of Newcastle, Ring Road, Callaghan, New South Wales, 2308, Australia. .,Hunter Medical Research Institute, New Lambton Heights, New South Wales, 2305, Australia.
| | - Shaun D Roman
- Priority Research Centre for Reproductive Science, Schools of Biomedical Science & Pharmacy and Environmental & Life Sciences, University of Newcastle, Ring Road, Callaghan, New South Wales, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, 2305, Australia.,Priority Research Centre for Drug Development, University of Newcastle, Callaghan, New South Wales, 2308, Australia
| | - Eileen A McLaughlin
- Priority Research Centre for Reproductive Science, Schools of Biomedical Science & Pharmacy and Environmental & Life Sciences, University of Newcastle, Ring Road, Callaghan, New South Wales, 2308, Australia.,School of Science, Western Sydney University, Penrith, NSW, 2751, Australia.,School of Biological Sciences, Faculty of Science, University of Auckland, Auckland, 1142, New Zealand
| | - Emma L Beckett
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, 2305, Australia.,School of Environmental & Life Sciences, Faculty of Science, University of Newcastle, Callaghan, New South Wales, 2308, Australia
| | - Jessie M Sutherland
- Priority Research Centre for Reproductive Science, Schools of Biomedical Science & Pharmacy and Environmental & Life Sciences, University of Newcastle, Ring Road, Callaghan, New South Wales, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, New South Wales, 2305, Australia
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Araban M, Karimy M, Armoon B, Zamani-Alavijeh F. Factors related to childbearing intentions among women: a cross-sectional study in health centers, Saveh, Iran. J Egypt Public Health Assoc 2020; 95:6. [PMID: 32813137 PMCID: PMC7364678 DOI: 10.1186/s42506-020-0035-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 01/23/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND One of the most important demographic challenges over the recent three decades in the world has been a significant fall in the fertility rate. This study aimed to investigate factors related to childbearing intentions among a sample of Iranian women. METHODS A cross-sectional study of a sample of Iranian married women attending 8 centers in Saveh was conducted in 2015. A total of 483 married women 15-49 years old participated in this study. A questionnaire was used to collect data about demographics, attitude, subjective norms, marital satisfaction, social support, hopefulness, and behavioral intentions of childbearing. RESULTS Overall, 62% of women in the study intended to have children in the next 2 years. The group willing to have children had a higher score on attitude, subjective norms, hopefulness, perceived social support, and marital satisfaction compared to the group unwilling to have children. Also, the regression results revealed that the variables of age, literacy status, employment status, husband literacy, women and husband occupation status, attitude, subjective norms, hopefulness, perceived social support, and marital satisfaction were significant predicting factors for childbearing intention (P < 0.05). CONCLUSIONS AND RECOMMENDATIONS The findings highlighted the importance of psychological factors such as marital satisfaction and social support in the childbearing process. Thus, health system planners should pay more attention to these determinants of fertility intention.
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Affiliation(s)
- Marzieh Araban
- Department of Health Education and Promotion, Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmood Karimy
- Department of Public Health, Faculty of Health, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Bahram Armoon
- Department of Public Health, Faculty of Health, Saveh University of Medical Sciences, Saveh, Iran
| | - Fereshteh Zamani-Alavijeh
- Department of Public Health, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Parental desire and fertility preservation in assigned female at birth transgender people living in Belgium. Fertil Steril 2020; 113:149-157.e2. [DOI: 10.1016/j.fertnstert.2019.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/30/2019] [Accepted: 09/03/2019] [Indexed: 11/20/2022]
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Ohnishi M, Machiyama K, Nishihara M, Sato M, Matsuyama A. Experiences of romantic relationships and desires to marry and have children among youth in a low-fertility society. J Rural Med 2019; 14:196-205. [PMID: 31788142 PMCID: PMC6877919 DOI: 10.2185/jrm.3004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/13/2019] [Indexed: 11/27/2022] Open
Abstract
Introduction: This study aims to explore experiences of romantic
relationships and to examine determinants of desires to marry and have children in the
future among Japanese university students. Methods: A cross-sectional study was conducted among undergraduate students
of A University, located in the capital city of a Japanese prefecture, using an anonymous
self-administered and structured questionnaire developed by an online survey software. Results: A total of 815 respondents with complete data were analyzed by
logistic regression analysis. Over 80% of males and females expressed the desire to marry
and have children in the future. It was found that for both female and male respondents,
the “desire to marry” was associated with currently being in a romantic relationship or
having experience of sexual intercourse. On the contrary, the “desire to have children”
was associated with currently being in a romantic relationship or having experience of
sexual intercourse only among male respondents, and no significant association was
observed among female respondents. Conclusion: “Currently being in a romantic relationship” and “having
experience of sexual intercourse” were associated with wanting to marry and have children
in the future among male university students. This suggests that these may be important
factors in providing a positive perception regarding having children when they attain
childbearing age.
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Affiliation(s)
- Mayumi Ohnishi
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | | | - Mika Nishihara
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Miho Sato
- Nagasaki University Graduate School of Tropical Medicine and Global Health, Japan
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Grootenhuis A, van den Hoogen A, Broekmans F, Torrance H, van Os-Medendorp H, Ockhuijsen H. Young women's opinions on the use of a blood test to predict the possibility of premature ovarian failure: a qualitative study. HUM FERTIL 2019; 24:304-314. [PMID: 31530237 DOI: 10.1080/14647273.2019.1665198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The anti-Müllerian hormone (AMH) test is increasingly being used to predict the age when women will enter menopause, signalling the end of their reproductive life. However, the accuracy of the AMH test varies widely. In this qualitative study, we asked young women of three differing education levels about the possibility of predicting premature ovarian failure (POF), defined as menopause that occurs before the age of 40. A total of 15 face-to-face semi-structured interviews were conducted. The overarching theme was 'considering the possibility of predicting POF', and the three interpretive themes were (i) limited fertility knowledge, (ii) preconditions for pregnancy and (iii) desire to have children. The interview was their first awareness of the concept of POF. All the women who participated in this study wished to have children at some point later in life and tended to think more about fulfilling preconditions before getting pregnant than about their actual fertility. Most participants (n = 8) were interested in the AMH test regardless of their education level. Five participants wanted to take the test in the future. This research provides some insight into young women's current thoughts about the possibility of predicting POF with an AMH test.
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Affiliation(s)
- Anouk Grootenhuis
- Clinical Health Sciences at the University Utrecht, Utrecht, The Netherlands
| | - Agnes van den Hoogen
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Frank Broekmans
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Helen Torrance
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Henrietta Ockhuijsen
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
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Boivin J, Koert E, Harris T, O'Shea L, Perryman A, Parker K, Harrison C. An experimental evaluation of the benefits and costs of providing fertility information to adolescents and emerging adults. Hum Reprod 2019; 33:1247-1253. [PMID: 29788136 PMCID: PMC6012744 DOI: 10.1093/humrep/dey107] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/02/2018] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Does the provision of fertility (compared to control) information affect fertility-related knowledge, perceived threat of infertility, anxiety, physical stress and fertility plans in adolescents and emerging adults? SUMMARY ANSWER The provision of fertility information was associated with increased fertility knowledge (emerging adults) and greater infertility threat (adolescents and emerging adults). WHAT IS KNOWN ALREADY According to fertility education research, adolescents and emerging adults know less than they should know about fertility topics. Fertility knowledge can be improved through the provision of information in older adults. STUDY DESIGN, SIZE, DURATION Experimental design. Secondary and university students completed pre-information questionnaires, were randomly assigned via computer to an experimental group, read either fertility (FertiEduc group) or healthy pregnancy information (Control group), and completed post-information questionnaires. Data were collected in group sessions via an online portal. PARTICIPANTS/MATERIALS, SETTING, METHODS Eligible participants were aged 16–18 (adolescents) or 21–24 years (emerging adults), childless, not currently pregnant (for men, partner not pregnant) or trying to conceive, presumed fertile and intending to have a child in the future. Of the 255 invited, 208 (n = 93 adolescents, n = 115 emerging adults) participated. The FertiEduc group received ‘A Guide to Fertility’, four online pages of information about fertility topics (e.g. ‘When are men and women most fertile?’) and the Control group received four online pages from the National Health Service (NHS) pregnancy booklet ‘Baby Bump and Beyond’. Participants completed a questionnaire (fertility knowledge, perceived threat of infertility, anxiety, physical stress and fertility plans, moderators) prior to and after the provision of information. Mixed factorial analysis of variance was used to examine the effects of information provision and hierarchical multiple regression to assess potential moderators of knowledge. MAIN RESULTS AND THE ROLE OF CHANCE The FertiEduc and Control groups were equivalent on age, gender, disability, relationship status and orientation at baseline. Results showed that fertility information significantly increased fertility knowledge for emerging adults only (P < 0.001) and threat of infertility for emerging adults and adolescents (P = 0.05). The moderators were not significant. Participation in the study was associated with an increase in feelings of anxiety but a decrease in physical stress reactions. Adolescents had more optimal fertility plans compared to emerging adults due to being younger. LIMITATIONS, REASONS FOR CAUTION This was an experimental study on a self-selected sample of men and women from selected educational institutions and only short term effects of information were studied. WIDER IMPLICATIONS OF THE FINDINGS Provision of fertility information can have benefits (increased fertility knowledge) but also costs (increase potential threat of infertility). Adolescents find fertility information positive but do not learn from it. Fertility education should be tailored according to age groups and created to minimise negative effects. Longitudinal examination of the effects of fertility information in multi-centre studies is warranted and should include measures of perceived threat of infertility. STUDY FUNDING/COMPETING INTEREST(S) Cardiff University funded this research. All authors have no conflicts of interest to declare.
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Affiliation(s)
- J Boivin
- School of Psychology, Cardiff University, Tower Building, Park Place, Cardiff, Wales, UK
| | - E Koert
- School of Psychology, Cardiff University, Tower Building, Park Place, Cardiff, Wales, UK
| | - T Harris
- School of Psychology, Cardiff University, Tower Building, Park Place, Cardiff, Wales, UK
| | - L O'Shea
- School of Psychology, Cardiff University, Tower Building, Park Place, Cardiff, Wales, UK
| | - A Perryman
- School of Psychology, Cardiff University, Tower Building, Park Place, Cardiff, Wales, UK
| | - K Parker
- School of Psychology, Cardiff University, Tower Building, Park Place, Cardiff, Wales, UK
| | - C Harrison
- School of Psychology, Cardiff University, Tower Building, Park Place, Cardiff, Wales, UK
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Mu Q, Hanson L, Hoelzle J, Fehring RJ. Young Women’s Knowledge About Fertility and Their Fertility Health Risk Factors. J Obstet Gynecol Neonatal Nurs 2019; 48:153-162. [DOI: 10.1016/j.jogn.2018.12.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2018] [Indexed: 11/16/2022] Open
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Roustaei Z, Räisänen S, Gissler M, Heinonen S. Fertility rates and the postponement of first births: a descriptive study with Finnish population data. BMJ Open 2019; 9:e026336. [PMID: 30782758 PMCID: PMC6340426 DOI: 10.1136/bmjopen-2018-026336] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We described the trend of fertility rates, age-specific fertility rates and associated factors in Finland over a 30-year period. DESIGN A descriptive population-based register study. SETTING Fertility data, including age at first birth, childlessness and educational levels were gathered from the Finnish Medical Birth Register and Statistics Finland. PARTICIPANTS All 1 792 792 live births from 1987 to 2016 in Finland. MAIN OUTCOME MEASURES Completed fertility rate, total fertility rate and age-specific fertility rate. RESULTS The total fertility rate of Finnish women fluctuated substantially from 1987 to 2016. Since 2010, the total fertility rate has gradually declined and reached the lowest during the study period in 2016: 1.57 children per woman. The mean maternal age at first birth rose by 2.5 years from 26.5 years in 1987 to 29 years in 2016. The proportion of childless women at the age of 50 years increased from 13.6% in 1989 to 19.6% in 2016. By considering the impact of postponement and childlessness, the effect on total fertility rates was between -0.01 and -0.12 points. Since 1987, the distribution of birth has declined for women under the age of 29 and increased for women aged 30 or more. However, start of childbearing after the age of 30 years was related to the completed fertility rate of less than two children per woman. The difference in completed fertility rate across educational groups was small. CONCLUSIONS Postponement of first births was followed by decline in completed fertility rate. Increasing rate of childlessness, besides the mean age at first birth, was an important determinant for declined fertility rates, but the relation between women's educational levels and the completed fertility rate was relatively weak.
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Affiliation(s)
- Zahra Roustaei
- Department of Health Sciences, University of Helsinki, Helsinki, Finland
| | - Sari Räisänen
- School of Health Care and Social Services, Tampere University of Applied Sciences, Tampere, Finland
| | - Mika Gissler
- Information Services Department, THL National Institute for Health and Welfare, Helsinki, Finland
- Department of Neurobiology Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
| | - Seppo Heinonen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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García D, Brazal S, Rodríguez A, Prat A, Vassena R. Knowledge of age-related fertility decline in women: A systematic review. Eur J Obstet Gynecol Reprod Biol 2018; 230:109-118. [PMID: 30248536 DOI: 10.1016/j.ejogrb.2018.09.030] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 08/23/2018] [Accepted: 09/12/2018] [Indexed: 01/18/2023]
Abstract
Age-related fertility decline (ARFD) knowledge has been evaluated in the past decade, showing that there is a general knowledge of the reduction of fertility with age. Here we review the studies published up to date which quantitatively measure this ARFD knowledge, to answer the question: how aware about ARFD is our society? We searched the terms "age", "fertility knowledge", "fertility awareness", "reproduction knowledge", "reproductive knowledge" and "reproductive health knowledge" in PubMed, Web of Science, PsychINFO and Scopus, within January 2000 and December 2016. We found 41 studies that quantitatively measured ARFD knowledge by asking for the most fertile age for a woman and/or when there are a slight and a marked decrease in female fertility. We obtained this searching for the questions: What is the most fertile age for a woman? (Q1). When there is a slight decrease in female fertility? (Q2) and, When there is a marked decrease in female fertility? (Q3). We further evaluated the knowledge increase in the 6 studies assessing an educational intervention, 4 of them randomized controlled trials (RCT). Participants reporting the most fertile age for women to be at 20-24 y.o. ranged 16%-89.4% (Q1); participants reporting a slight decrease in female fertility at 25-29 y.o. ranged 5.1%-83% (Q2), and those reporting that a marked decrease occurs between 35-39 y.o. ranged 5.6%-60% (Q3). On the whole, the studies included in this review conclude that ARFD knowledge is insufficient, particularly in determining when female fertility markedly decreases. ARFD knowledge can be increased through targeted campaigns, but few interventional studies have been performed up to date. In view of these results, ARFD campaigns targeted to reproductive age people and healthcare providers are necessary; this would help the society to make informed reproductive decisions throughout life.
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Affiliation(s)
| | | | | | - Andrés Prat
- Department Medicine, School of Medicine, University of Barcelona, Spain
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García D, Rodríguez A, Vassena R. Actions to increase knowledge about age-related fertility decline in women. EUR J CONTRACEP REPR 2018; 23:371-378. [PMID: 30354690 DOI: 10.1080/13625187.2018.1526895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE There is a strong body of published data corroborating the current lack of awareness of age-related fertility decline (ARFD), but few studies have evaluated specific interventions aimed at increasing ARFD knowledge. Here, we review the literature examining the instruments developed and the educational interventions performed to date. METHODS We carried out a narrative review based on a literature search in PubMed, Web of Science, PsycINFO and Scopus between January 2010 and December 2017. RESULTS The instruments available comprise websites, paper brochures, slide presentations and tailored information, mainly developed with the input of university students. The eight interventions reviewed include surveys before and/or after a specific intervention, with and without a control group, in randomised and non-randomised designs. Overall, the interventions were effective in increasing ARFD knowledge and lowering the desired age for childbearing in the short term. These results were not always maintained, however, in the long term, possibly due to a lack of perceived risk of future infertility among those studied. CONCLUSION Further interventions need to be targeted to both young people and health care providers, and should be as personalised as possible. A greater number of validated instruments are also needed to reliably measure the effectiveness of any intervention.
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Sylvest R, Koert E, Vittrup I, Birch Petersen K, Hvidman HW, Hald F, Schmidt L. Men's expectations and experiences of fertility awareness assessment and counseling. Acta Obstet Gynecol Scand 2018; 97:1471-1477. [DOI: 10.1111/aogs.13449] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/20/2018] [Accepted: 08/20/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Randi Sylvest
- Department of Obstetrics and Gynecology; Copenhagen University Hospital; Hvidovre Denmark
| | - Emily Koert
- Fertility Clinic; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - Ida Vittrup
- Fertility Clinic; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | | | - Helene W Hvidman
- Fertility Clinic; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - Finn Hald
- Fertility Clinic, Horsens Regional Hospital; Horsens Denmark
| | - Lone Schmidt
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
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Fooladi E, Weller C, Salehi M, Abhari FR, Stern J. Using reproductive life plan-based information in a primary health care center increased Iranian women's knowledge of fertility, but not their future fertility plan: A randomized, controlled trial. Midwifery 2018; 67:77-86. [PMID: 30267937 DOI: 10.1016/j.midw.2018.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/23/2018] [Accepted: 09/16/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Reproductive Life Plan (RLP)-based information in counseling has been reported in the USA and Sweden to increase women's knowledge of fertility and informed decision making about future fertility plans. This study examined if utilizing the RLP tool would have the same impact on Iranian women. DESIGN A randomized, three-armed, controlled trial. 181 women were randomly allocated to the intervention group (IG, n = 61), control group 1 (CG1, n = 60) or control group 2 (CG2, n = 60). SETTING A primary health care center in the Sari city, the Provincial capital of Mazandaran, Iran. PARTICIPANTS Women of reproductive age who were able to conceive. INTERVENTIONS The intervention group received oral and written information about fertility based on the RLP tool. Participants were contacted 2 months after the intervention. The primary outcome measure was the change in women's knowledge of fertility, particularly folic acid intake prior to pregnancy, over a 2 month period. The change in women's family planning intentions were also assessed. The participants in the IG shared their experiences at follow-up. FINDINGS At baseline, there was no difference between the groups regarding the mean knowledge of fertility score. At 2 months, after adjustment for age, history of pregnancy and baseline values, the between group difference in change from baseline was 5.8 (p < 0.001). While there was no significant difference between the IG and CG1 for folic acid intake prior to pregnancy at baseline, the group difference for folic acid intake prior to pregnancy post intervention was statistically significant (85% vs 25%, p < 0.001). At follow-up, women's desire to have more children, preferred age to conceive the last child and the desired age gap between children in the IG and CG1 did not significantly change over time. Women reported the RLP counseling tool used by midwives as useful. KEY CONCLUSIONS Provision of RLP-based information for Iranian women with a clear pregnancy intention in the context of a stable relationship, increased knowledge of fertility without changing their future fertility plan. The RPL counseling tool was appreciated by study participants. The lack of improvement in women's fertility intentions over time may reflect the involvement of other factors influencing decision making about childbearing in Iran. Whether the RLP can change women's behavior is yet to be established. IMPLICATIONS FOR PRACTICE The RLP can be used by health care professionals, especially midwives, as a tool to increase women's fertility knowledge, which may result in fertility behavior change.
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Affiliation(s)
- Ensieh Fooladi
- School of Nursing and Midwifery, Monash University, Melbourne, Australia; Reproductive and Sexual Health Research Centre, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.
| | - Carolina Weller
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Maryam Salehi
- Reproductive and Sexual Health Research Centre, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
| | - Farideh Rezaee Abhari
- Reproductive and Sexual Health Research Centre, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
| | - Jenny Stern
- Department of Health Promotion, Sophiahemmet University, Stockholm, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Nishioka E. [Trends in Research on Adolescent Sexuality Education, Fertility Awareness, and the Possibility of Life Planning Based on Reproductive Health Education]. Nihon Eiseigaku Zasshi 2018; 73:185-199. [PMID: 29848871 DOI: 10.1265/jjh.73.185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this paper, we describe the trends in research on adolescent sexuality education in Japan and other countries and on fertility awareness, as well as the possibility of life planning based on sex and reproductive health education. Mason-Jones AJ et al. reviewed the results of school-based intervention studies on the prevention of human immunodeficiency virus infection, sexually transmitted diseases, and pregnancy. There is little evidence supporting the idea that educational curriculum-based programs alone are effective in improving sex and reproductive health outcomes in adolescents. In another study, the effectiveness of school-based sexuality education for adolescents in Japan was evaluated. The Japan Medical Abstract Society was searched for articles published in the last 10 years. In many studies, the effects were compared before and after a single sexuality education lecture by professionals, such as doctors, midwives, and public health nurses. In Japan, effort has been directed toward sexuality education, but no systematic program based on behavior theory has been adopted. Therefore, sex education is insufficient. A third study clarified research on fertility awareness in adults and issues regarding improvements in related education and research. The Japan Medical Abstract Society and PubMed were searched for articles published in the last 10 years. The review suggested that awareness of female fertility is insufficient. Delaying childbearing based on inaccurate knowledge of the decline in female fertility could lead to unintended infertility. For males and females, sexual health education in schools and communities should include information on the age-related decline in female fertility. Although the determinants of the timing of childbearing are multifactorial, education on fertility issues is necessary to help adults make informed reproductive decisions based on accurate information. Finally, in this paper, we introduce examples of the pioneering efforts in sexual health education through collaboration between the governments of Oita and Okayama Prefectures and Oita and Okayama Universities.
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Affiliation(s)
- Emiko Nishioka
- National Defense Medical College Division of Nursing Maternal Nursing
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Fritz R, Klugman S, Lieman H, Schulkin J, Taouk L, Castleberry N, Buyuk E. Counseling patients on reproductive aging and elective fertility preservation-a survey of obstetricians and gynecologists' experience, approach, and knowledge. J Assist Reprod Genet 2018; 35:1613-1621. [PMID: 30073435 DOI: 10.1007/s10815-018-1273-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 07/17/2018] [Indexed: 01/25/2023] Open
Abstract
PURPOSE What are the experience, approach, and knowledge of US Obstetricians and Gynecologists' (ob-gyn) towards counseling patients on reproductive aging (RA) and elective fertility preservation (EFP). METHODS A cross-sectional survey emailed by the American College of Obstetricians and Gynecologists (ACOG) to 5000 ACOG fellows consisting of 9 demographic and 28 questions relating to counseling patients on RA and EFP. RESULTS Seven hundred and eighty-four responders completed the survey. Although 82.8% agreed that conversations relating to RA should take place with patients desiring future childbearing and delaying due to social reasons, only 27.6% stated that they frequently counsel these women aged 18-34 years old, compared to 75.8% aged 35-44 years old (P < 0.01). Limited time (75.8%) and limited knowledge (41.4%) were amongst the most frequent reported barriers towards counseling patients on RA. Fifty-eight percent stated that they have been asked about EFP by patients. Although 74.8% agreed that conversations should take place related to EFP in women desiring future childbearing and delaying due to social reasons, only 27.6% stated that they frequently counsel these patients on EFP (P < 0.01). Limited time (75%) and limited knowledge (59.9%) were amongst the most frequent barriers towards counseling on EFP. CONCLUSIONS In the USA, methods to improve patient counseling and provider knowledge on RA and EFP are warranted and further studies are needed to address optimal methods to improve counseling and knowledge related to these topics.
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Affiliation(s)
- Rani Fritz
- Montefiore Institute for Reproductive Medicine and Health, Department of Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, 10461, USA
| | - Susan Klugman
- Montefiore Institute for Reproductive Medicine and Health, Department of Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, 10461, USA
| | - Harry Lieman
- Montefiore Institute for Reproductive Medicine and Health, Department of Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, 10461, USA
| | - Jay Schulkin
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, 98195, USA
| | - Laura Taouk
- Research Department, The American College of Obstetricians and Gynecologists (ACOG), Washington, DC, 20024, USA
| | - Neko Castleberry
- Research Department, The American College of Obstetricians and Gynecologists (ACOG), Washington, DC, 20024, USA
| | - Erkan Buyuk
- Montefiore Institute for Reproductive Medicine and Health, Department of Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, 10461, USA.
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Sylvest R, Koert E, Birch Petersen K, Malling G, Hald F, Nyboe Andersen A, Schmidt L. Attitudes towards family formation among men attending fertility counselling. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2018; 6:1-9. [PMID: 30182067 PMCID: PMC6120434 DOI: 10.1016/j.rbms.2018.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/06/2018] [Accepted: 06/18/2018] [Indexed: 05/08/2023]
Abstract
Men and women are increasingly postponing childbearing until an age where fertility has decreased, meaning that they might have difficulties in achieving their desired family size. This study explored childless men's attitudes towards family formation. Data were collected through semi-structured qualitative interviews with 21 men attending the Fertility Assessment and Counselling Clinic in Copenhagen or Horsens, Denmark. Data were analysed using content analysis. The men envisioned a nuclear family with their own biological children, but they experienced doubts and ambivalence about parenthood and feeling 'ready'. Their lack of readiness was linked to their awareness of the sacrifices and costs involved with parenthood, and their belief that they could safely delay parenthood. The men did not consider that they may be unable to have their own biological children. This study highlights the importance of considering men's attitudes and preferences towards family formation when understanding couples' decision-making. Contrary to common understanding, the findings show that men are as concerned with the planning and timing of parenthood as women, but their knowledge of the age-related decline in fertility is poor. Men need to gain more awareness of the limitations of fertility and the impact of female and male age on the ability to achieve parenthood aspirations.
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Affiliation(s)
- R. Sylvest
- Fertility Clinic, Department of Obstetrics and Gynaecology, Hvidovre Hospital, University Hospital of Copenhagen, 2650 Hvidovre, Denmark
- Corresponding author.
| | - E. Koert
- Fertility Clinic, University Hospital of Copenhagen, Rigshospitalet, 2100 Copenhagen Ø, Denmark
| | - K. Birch Petersen
- Fertility Clinic, University Hospital of Zealand, 4300 Holbæk, Denmark
| | - G.M.H. Malling
- Department of Public Health, University of Copenhagen, 1014 Copenhagen K, Denmark
| | - F. Hald
- Fertility Clinic, Region Hospital Horsens, 8700, Horsens, Denmark
| | - A. Nyboe Andersen
- Fertility Clinic, University Hospital of Copenhagen, Rigshospitalet, 2100 Copenhagen Ø, Denmark
| | - L. Schmidt
- Department of Public Health, University of Copenhagen, 1014 Copenhagen K, Denmark
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Boivin J, Sandhu A, Brian K, Harrison C. Fertility-related knowledge and perceptions of fertility education among adolescents and emerging adults: a qualitative study. HUM FERTIL 2018; 22:291-299. [PMID: 29989473 DOI: 10.1080/14647273.2018.1486514] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Research shows that young people do not know much about their fertility. In the present study, we examined fertility knowledge and perceptions of a fertility educational brochure (i.e. 'A Guide to Fertility') in five focus groups with adolescents (16-18 years, n = 19) and emerging adults (21-24 years, n = 14) who were childless, not currently pregnant (or for men partner not pregnant) or trying to conceive but intending to have a child in the future. Participants (n = 33) reported having poor knowledge of a range of fertility topics and feelings of surprise, fear and concern in response to the brochure, despite perceiving benefits of the provision of fertility education and feasibility of 'A Guide to Fertility'. Comparison between age groups showed that adolescents lacked confidence in their fertility knowledge and emerging adults more frequently referred to gender and family planning issues when considering the fertility information. The findings show the need and importance of ensuring fertility education is tailored to different age groups for it to be integrated at specific stages of the life course and optimize its benefits over costs. Results point to educators and researchers working together to determine how best to disseminate fertility information to relevant age groups.
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Affiliation(s)
- Jacky Boivin
- School of Psychology, Cardiff University, Cardiff, Wales, UK
| | - Amea Sandhu
- School of Psychology, Cardiff University, Cardiff, Wales, UK
| | - Kate Brian
- Royal College of Obstetricians and Gynaecologists, London, UK
| | - China Harrison
- School of Psychology, Cardiff University, Cardiff, Wales, UK
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Jensen RE, Martins N, Parks MM. Public Perception of Female Fertility: Initial Fertility, Peak Fertility, and Age-Related Infertility Among U.S. Adults. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1507-1516. [PMID: 29582267 DOI: 10.1007/s10508-018-1197-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 02/28/2018] [Accepted: 03/14/2018] [Indexed: 06/08/2023]
Abstract
Perceptions of fertility are thought to impact reproductive behaviors, yet little is known about how lay people conceptualize the female fertility timeline. In this research, public perception of the female fertility timeline was assessed via a national survey of U.S. adults (N = 990) ranging in age from 18 to 89 years. Although there is no scientific consensus on the makeup of the female fertility timeline, results from this research indicate that the U.S. public posits fertility onset at (approximately) 13 years, peak fertility at 22, ideal first pregnancy age at 23, too late for pregnancy at 46, and infertility at 49. Regression analysis revealed that perceived peak fertility and ideal pregnancy age were positively correlated such that participants perceived the ideal pregnancy age as directly following peak fertility. Education was significantly related to fertility perceptions; those with more education perceived initial fertility to be lower and peak fertility and ideal pregnancy age to be higher. In other words, more highly educated individuals perceived fertility to manifest over a longer period of time as compared to individuals with less education. Black and Hispanic participants and participants with lower income perceived ideal first pregnancy age as significantly lower than did White participants and participants with higher income. These differences may suggest that the seeds of health disparities associated with phenomena such as adolescent pregnancy are lurking in fertility timeline perceptions.
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Affiliation(s)
- Robin E Jensen
- Department of Communication, University of Utah, 255 S. Central Campus Drive, Salt Lake City, UT, 84108, USA.
| | - Nicole Martins
- The Media School, Indiana University, Bloomington, IN, USA
| | - Melissa M Parks
- Department of Communication, University of Utah, 255 S. Central Campus Drive, Salt Lake City, UT, 84108, 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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Hickman LC, Fortin C, Goodman L, Liu X, Flyckt R. Fertility and fertility preservation: knowledge, awareness and attitudes of female graduate students. EUR J CONTRACEP REPR 2018; 23:130-138. [PMID: 29667456 DOI: 10.1080/13625187.2018.1455085] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate the general knowledge of female graduate students on reproductive aging and fertility preservation options, as well as to investigate the perceptions, personal beliefs, and desires regarding fertility and preservation modalities. MATERIALS AND METHODS A cross-sectional online survey study of female graduate students and medical trainees from academic institutions in Ohio was performed. Women were excluded if the online survey was incomplete or if they were >45 years. RESULTS Analysis of 590 surveys was performed (response rate of 26.3%). Ninety-four percent (557/590) of subjects were between 20 and 35 years. Our respondents tended to be nulliparous (87%), married or in a relationship (51%) and interested in future fertility (77%). The reasons cited for delaying childbearing were multi-factorial, with career building noted most commonly (69%). Nearly 60% of women reported they would consider fertility preservation in the future; however, the majority (87%) cited two or more barriers. When asked about their desire for information on fertility preservation, 28% desired to receive education on their choices and 36% wanted their Ob/Gyn to discuss fertility preservation options. Women >30 years were significantly more likely to desire future fertility, want more fertility preservation education and consider pursuing fertility preservation in the future. CONCLUSIONS Graduate-level women often delay childbearing for professional pursuits. This study demonstrates a need for increased fertility preservation awareness and education, especially by Ob/Gyn providers.
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Affiliation(s)
- Lisa C Hickman
- a Department of Obstetrics/Gynecology , Cleveland Clinic Foundation , Cleveland , OH , USA
| | - Chelsea Fortin
- a Department of Obstetrics/Gynecology , Cleveland Clinic Foundation , Cleveland , OH , USA
| | - Linnea Goodman
- a Department of Obstetrics/Gynecology , Cleveland Clinic Foundation , Cleveland , OH , USA
| | - Xiaobo Liu
- b Department of Quantitative Health Science , Cleveland Clinic Foundation , Cleveland , OH , USA
| | - Rebecca Flyckt
- a Department of Obstetrics/Gynecology , Cleveland Clinic Foundation , Cleveland , OH , USA
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Cheung NK, Coffey A, Woods C, de Costa C. Natural fertility, infertility and the role of medically assisted reproduction: The knowledge amongst women of reproductive age in North Queensland. Aust N Z J Obstet Gynaecol 2018; 59:140-146. [PMID: 29658986 DOI: 10.1111/ajo.12806] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 02/21/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The demand for medically assisted reproduction continues to increase, with more women encountering challenges with fertility. Due to misconceptions and gaps in knowledge, women are often unaware of the risks related to delayed childbearing. Lack of understanding of natural fertility, infertility and the role of medically assisted reproduction can lead to emotional suffering and changes in family plans. AIMS To assess the understanding and knowledge that women of reproductive age in North Queensland have regarding natural fertility, infertility and the role of medically assisted reproduction. MATERIALS AND METHODS Data were collected from 120 women (30 nurses, 30 teachers, 30 university students and 30 Technical and Further Education students) via the distribution of a structured questionnaire. Participants were surveyed in person about their personal plans and opinions, knowledge about natural fertility, infertility and medically assisted reproduction, and their preferred source of information. RESULTS Participants demonstrated suboptimal knowledge levels throughout all sections of the questionnaire, in particular when asked about medically assisted reproduction. When asked to identify their main source of information, 'friends and family' was the most popular choice. CONCLUSIONS Results from this North Queensland study add to the existing international literature, highlighting the widespread nature of the problem. Without adequate understanding of natural fertility, the risks of infertility, and the role and limitations of medically assisted reproduction, women make uninformed decisions. Development of local reproductive health education programs need to be instigated in response.
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Affiliation(s)
- Nicole K Cheung
- James Cook University College of Medicine and Dentistry, Cairns, Queensland, Australia
| | - Anne Coffey
- Queensland Fertility Group, Cairns, Queensland, Australia
| | - Cindy Woods
- James Cook University College of Medicine and Dentistry, Cairns, Queensland, Australia
| | - Caroline de Costa
- James Cook University College of Medicine and Dentistry, Cairns, Queensland, Australia
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Özerdoğan N, Yilmaz B. Turkish University seniors' knowledge of and opinions on fertility and expectations of having children. Afr Health Sci 2018; 18:172-179. [PMID: 29977271 PMCID: PMC6016992 DOI: 10.4314/ahs.v18i1.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background In recent years the trend of postponement of child bearing has been increasing. Aim To assess knowledge on fertility and expectations of having children in seniors at a Turkish University. Methods The cross-sectional study sample (n=485) comprised senior students of the University in the branches of medicine, social sciences, and life sciences. Data were collected via a self-administered questionnaire in 2015. Results The mean age of the students was 23.03±1.93 and 98.1% were unmarried. 88.45% of these students wanted to have children in the future. A higher percentage of females planned parenthood in the future than males. Males desired more children than females. Most students wanted to have their first child at age 25–29. Males wanted to have their first and last child later than did females. In case of infertility, 74.4% of females and 54.2% of males stated that they can benefit from assisted reproduction techniques. Students overestimated the success rate of assisted reproduction techniques. The percentage of students who were aware of the age at which fertility begins to decline was low. Conclusion The expectations of seniors at a Turkish university to have children in the future are high, with insufficient knowledge on fertility.
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Affiliation(s)
- Nebahat Özerdoğan
- Department of Midwifery, Faculty of Health Sciences, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Burcu Yilmaz
- Department of Midwifery, Faculty of Health Sciences, Eskisehir Osmangazi University, Eskisehir, Turkey
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Isbir GG, Ozan YD. Nursing and midwifery students’ experiences with the course of infertility and assisted reproductive techniques: A focus group study from Turkey. Nurse Educ Pract 2018; 28:235-241. [DOI: 10.1016/j.nepr.2017.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 08/19/2017] [Accepted: 10/05/2017] [Indexed: 11/24/2022]
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Podfigurna A, Lukaszuk K, Czyzyk A, Kunicki M, Maciejewska-Jeske M, Jakiel G, Meczekalski B. Testing ovarian reserve in pre-menopausal women: why, whom and how? Maturitas 2017; 109:112-117. [PMID: 29292013 DOI: 10.1016/j.maturitas.2017.11.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/08/2017] [Accepted: 11/20/2017] [Indexed: 11/30/2022]
Abstract
Numerous social and environmental factors (environmental hazards, social factors such as education and career, higher economic status desired before the decision is made to have children) influence a women's decision to postpone pregnancy until late reproductive age. In turn, age is related to a fall in ovarian reserve. The main goal of testing ovarian reserve is the identification of women with so-called diminished ovarian reserve (DOR). Additionally, it provides assistance in the counselling of women who are planning to use assisted reproductive techniques (ART). This review examines current methods of testing ovarian reserve and their application. The most useful methods of assessing ovarian reserve are ultrasonographic count of ovarian antral follicles (AFC) and serum tests of both the anti-Müllerian hormone (AMH) level and the third-day level of follicle stimulating hormone (FSH). However, there are limitations to the currently used methods of testing ovarian reserve, especially in relation to their specificity and sensitivity. It is also difficult to predict egg quality based on these tests. The value of screening programmes of ovarian reserve is yet to be determined.
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Affiliation(s)
- Agnieszka Podfigurna
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Lukaszuk
- INVICTA Fertility and Reproductive Center, Gdańsk, Poland; INVICTA Fertility and Reproductive Center, Warsaw, Poland; Department of Gynecological Endocrinology, Medical University of Warsaw, Warsaw, Poland; Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdańsk, Poland
| | - Adam Czyzyk
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Michal Kunicki
- INVICTA Fertility and Reproductive Center, Warsaw, Poland
| | | | - Grzegorz Jakiel
- INVICTA Fertility and Reproductive Center, Warsaw, Poland; Department of Obstetrics and Gynecology, Center of Postgraduate Education, Warsaw, Poland
| | - Blazej Meczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
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Hammarberg K, Collins V, Holden C, Young K, McLachlan R. Men's knowledge, attitudes and behaviours relating to fertility. Hum Reprod Update 2017; 23:458-480. [PMID: 28333354 DOI: 10.1093/humupd/dmx005] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/26/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The increasingly common practice in high-income countries to delay childbearing to the fourth and fifth decades of life increases the risk of involuntary childlessness or having fewer children than desired. Older age also increases the risk of age-related infertility, the need for ART to conceive, and obstetric and neonatal complications. Existing research relating to childbearing focusses almost exclusively on women, and in public discourse declining fertility rates are often assumed to be the result of women delaying childbearing to pursue other life goals such as a career and travel. However, evidence suggests that the lack of a partner or a partner willing to commit to parenthood is the main reason for later childbearing. OBJECTIVE AND RATIONALE To better understand men's contributions to childbearing decisions and outcomes, the literature pertaining to men's fertility-related knowledge, attitudes and behaviours was reviewed. SEARCH METHODS The electronic databases of Medline, Embase and PsycINFO were searched to identify investigations of men's knowledge, attitudes and behaviours relating to fertility, infertility, reproductive health or childbearing using relevant fertility keyword search terms. Studies were included if they had investigated factors associated with men's fertility-related knowledge, attitudes and behaviours, had been conducted in a high-income country and were published in an English language peer-reviewed journal between January 2005 and August 2016. OUTCOMES The search yielded 1349 citations. Of these, 47 papers representing 43 unique studies were included in the review. Where response rate was reported, it ranged between 13 and 94%. Studies varied in terms of research design; inclusion and exclusion criteria; recruitment strategies; adequacy of sample size; recruitment and retention rates and data collection tools. However, findings were consistent and indicate that men almost universally value parenthood, want and expect to become fathers, and aspire to have at least two children. Yet most men have inadequate knowledge about the limitations of female and male fertility and overestimate the chance of spontaneous and assisted conception. Perceptions of ideal circumstances in which to have children included being in a stable and loving relationship, having completed studies, secured a permanent job and a dependable income, having achieved personal maturity, and having a partner who desires children and is 'suitable' as a potential co-parent. Although all studies were conducted in high-income countries, between-country social and cultural differences may have influenced the findings relating to attitudes. WIDER IMPLICATIONS Men aspire to parenthood as much as women do but have limited knowledge about the factors that influence fertility. The gap between ideal biological and ideal social age for having children appears to be widening, narrowing the time frame in which parenthood can be achieved. This may lead to unfulfilled parenthood aspirations. The findings can inform government policies and public education strategies aimed to support childbearing during the most fertile years, reduce the personal and societal cost of infertility and ART use, and allow people to fulfil their parenthood goals.
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Affiliation(s)
- Karin Hammarberg
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne 3004, Australia.,Victorian Assisted Reproductive Treatment Authority, Level 30, 570 Bourke Street, Melbourne 3000, Australia
| | - Veronica Collins
- Andrology Australia, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne 3004, Australia
| | - Carol Holden
- Andrology Australia, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne 3004, Australia
| | - Kate Young
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne 3004, Australia
| | - Robert McLachlan
- Andrology Australia, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne 3004, Australia.,Hudson Institute of Medical Research, 27-31 Wright Street, Clayton 3168, Australia
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Sheinis M, Carpe N, Gold S, Selk A. Ignorance is bliss: women's knowledge regarding age-related pregnancy risks. J OBSTET GYNAECOL 2017; 38:344-351. [PMID: 29022426 DOI: 10.1080/01443615.2017.1357685] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pregnancy risks rise with age and the average age of first time mothers is rising. This study aimed to assess women's actual knowledge and their perceived knowledge of pregnancy complications relating to advanced maternal age. A cross-sectional survey was administered to primiparous women measuring demographics, knowledge of age-related pregnancy risks, previous counselling and health literacy. Of the 218 women surveyed, the mean knowledge score was not significantly different for women <35 years of age compared to women ≥35 years of age (p = .09). Although there was no difference in knowledge between the two groups, women ≥35 years of age perceived themselves to be more knowledgeable than those under 35 (p < .01). The majority of women (67%) wanted further counselling on this topic and indicated a preference for their doctor to counsel them (76%). Women require counselling informing them of their increased risk of complications if they begin childbearing at older ages. Impact statement What is already known on this subject: The average age of first time mothers is rising worldwide. Pregnancy risks rise with age, especially in first time mothers. Previous studies have shown that knowledge of age-related pregnancy risks correlate with educational level and health literacy. What the results of this study add: This study supports those findings and also demonstrates that perceived knowledge does not correlate with measured knowledge of age-related pregnancy risks. Women ≥35 years of age (higher-risk women) are no more knowledgeable than their younger counterparts though they perceive themselves to be better informed. Greater education regarding these risks may allow women to mitigate some of these risks through lifestyle and diet alteration and will prepare women for what to expect if these risks and complications occur. The majority of women in this study seek pregnancy information on the internet, but desire further counselling from their doctors regarding age-related pregnancy risks. What the implications are of these findings for clinical practice and/or further research: Given these results, physicians must consider making greater efforts to counsel women about pregnancy risks in advanced maternal age and tailor these conversations to suit the educational level and health literacy of each individual patient.
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Affiliation(s)
- Michal Sheinis
- a Faculty of Medicine , University of Toronto , Toronto , Canada
| | - Nicole Carpe
- a Faculty of Medicine , University of Toronto , Toronto , Canada
| | - Shira Gold
- a Faculty of Medicine , University of Toronto , Toronto , Canada
| | - Amanda Selk
- b Department of Obstetrics and Gynaecology , Mount Sinai Hospital , Toronto , Canada.,c Department of Obstetrics and Gynaecology , University of Toronto , Toronto , Canada
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Vujčić I, Radičević T, Dubljanin E, Maksimović N, Grujičić S. Serbian medical students’ fertility awareness and attitudes towards future parenthood. EUR J CONTRACEP REPR 2017; 22:291-297. [PMID: 28902528 DOI: 10.1080/13625187.2017.1368478] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Isidora Vujčić
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tijana Radičević
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Eleonora Dubljanin
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nataša Maksimović
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Sandra Grujičić
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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