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Hagege E, Pirtea P, Burette J, Canepa AS, Graesslin O, de Ziegler D. Patient experience of social and medical fertility preservation fully reimbursed in France. J Assist Reprod Genet 2024:10.1007/s10815-024-03222-6. [PMID: 39138766 DOI: 10.1007/s10815-024-03222-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 08/06/2024] [Indexed: 08/15/2024] Open
Abstract
PURPOSE The purpose of this study is to review patient experience with social fertility preservation (sFP), as compared to medical fertility preservation (mFP), in a context where sFP is fully reimbursed. METHODS We conducted a retrospective cohort study involving patients who underwent oocyte cryopreservation for mFP between 2017 and 2023 and sFP between 2022 and 2023 at a large ART single center. Additionally, we surveyed patients undergoing sFP and mFP, regarding their experiences, intentions, awareness, and financial consideration. RESULTS A total of 97 oocyte retrievals were performed for sFP in 75 women, and 155 were performed in mFP (127 women). Median ages were 36.4 years for sFP and 28.9 years for mFP. Median oocytes retrieved per session were 10 for sFP and 8 for mFP. Ninety-seven percent of of mFP participants were informed by healthcare professionals, while half of sFP participants learned through personal acquaintances. The primary motivation for sFP was a desire for pregnancy while being single. Most respondents in both groups knew that 15-20 oocytes are typically needed for a successful birth. None were aware of the "DuoStim" option, but interest was expressed by most women. Surprisingly, despite full reimbursement for sFP in France, 78% expressed willingness to pay if necessary. CONCLUSION Many women choose sFP due to concerns about declining fertility, often informed by non-medical sources. Free access to sFP can help mitigate the global decline in natality by allowing women to anticipate age-related fertility decline. This study should be considered by other countries as they may increasingly cover sFP costs in the future.
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Affiliation(s)
- Estelle Hagege
- Department of Obstetrics, Gynecology and Reproductive Medicine, Reims University Hospital Center, Reims, France.
| | - Paul Pirtea
- Department of Obstetrics, Gynecology and Reproductive Medicine, Foch Hospital, Suresnes, France
| | - Julie Burette
- Department of Obstetrics, Gynecology and Reproductive Medicine, Reims University Hospital Center, Reims, France
| | - Anne-Sophie Canepa
- Department of Obstetrics, Gynecology and Reproductive Medicine, Reims University Hospital Center, Reims, France
| | - Olivier Graesslin
- Department of Obstetrics, Gynecology and Reproductive Medicine, Reims University Hospital Center, Reims, France
| | - Dominique de Ziegler
- Department of Obstetrics, Gynecology and Reproductive Medicine, Foch Hospital, Suresnes, France
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Fente BM, Asgedom YS, Asmare ZA, Kebede TN, Damtew BS, Workneh TW, Beyene MA, Seifu BL. Knowledge of fertility period among reproductive age women in Kenya: a multilevel analysis based on 2022 Kenyan demographic and health survey. Contracept Reprod Med 2024; 9:27. [PMID: 38790022 PMCID: PMC11127376 DOI: 10.1186/s40834-024-00287-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Knowledge of the fertility period aids women in refraining and engaging in sexual intercourse to avoid and to get pregnant, respectively. The effect of community-level factors on knowledge of the fertility period was not yet known in Kenya. Therefore, we aimed to investigate the community- and individual-level determinants of knowledge of fertility period among women of childbearing age in Kenya. METHODS The 2022 Kenyan Demography and Health Survey data was used for the current study. This study included 16,901 women of reproductive age. To account for the clustering effects of DHS data and the binary nature of the outcome variable, a multilevel binary logistic regression model was applied. An adjusted odds ratio with a 95% confidence interval was reported to declare the statistical significance. In addition, the model that had the lowest deviance was the one that best fit the data. RESULTS The overall prevalence of knowledge of the fertility period among Kenyan women was 38.1% (95%CI = 37.3, 38.9). Women's age, women's education status, heard FP, contraceptive use, media exposure, and distance from health facility significant individual factors while place of residence, and community-level education, were all of factors were found to be strongly associated with knowledge of fertility period. CONCLUSION As per the findings of our study, Knowledge of the fertility period among reproductive women was low in Kenya. In the era of increasing refusal of hormone-based family planning, fertility-awareness-based family planning methods may be an option. Promoting the correct fertility period through education and media outreach may be helpful strategies for enhancing fertility decision-making.
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Affiliation(s)
- Bezawit Melak Fente
- Department of General Midwifery, School of Midwifery, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Yordanos Sisay Asgedom
- Department of Epidemiology and Biostatics, College of Health Sciences and Medicine, Wolaita Sodo University, Soddo, Ethiopia
| | - Zufan Alamrie Asmare
- Department of Ophthalmology, School of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tirusew Nigussie Kebede
- Department of Midwifery, School of Nursing and Midwifery Asrat Woldeyes Health Science campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Beyene Sisay Damtew
- Department of Midwifery, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Tadesu Wondu Workneh
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluken Adamu Beyene
- Department of Midwifery, College of Health Sciences, Assosa University, Assosa, Ethiopia
| | - Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Semera, Ethiopia
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Mirghafourvand M, Asghari Jafarabadi M, Gharacheh M, Maeda E, Haghani S, Ranjbar F. Psychometric properties of persian version of the cardiff fertility knowledge scale (CFKS-P). Heliyon 2024; 10:e30534. [PMID: 38765088 PMCID: PMC11101774 DOI: 10.1016/j.heliyon.2024.e30534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 04/12/2024] [Accepted: 04/29/2024] [Indexed: 05/21/2024] Open
Abstract
Background The level of fertility knowledge of reproductive-age people is low to moderate, and the inadequate knowledge of infertility-related factors may cause some people to unconsciously engage in activities that reduce their fertility. Given the significance of fertility knowledge, and the lack of standard instruments to evaluate it in Iran, the present study aimed at determining psychometric properties of the Persian version of the Cardiff Fertility Knowledge Scale (CFKS-P) in Iranian population. Materials and methods In this cross-sectional study, a total of 280 participants (comprising 140 couples) attending mandatory pre-marriage educational sessions at two public health centers in Tehran were consecutively sampled from July to September 2021. The study examined the face, content, and structural validity (through confirmatory factor analysis) of the questionnaire. The reliability of the questionnaire was assessed using measures of internal consistency. Results The structural validity of CFKS-P was approved with 13 items and two factors (basic knowledge of fertility and misconception about fertility) based on confirmatory factor analysis (RMSEA = 0.023, 90 % CI = 0.053-0.082, TLI = 0.916 and CFI = 0.972, χ 2 = 148.345). Kuder-Richardson coefficient of the scale was calculated to be 0.85. The overall percentage of correct answers for fertility knowledge was 50.76 %. Conclusion The CFKS-P is a valid and reliable instrument for measuring the fertility knowledge in Iranian men and women. This scale can help the health care providers to assess the fertility knowledge of their clients or the quality of health education provided.
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Affiliation(s)
- Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, VIC, 3144, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Maryam Gharacheh
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Graduate School of Medicine, Akita University, Akita, Japan
| | - Shima Haghani
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ranjbar
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Nakou P. Women's reproductive choice and (elective) egg freezing: is an extension of the storage limit missing a bigger issue? New Bioeth 2024; 30:11-33. [PMID: 38506261 DOI: 10.1080/20502877.2023.2300233] [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] [Indexed: 03/21/2024]
Abstract
Egg freezing can allow women to preserve their eggs to avoid age-related infertility. The UK's recent extension of elective egg freezing storage has been welcomed as a way of enhancing the reproductive choices of young women who wish to delay having children. In this paper, I explore the issue of enhancing women's reproductive choices, questioning whether there is a more significant aspect overlooked in egg freezing. While increasing storage limits expands reproductive choices for some women, focus on this extension alone, I argue, misses a fundamental issue with egg preservation that often remains ignored; the importance of effective information on egg freezing and the effect this has on women's reproductive choices. Ultimately, I highlight the crucial role of balanced information in enhancing women's choices regarding egg freezing and argue that focusing on extending and increasing provision may obscure this real opportunity to empower women and their authentic reproductive choices.
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Affiliation(s)
- Panagiota Nakou
- Department of Law, Centre for Social Ethics and Policy, The University of Manchester, Manchester, UK
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Bayoumi RR, Hurt L, Zhang N, Law YJ, Venetis C, Fatem HM, Serour GI, van der Poel S, Boivin J. A critical systematic review and meta-analyses of risk factors for fertility problems in a globalized world. Reprod Biomed Online 2024; 48:103217. [PMID: 38244345 DOI: 10.1016/j.rbmo.2023.04.008] [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: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 01/22/2024]
Abstract
Globally, fertility awareness efforts include well-established risk factors for fertility problems. Risks disproportionately affecting women in the Global South, however, are neglected. To address this gap, we conducted a systematic review and meta-analyses of relevant risk factors to examine the association between risk factors and fertility problems. MEDLINE, Embase, Cochrane Library, regional databases and key organizational websites were used. Three authors screened and extracted data independently. Studies assessing exposure to risk (clinical, community-based samples) were included, and studies without control groups were excluded. Outcome of interest was fertility problems, e.g. inability to achieve pregnancy, live birth, neonatal death depending on study. The Newcastle-Ottawa Scale was used to assess study quality. A total of 3843 studies were identified, and 62 were included (58 in meta-analyses; n = 111,977). Results revealed the following: a ninefold risk of inability to become pregnant in genital tuberculosis (OR 8.91, 95% CI 1.89 to 42.12); an almost threefold risk in human immunodeficiency virus (OR 2.93, 95% CI 1.95 to 4.42) and bacterial vaginosis (OR 2.81, 95% CI 1.85 to 4.27); a twofold risk of tubal-factor infertility in female genital mutilation/cutting-Type II/III (OR 2.06, 95% CI 1.03 to 4.15); and postnatal mortality in consanguinity (stillbirth, OR 1.28, 95% CI 1.04 to 1.57; neonatal death, OR 1.57, 95% CI 1.22 to 2.02). It seems that risk factors affected reproductive processes through multiple pathways. Health promotion encompassing relevant health indicators could enhance prevention and early detection of fertility problems in the Global South and disproportionately affected populations. The multifactorial risk profile reinforces the need to place fertility within global health initiatives.
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Affiliation(s)
| | - Lisa Hurt
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, Wales, UK
| | - Ning Zhang
- Department of Obstetrics and Gynaecology, Royal North Shore Hospital, Sydney, Australia
| | - Yin Jun Law
- Department of Obstetrics and Gynaecology, The Canberra Hospital, Australian Capital Territory, Australia
| | - Christos Venetis
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | | | | | | | - Jacky Boivin
- School of Psychology, Cardiff University, Cardiff, Wales, UK.
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Essien SK, Chireh B, Essien JK. Knowledge about unintended pregnancy shortly after childbirth: An issue of ineffective counseling or adherence? WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241255655. [PMID: 38778791 PMCID: PMC11113048 DOI: 10.1177/17455057241255655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/23/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Being aware of the possibility of becoming pregnant shortly after childbirth before the resumption of the menstrual period is often overlooked but remains a significant contributor to unintended pregnancies and may lead to maternal and neonatal comorbidities. Exploring the extent of awareness and associated factors could help tailor more interventions toward reducing the rates of short-interval unplanned pregnancies. OBJECTIVE This study explores the extent to which Ghanaian women are aware of the possibility of becoming pregnant shortly after childbirth before the resumption of the menstrual period and its associated factors. DESIGN A cross-sectional study was conducted using the 2017 Ghana Maternal Health Survey. The women participants were sampled using a two-stage cluster sampling design. METHODS We analyzed the 2017 Ghana Maternal Health Survey data of 8815 women who had given birth and received both antenatal care and postnatal checks after delivery in health facilities (private and public) and responded to questions on being aware of short interpregnancy intervals. A multivariable survey logistic regression was used for the analysis. RESULTS Of the 8815 women, approximately 62% of women who received both antenatal care and postnatal examinations before discharge reported being aware of short interpregnancy intervals. Postnatal examination before discharge but not antenatal care was associated with a higher awareness of short interpregnancy intervals. Women who received a postnatal examination were more aware of short interpregnancy intervals than their counterparts (adjusted odds ratio = 1.29, 95% confidence interval: 1.03-1.61). Also, awareness of short interpregnancy intervals increased with age, education, knowledge of the fertile period, contraceptive use, and delivery via cesarean section. CONCLUSION Over a decade following the initiation of Ghana's free maternal health policy, there remains a significant gap in the awareness of short interpregnancy intervals, even among women who received both antenatal pregnancy care and postnatal examinations before discharge. The unawareness of the short interpregnancy interval observed in approximately 38% of women raises concerns about the effectiveness of counseling or education provided during antenatal care and immediate post-partum care regarding birth spacing, contraceptive use, the timing of resumption of sexual activity, and the extent to which women adhere to such guidance.
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Affiliation(s)
- Samuel Kwaku Essien
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
- EPID@Work (Enhancing the Prevention of Injury & Disability @ Work) Research Institute, Lakehead University, Thunder Bay, ON, Canada
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, SK, Canada
| | - Batholomew Chireh
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
- EPID@Work (Enhancing the Prevention of Injury & Disability @ Work) Research Institute, Lakehead University, Thunder Bay, ON, Canada
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Bodin M, Plantin L, Schmidt L, Ziebe S, Elmerstig E. The pros and cons of fertility awareness and information: a generational, Swedish perspective. HUM FERTIL 2023; 26:216-225. [PMID: 34423731 DOI: 10.1080/14647273.2021.1968045] [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: 02/25/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
Being aware of factors that affect fertility can help people make informed decisions about their reproductive futures. To some, however, fertility information leads to worry and self-blame. In this paper, we explore how people from different generations discuss fertility and reproductive decision-making, along with their perceptions of fertility information. The study was conducted in southern Sweden with 26 focus-group discussions that included a total of 110 participants aged 17-90 years. The material was analysed thematically. Our results show that fertility knowledge and openness to talking about fertility problems have increased over generations. Participants who were assigned female at birth were more often concerned about their fertility than those who were not, and fertility concerns were transferred from mothers to daughters. While age-related fertility concerns had been uncommon in older generations, participants aged 25-40 often expressed these concerns. Young adults appreciated being knowledgeable about fertility but simultaneously expressed how fertility information could lead to distress. Our conclusion is that fertility information was best received by high-school students, and efforts to improve fertility education in schools are therefore recommended.
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Affiliation(s)
- Maja Bodin
- Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden
| | - Lars Plantin
- Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, København, Denmark
| | - Søren Ziebe
- Fertility Clinic, Copenhagen University Hospital, Copenhagen, Denmark
| | - Eva Elmerstig
- Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden
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Maslowski K, Reiss MJ, Biswakarma R, Harper J. Reproductive health education in the schools of the four UK nations: is it falling through the gap? HUM FERTIL 2023; 26:527-539. [PMID: 37356204 DOI: 10.1080/14647273.2023.2216395] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 05/08/2023] [Indexed: 06/27/2023]
Abstract
Reproductive health education is crucial to ensure young people understand their reproductive system and can make informed decisions about their sexual lives and fertility, including whether they want to have children or not. This study involved an investigation of the intended UK school curricula for 14-18 year-olds as they relate to reproductive health. Analysis revealed substantial differences. Most, but not all, specifications include sexually transmitted infections, hormonal aspects of reproduction, contraception, the menstrual cycle and assisted reproductive technology (ART). Important topics, such as endometriosis, fertility, preconception health, pregnancy, miscarriage, menopause and infertility (except in the context of ART) are missing from examination specifications and/or the RSE/RSHP curricula. We conclude that many young people in the UK are at risk of leaving school with inadequate understanding of concepts that have important implications for their reproductive health. There are differences between nations, with Scotland having the most comprehensive coverage of topics in its curriculum. High-quality reproductive health education should be an entitlement for all young people. It should give young people accurate and up-to-date information and enable them to discuss issues and develop their own thinking. Ideally, sex and reproductive health education would be taught comprehensively across the RSE/RSHP and science curricula.
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Affiliation(s)
| | - Michael J Reiss
- UCL's Faculty of Education and Society, IOE, University College London, London, UK
| | - Rina Biswakarma
- UCL's Faculty of Education and Society, IOE, University College London, London, UK
| | - Joyce Harper
- EGA Institute for Women's Health, University College London, London, UK
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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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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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Abdennebi I, Pasquier M, Vernet T, Levaillant JM, Massin N. Fertility Check Up: A concept of all-in-one ultrasound for the autonomous evaluation of female fertility potential: Analysis and evaluation of first two years of experience. J Gynecol Obstet Hum Reprod 2022; 51:102461. [DOI: 10.1016/j.jogoh.2022.102461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/15/2022] [Accepted: 08/23/2022] [Indexed: 10/31/2022]
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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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13
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Grace B, Shawe J, Barrett G, Usman NO, Stephenson J. What does family building mean? A qualitative exploration and a new definition: a UK-based study. Reprod Health 2022; 19:203. [PMID: 36307844 PMCID: PMC9617350 DOI: 10.1186/s12978-022-01511-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 10/08/2022] [Indexed: 11/24/2022] Open
Abstract
Background The importance of improving men’s and women’s knowledge of sexual and reproductive health has been emphasised in numerous global health policies. Fertility awareness literature highlights a disproportionately higher number of articles related to pregnancy-prevention compared to pregnancy-planning, which is justifiable in many contexts. However, recent concerted effort to improve fertility-awareness warrants a closer investigation of basic reproductive health terminologies. The objective of this study is to explore participants’ views of “family building” and provide a definition. Methods We conducted 35 qualitative in-depth interviews on men, women and healthcare professionals who were sampled from a UK cross-sectional survey. We asked participants about terms such as ‘family planning’ and ‘family building’ to elicit views and explored the appropriateness of the term “family building.” Data were transcribed and analysed via Framework analysis.
Results When asked what ‘family planning’ meant to them, study participants stated that the term meant the avoidance of pregnancy. They viewed it as an “umbrella term for the use of contraception methods,” that “paradoxically, the term family planning almost has a negative connotation regarding having a family,” but could not state similar terminology for planning a family. Reasons cited for this perspective include the focus of school education and usage in clinical settings. Conclusions In the absence of an explicit definition in literature, we generated a new definition for family building as follows: “Family building refers to the construction or formation of a family, which can include steps or actions taken by an individual towards having children. In contrast to family planning, the intent focuses on pregnancy planning and childbearing rather than pregnancy prevention. However, it can also include actions taken to space the number of children one has.” Some balance in the global public health messages, including bridging the gap in reproductive health literature, policies, processes and practices may contribute to the effort to improve fertility knowledge. Use of appropriate terminologies help optimise reproductive health services in order to enable men and women achieve their desired fertility intentions, whatever they may be. Trial registration Not applicable Global health policies have emphasised the importance of improving individual’s knowledge of sexual and reproductive health. Fertility awareness literature highlights a disproportionately higher number of articles related to pregnancy-prevention compared to pregnancy-planning, which is justifiable in many contexts. However, the recent concerted effort to improve fertility awareness warrants a closer investigation of basic terminologies in the field. For example, although the term family planning encompasses attaining the desired number of children and spacing pregnancies, it is almost synonymous with not having children, while there is currently no widely accepted equivalent terminology for planning to have children, either in general usage or clinical settings. We conducted 35 qualitative in-depth interviews on men, women and healthcare professionals who were sampled from a UK cross-sectional survey. When asked what ‘family planning’ meant to them, study participants stated avoidance of pregnancy. They viewed it as an “umbrella term for the use of contraception methods”, that “paradoxically, the term family planning almost has a negative connotation regarding having a family,” but could not state similar terminology for planning a family. We introduced family building and provided a new definition. We believe that some balance in the global public health messages, including revisiting widely used terminologies can help bridge the gap in reproductive health literature, and contribute to the effort to improve fertility knowledge. Additionally, this has implications for promotion of preconception and optimising reproductive health in relevant policies, processes and practices, in order to help people achieve their desired fertility intentions, whatever they may be.
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Affiliation(s)
- Bola Grace
- Research Department of Reproductive Health, UCL EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, Room 236 Medical School Building, 74 Huntley Street, London, WC1E 6A, UK.
| | - Jill Shawe
- Faculty of Health, University of Plymouth Devon, Plymouth, UK.,SW Clinical School, Royal Cornwall Hospital, Truro, UK
| | - Geraldine Barrett
- Research Department of Reproductive Health, UCL EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, Room 236 Medical School Building, 74 Huntley Street, London, WC1E 6A, UK
| | | | - Judith Stephenson
- Research Department of Reproductive Health, UCL EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, Room 236 Medical School Building, 74 Huntley Street, London, WC1E 6A, UK
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14
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Barron ML, Lithgow D, Wade GH, Mueller Luckey G. Fertility Health Knowledge in U.S. Adults: Men Narrowing the Knowledge Gap. Am J Mens Health 2022; 16:15579883221117915. [PMID: 36112813 PMCID: PMC9478737 DOI: 10.1177/15579883221117915] [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] [Indexed: 01/26/2023] Open
Abstract
Much of young people's fertility health knowledge has been limited to avoiding sexually transmitted infections and preventing pregnancy thus lacking what is necessary to support future overall health as well as reproductive goals. This study assesses university students' knowledge related to fertility health factors to verify consistencies and discrepancies in fertility health knowledge, with a sub-assessment focusing on men's knowledge. The Fertility Health Knowledge survey was delivered to 17,189 students at three American universities. Twenty percent or 546 of the 2,692 participants were male. The 30-question survey addresses knowledge of modifiable and non-modifiable risk factors on fertility health in men and women, and four questions regarding fertility intentions. Across all 30 questions, 63% of female responses were correct and 61% of male responses were correct. For 10 questions, less than 70% of males and females answered correctly, with men answering correctly more often than females for six of the questions. Males exhibited more knowledge regarding male fertility. Knowledge of fertility health was consistently limited, regardless of site or demographics. Men demonstrated improved overall fertility health knowledge and more knowledge regarding male factors. There are still considerable gaps in knowledge of modifiable risk factors that may impact fertility health and future overall health. Fertility health promotion through education should be comprehensive and widely available in secondary schools, colleges, and universities. As well, increased education regarding fertility health in primary care settings should become the norm-with male inclusion as a standard of their care.
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Affiliation(s)
- Mary L. Barron
- School of Nursing, Southern Illinois
University-Edwardsville, Edwardsville, IL, USA,Mary L. Barron, School of Nursing, Southern
Illinois University-Edwardsville, Box 1066 Alumni Hall, Edwardsville, IL 62026,
USA.
| | - Diana Lithgow
- College of Graduate Nursing, Western
University of Health Sciences, Pomona, CA, USA
| | - Gail H. Wade
- University of Delaware School of
Nursing, Newark, DE, USA
| | - Georgia Mueller Luckey
- Department of Family and Community
Medicine, School of Medicine, Southern Illinois University, Springfield, IL,
USA
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15
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Grace B, Shawe J, Johnson S, Usman NO, Stephenson J. The ABC of reproductive intentions: a mixed-methods study exploring the spectrum of attitudes towards family building. Hum Reprod 2022; 37:988-996. [PMID: 35238351 PMCID: PMC9071225 DOI: 10.1093/humrep/deac036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/02/2022] [Indexed: 11/26/2022] Open
Abstract
STUDY QUESTION What are the intentions of men and women of reproductive age in the UK regarding reproduction and family building? SUMMARY ANSWER We identified six main categories of people; Avoiders, Betweeners, Completers, Desirers, Expectants and Flexers, for whom reproduction education strategies should be tailored differently to suit intentions. WHAT IS KNOWN ALREADY Several studies have highlighted poor fertility awareness across men and women of reproductive age. As the average age of first-time parents continues to rise, there has been a concerted effort from educators, healthcare professionals, charities, reproductive health groups and government policymakers, to improve fertility awareness. In order to ensure that these messages are effective and to deploy the best strategies, it is important to understand people's reproductive health needs. This study therefore aimed to explore different reproductive intentions to aid tailoring of information to help individuals and couples achieve their family building desires. STUDY DESIGN, SIZE, DURATION We conducted a mixed-method study via a UK-wide cross-sectional survey with 1082 participants and semi-structured interviews of 20 women and 15 men who agreed to follow-up interviews. Interviews lasted an hour on average. Ethics approval from UCL Research Ethics Committee. PARTICIPANTS/MATERIALS, SETTING, METHODS Survey participants were recruited nationwide via online newspaper and social media adverts. Interviewees were purposely sampled to include men and women from the reproductive age range (18-45 years), varying ethnicity and education background. Survey data were analysed using the Minitab statistical software package. Interview data were transcribed and analysed using the framework method. MAIN RESULTS AND THE ROLE OF CHANCE From the survey and interviews, we identified six key categories of people, grouped alphabetically, in a user-friendly manner to highlight a spectrum of reproductive intentions: Avoiders describes respondents who have no children and do not want to have children in the future; Betweeners describes those who already have child(ren) and want more in the future but are not actively trying to conceive; Completers describes those who have child(ren) but do not want more; Desirers describes those who are actively trying to conceive or plan to have child(ren) in the future; Expectants describes those who were pregnant at the time of the study; and Flexers describes those who may or may not already have and are unsure but or open to having child(ren) in the future. Analysis of survey data identified the following proportions in our study: Avoiders, 4.7%; Betweeners, 11.3%; Completers, 13.6%; Desirers, 36.9%; Expectants, 4.1%; and Flexers 28.4% and 2.4% preferring not to answer. There was one 'other' group from qualitative analysis, who would like to have children in the future but were unsure whether they could or had changing views. We recommend classifying as 'Desirers' or 'Flexers' for the purposes of fertility education. A majority of the survey population were trying to get pregnant; were pregnant; or planning to have a child in the future-whether actively, passively or simply open to the idea, with interviews providing deep insights into their family building decision-making. LIMITATIONS, REASONS FOR CAUTION Due to the online recruitment method, there may be a bias towards more educated respondents. WIDER IMPLICATIONS OF THE FINDINGS We developed a user-friendly, alphabetical categorization of reproductive intentions, which may be used by individuals, healthcare professionals, educators, special interest groups, charities and policymakers to support and enable individuals and couples in making informed choices to achieve their desired intentions, if and when they choose to start a family. STUDY FUNDING/COMPETING INTEREST(S) There was no external funding for this study. The authors report no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- B Grace
- Department of Sexual and Reproductive Health, UCL Institute for Women’s Health, Faculty of Population Health Sciences, University College London, London, UK
| | - J Shawe
- Faculty of Health, University of Plymouth, Devon, UK
- SW Clinical School, Royal Cornwall Hospital, Truro, UK
| | - S Johnson
- QIAGEN Manchester Ltd, Manchester, UK
| | - N O Usman
- Department of Community Medicine, Kaduna State University, Kaduna, Nigeria
| | - J Stephenson
- Department of Sexual and Reproductive Health, UCL Institute for Women’s Health, Faculty of Population Health Sciences, University College London, London, UK
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16
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Grace B, Shawe J, Johnson S, Usman NO, Stephenson J. The ABC of reproductive intentions: a mixed-methods study exploring the spectrum of attitudes towards family building. HUMAN REPRODUCTION (OXFORD, ENGLAND) 2022. [PMID: 35238351 DOI: 10.1093/humrep/deac036/6541644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
STUDY QUESTION What are the intentions of men and women of reproductive age in the UK regarding reproduction and family building? SUMMARY ANSWER We identified six main categories of people; Avoiders, Betweeners, Completers, Desirers, Expectants and Flexers, for whom reproduction education strategies should be tailored differently to suit intentions. WHAT IS KNOWN ALREADY Several studies have highlighted poor fertility awareness across men and women of reproductive age. As the average age of first-time parents continues to rise, there has been a concerted effort from educators, healthcare professionals, charities, reproductive health groups and government policymakers, to improve fertility awareness. In order to ensure that these messages are effective and to deploy the best strategies, it is important to understand people's reproductive health needs. This study therefore aimed to explore different reproductive intentions to aid tailoring of information to help individuals and couples achieve their family building desires. STUDY DESIGN, SIZE, DURATION We conducted a mixed-method study via a UK-wide cross-sectional survey with 1082 participants and semi-structured interviews of 20 women and 15 men who agreed to follow-up interviews. Interviews lasted an hour on average. Ethics approval from UCL Research Ethics Committee. PARTICIPANTS/MATERIALS, SETTING, METHODS Survey participants were recruited nationwide via online newspaper and social media adverts. Interviewees were purposely sampled to include men and women from the reproductive age range (18-45 years), varying ethnicity and education background. Survey data were analysed using the Minitab statistical software package. Interview data were transcribed and analysed using the framework method. MAIN RESULTS AND THE ROLE OF CHANCE From the survey and interviews, we identified six key categories of people, grouped alphabetically, in a user-friendly manner to highlight a spectrum of reproductive intentions: Avoiders describes respondents who have no children and do not want to have children in the future; Betweeners describes those who already have child(ren) and want more in the future but are not actively trying to conceive; Completers describes those who have child(ren) but do not want more; Desirers describes those who are actively trying to conceive or plan to have child(ren) in the future; Expectants describes those who were pregnant at the time of the study; and Flexers describes those who may or may not already have and are unsure but or open to having child(ren) in the future. Analysis of survey data identified the following proportions in our study: Avoiders, 4.7%; Betweeners, 11.3%; Completers, 13.6%; Desirers, 36.9%; Expectants, 4.1%; and Flexers 28.4% and 2.4% preferring not to answer. There was one 'other' group from qualitative analysis, who would like to have children in the future but were unsure whether they could or had changing views. We recommend classifying as 'Desirers' or 'Flexers' for the purposes of fertility education. A majority of the survey population were trying to get pregnant; were pregnant; or planning to have a child in the future-whether actively, passively or simply open to the idea, with interviews providing deep insights into their family building decision-making. LIMITATIONS, REASONS FOR CAUTION Due to the online recruitment method, there may be a bias towards more educated respondents. WIDER IMPLICATIONS OF THE FINDINGS We developed a user-friendly, alphabetical categorization of reproductive intentions, which may be used by individuals, healthcare professionals, educators, special interest groups, charities and policymakers to support and enable individuals and couples in making informed choices to achieve their desired intentions, if and when they choose to start a family. STUDY FUNDING/COMPETING INTEREST(S) There was no external funding for this study. The authors report no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- B Grace
- Department of Sexual and Reproductive Health, UCL Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK
| | - J Shawe
- Faculty of Health, University of Plymouth, Devon, UK.,SW Clinical School, Royal Cornwall Hospital, Truro, UK
| | - S Johnson
- QIAGEN Manchester Ltd, Manchester, UK
| | - N O Usman
- Department of Community Medicine, Kaduna State University, Kaduna, Nigeria
| | - J Stephenson
- Department of Sexual and Reproductive Health, UCL Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK
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17
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Oocyte vitrification for elective fertility preservation: a SWOT analysis. Reprod Biomed Online 2022; 44:1005-1014. [DOI: 10.1016/j.rbmo.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 01/19/2022] [Accepted: 02/01/2022] [Indexed: 11/17/2022]
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18
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French RS, Shawe J, Tilouche N, Earle S, Grenfell P. (Not) talking about fertility: the role of digital technologies and health services in helping plan pregnancy. A qualitative study. BMJ SEXUAL & REPRODUCTIVE HEALTH 2022; 48:16-21. [PMID: 33361118 PMCID: PMC8762009 DOI: 10.1136/bmjsrh-2020-200862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/17/2020] [Accepted: 12/07/2020] [Indexed: 05/08/2023]
Abstract
AIM To explore how women and their partners navigate (pre)conception healthcare and the role of Natural Cycles fertility awareness technology in this process. METHODS In-depth interviews with 24 cisgender women aged 24-43 years who had used Natural Cycles' 'Plan a Pregnancy' mode, and six partners of Natural Cycles users, all cisgender men aged 30-39 years. Participants were recruited via direct messaging in the Natural Cycles app, social media and, for partners, snowball sampling. Purposive sampling was conducted to ensure diversity among participants. Interviews were audio-recorded and transcribed verbatim. An iterative, inductive approach was adopted for thematic data analysis. RESULTS Natural Cycles helped most users better understand their menstrual cycles and fertility. Fertility awareness and preconception counselling with healthcare providers were uncommon. Women felt discussions about planning pregnancy in healthcare settings were often fraught with difficulties. They described not wanting to be an extra burden to overworked staff, being concerned that their worries about trying for pregnancy would be dismissed, or feeling staff did not have expertise in fertility awareness. Some women had shared their Natural Cycles data with healthcare professionals to demonstrate their menstrual cycle data or time of conception. However, it was not always clear to those not accessing services when they should seek further advice, for example, those using the app for longer time periods who had not yet conceived. CONCLUSIONS Digital technologies can provide information and support for those wanting to conceive. They should, however, complement care in statutory services, and be accompanied by greater investment in fertility awareness and preconception support.
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Affiliation(s)
- Rebecca S French
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Jill Shawe
- School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Nerissa Tilouche
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah Earle
- School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, UK
| | - Pippa Grenfell
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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19
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Özşahin Z, Aksoy Derya Y. Fertility awareness scale development study in Turkish women. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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20
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Yokomizo R, Nakamura A, Sato M, Nasu R, Hine M, Urayama KY, Kishi H, Sago H, Okamoto A, Umezawa A. Smartphone application improves fertility treatment-related literacy in a large-scale virtual randomized controlled trial in Japan. NPJ Digit Med 2021; 4:163. [PMID: 34848798 PMCID: PMC8632894 DOI: 10.1038/s41746-021-00530-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 10/19/2021] [Indexed: 12/04/2022] Open
Abstract
People of reproductive age have unmet needs related to deficiencies in fertility literacy. Here, we aimed to investigate whether providing fertility-related information via a smartphone application could improve fertility treatment-related literacy in participants. We performed a randomized control-group pretest posttest study and recruited participants between June 18 and 25, 2020. Participants’ fertility treatment-related literacy was assessed with a pretest that comprised of 28 questions and participants were allocated with stratified randomization to either intervention group or control group. The intervention comprised a one-week smartphone application-based provision of information on fertility-related information and the control group received general information about women’s healthcare. Effectiveness of intervention was assessed using a posttest. A total of 4137 participants were administered the questionnaire and pretest, among which 3765 participants (91.0 %) responded and were randomly allocated into either the intervention group (N = 1883) or the control group (N = 1882). A significantly higher posttest mean score was observed for the intervention group compared to the control group (P = 0.0017). We also observed that posttest scores were significantly improved compared to pretest scores in both the intervention and control group (P < 0.001). When examining by specific test question, the proportion answering correctly increased at posttest compared to pretest for both intervention and control groups (P < 0.001). Furthermore, the intervention group showed a greater mean difference between posttest and pretest scores than the control group (P < 0.001). In conclusion, educational intervention using a smartphone application contributed to enhancing fertility treatment-related literacy.
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Affiliation(s)
- Ryo Yokomizo
- Center for Regenerative Medicine, National Center for Child Health and Development Research Institute, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan.,Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato, Tokyo, 105-8461, Japan.,Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan
| | - Akari Nakamura
- Department of Healthcare Business, MTI Ltd., 3-20-2 Nishishinjuku, Shinjuku, Tokyo, 163-1435, Japan
| | - Makoto Sato
- Department of Healthcare Business, MTI Ltd., 3-20-2 Nishishinjuku, Shinjuku, Tokyo, 163-1435, Japan
| | - Risa Nasu
- Department of Healthcare Business, MTI Ltd., 3-20-2 Nishishinjuku, Shinjuku, Tokyo, 163-1435, Japan
| | - Maaya Hine
- Department of Healthcare Business, MTI Ltd., 3-20-2 Nishishinjuku, Shinjuku, Tokyo, 163-1435, Japan
| | - Kevin Y Urayama
- Department of Social Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan.,Graduate School of Public Health, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hiroshi Kishi
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato, Tokyo, 105-8461, Japan
| | - Haruhiko Sago
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato, Tokyo, 105-8461, Japan
| | - Akihiro Umezawa
- Center for Regenerative Medicine, National Center for Child Health and Development Research Institute, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan.
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21
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Harper JC, Hammarberg K, Simopoulou M, Koert E, Pedro J, Massin N, Fincham A, Balen A. The International Fertility Education Initiative: research and action to improve fertility awareness. Hum Reprod Open 2021; 2021:hoab031. [PMID: 34532596 PMCID: PMC8441587 DOI: 10.1093/hropen/hoab031] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/21/2021] [Indexed: 12/16/2022] Open
Affiliation(s)
- Joyce C Harper
- EGA Institute for Women's Health, Reproductive Science and Society Group, University College London, London, UK
| | - Karin Hammarberg
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Victorian Assisted Reproductive Treatment Authority, Melbourne, VIC, Australia
| | - Mara Simopoulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Emily Koert
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Juliana Pedro
- Centre for Reproductive Genetics A. Barros, Porto, Portugal.,Centre for Psychology at University of Porto, Porto, Portugal
| | - Nathalie Massin
- Department of Gynecology, Obstetrics and Reproductive Medicine, Intercommunal Hospital, Creteil Cedex, France
| | | | - Adam Balen
- Reproductive Medicine, Leeds Teaching Hospitals, Leeds, UK
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22
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Harper JC, Hammarberg K, Simopoulou M, Koert E, Pedro J, Massin N, Fincham A, Balen A. The International Fertility Education Initiative: research and action to improve fertility awareness. Hum Reprod Open 2021. [PMID: 34532596 DOI: 10.1093/hropen/hoab031/6357711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Joyce C Harper
- EGA Institute for Women's Health, Reproductive Science and Society Group, University College London, London, UK
| | - Karin Hammarberg
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Victorian Assisted Reproductive Treatment Authority, Melbourne, VIC, Australia
| | - Mara Simopoulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Emily Koert
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Juliana Pedro
- Centre for Reproductive Genetics A. Barros, Porto, Portugal.,Centre for Psychology at University of Porto, Porto, Portugal
| | - Nathalie Massin
- Department of Gynecology, Obstetrics and Reproductive Medicine, Intercommunal Hospital, Creteil Cedex, France
| | | | - Adam Balen
- Reproductive Medicine, Leeds Teaching Hospitals, Leeds, UK
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23
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Szalma I, Bitó T. Knowledge and attitudes about assisted reproductive technology: Findings from a Hungarian online survey. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2021; 13:75-84. [PMID: 34381884 PMCID: PMC8340049 DOI: 10.1016/j.rbms.2021.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 04/23/2021] [Accepted: 06/08/2021] [Indexed: 05/19/2023]
Abstract
This study aimed to evaluate the general knowledge and attitudes about assisted reproductive technology (ART) and the influence of sociodemographic features on knowledge and attitudes in a large sample of men and women of reproductive age in Hungary. A cross-sectional online survey study was conducted among 1370 men and women between 18 and 50 years of age in Hungary. The questionnaire included questions about self-rated knowledge, an attitude item, and eight questions concerning general knowledge about ART. In addition, participants were asked sociodemographic background questions. The results show that approximately half of the respondents (49.3%) rated themselves as fairly knowledgeable about ART. However, 56% of the respondents answered just three of the eight knowledge questions correctly. Both men and women had limited knowledge about the success rate of ART, the costs of ART and the age limit to access ART. The greatest lack of knowledge about ART was about its risks: the majority of respondents did not know that in-vitro fertilization poses health risks for women and conceived children. Regarding attitudes, the majority of respondents had a very positive attitude towards ART. Only those respondents who were religious were less supportive of ART. These data suggest that men and women of reproductive age overestimate their ART-related knowledge. As most men and women would like to have biological children in Hungary, there is a critical need for public education.
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Affiliation(s)
- Ivett Szalma
- Centre for Social Sciences, Hungarian Academy of Sciences Centre of Excellence, Budapest, Hungary
- Corvinus University of Budapest, Budapest, Hungary
- Corresponding author at: Centre for Social Sciences, Hungarian Academy of Sciences Centre of Excellence, Budapest, Hungary.
| | - Tamás Bitó
- Department of Obstetrics and Gynaecology, University of Szeged, Szeged, Hungary
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24
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Stevenson EL, Ching-Yu C, Chia-Hao C, McEleny KR. Men's perception and understanding of male-factor infertility in the UK. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:S8-S16. [PMID: 33983808 DOI: 10.12968/bjon.2021.30.9.s8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Male-factor infertility is a common but stigmatised issue, and men often do not receive the emotional support and the information they need. This study sought to understand awareness of male fertility issues compared to female fertility among the UK general male public, and also what were perceived as being the optimum methods for providing support for affected men, emotionally and through information. Men feel that male infertility is not discussed by the public as much as female infertility. Lifestyle issues that affect male fertility are not well understood, and men affected by infertility desire more support, including online, from health professionals and through peer support. Health professionals, including those in public health, could offer evidence-based programmes to reduce stigma and increase public knowledge about infertility, as well as offer emotional support to men with infertility problems.
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Affiliation(s)
| | - Cheng Ching-Yu
- Professor and Research Fellow, Department of Nursing, Chang Gung University of Science and Technology and Chang Gung Memorial Hospital at Chiayi, Putz, Chiayi County, Taiwan
| | - Chang Chia-Hao
- Associate Professor, Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Putz, Chiayi County, Taiwan
| | - Kevin R McEleny
- Consultant Urologist, Newcastle Fertility Centre, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne
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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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Jurkowski L, Manubens R, Ryberg JO, Rossi M. Fertility awareness, attitudes towards parenting, and knowledge about Assisted Reproductive Technology among university students in Argentina. JBRA Assist Reprod 2021; 25:453-458. [PMID: 34061481 PMCID: PMC8312293 DOI: 10.5935/1518-0557.20210019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: The aim of this study was to assess the fertility awareness, attitudes towards parenting, and knowledge about Assisted Reproductive Technology of Argentinian university students. Methods: This naturalistic, cross-sectional and quantitative study included the translation into Spanish of the Swedish Fertility Awareness Questionnaire; adjustments were also made to fit the questionnaire to local cultural norm. Through a snowball design using social media, university students were contacted in June 2019 and asked to complete an anonymous online self-report survey. Results: A total of 680 students (83.2% females and 16.4% males) aged 24.7 years on average (SD=5.6) answered the questionnaire. Approximately 70% believed they had high levels of knowledge about human reproduction; nevertheless, 46% thought that women could get pregnant in any stage of the cycle; 36.2% believed that fertility in women decreased between the ages of 45 and 50, 33.2% between the ages of 40 and 45, and 25.9% between the ages of 35 and 40 years. Half of the studied population thought that the chances of getting pregnant during the ovulation period ranged between 80-100%. In regard to age-related fertility decline in men, 57% believed that it simply did not happen. As to their desire to become parents, 58.3% stated that they planned to have children, and 50% said it was very important. The risk factors tied to infertility listed by the students were as follows: drug use (79.2%); aging (78.2%); smoking (69.2%); alcohol (66.5%); and sexually transmitted infections (43%). Conclusions: Argentinian university students wrongly see themselves as knowledgeable about fertility. Interventions are required to improve awareness over fertility among university students in Argentina.
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Affiliation(s)
- Ludmila Jurkowski
- Universidad de San Martin Psychology Department, Buenos Aires Argentina Psychology Department, Universidad de San Martin, Buenos Aires, Argentina
| | - Rocio Manubens
- Universidad de Belgrano Psychology Research Department CABA Argentina Psychology Research Department, Universidad de Belgrano, CABA, Argentina
| | - Julieta Olivera Ryberg
- Universidad de la Marina Mercante Psychology Research Department CABA Argentina Psychology Research Department, Universidad de la Marina Mercante, CABA, Argentina
| | - Mariela Rossi
- Fertilis Medicina Reproductiva Psychology Department Buenos Aires Argentina Psychology Department, Fertilis Medicina Reproductiva, Buenos Aires, Argentina
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Sedlander E, Bingenheimer JB, Lahiri S, Thiongo M, Gichangi P, Munar W, Rimal RN. Does the Belief That Contraceptive Use Causes Infertility Actually Affect Use? Findings from a Social Network Study in Kenya. Stud Fam Plann 2021; 52:343-359. [PMID: 34255872 PMCID: PMC8457152 DOI: 10.1111/sifp.12157] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The belief that contraceptive use causes infertility has been documented across sub‐Saharan Africa, but its quantitative association with actual contraceptive use has not been examined. We collected and analyzed sociocentric network data covering 74 percent of the population in two villages in rural Kenya. We asked respondents to nominate people from their village (their network), and then we matched their network (alters) to the individual participant (ego) to understand how their beliefs and behaviors differ. We asked about contraceptive use and level of agreement with a statement about contraceptive use causing infertility. We calculated the average nominated network contraceptive use score and the average nominated network belief score. Holding the individual belief that contraceptive use causes infertility was associated with lower odds of using contraceptive (AOR = 0.82, p = < 0.01); however, when one's own nominated network connections held this belief, the odds of using contraceptive were even lower (AOR = 0.75, p <0.01). Our findings show that this belief is associated with lower odds of contraceptive use and highlights the role that other people in one's network play in reinforcing it. Sexual and reproductive health programs should address this misperception at the individual and social network level.
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Affiliation(s)
- Erica Sedlander
- Erica Sedlander, Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA. University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA, USA
| | - Jeffrey B Bingenheimer
- Jeffrey B. Bingenheimer, The George Washington University, Milken Institute School of Public Health, Department of Prevention and Community Health, Washington, DC, USA
| | - Shaon Lahiri
- Shaon Lahiri, The George Washington University, Milken Institute School of Public Health, Department of Prevention and Community Health, Washington, DC, USA
| | - Mary Thiongo
- Mary Thiongo, International Center for Reproductive Health Kenya, Mombasa, Kenya
| | - Peter Gichangi
- Peter Gichangi, Technical University of Mombasa, Mombasa, Kenya. Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Wolfgang Munar
- Wolfgang Munar, Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Rajiv N Rimal
- Rajiv N. Rimal, Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD, USA
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Stuhmcke A. Reframing the Australian Medico-Legal Model of Infertility. JOURNAL OF BIOETHICAL INQUIRY 2021; 18:305-317. [PMID: 33638123 DOI: 10.1007/s11673-021-10094-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
Australian law affirms a binary construction of fertility/infertility. This model is based upon the medical categorization of infertility as a disease. Law supports medicine in prioritizing technology, such as in vitro fertilization, as treatment for infertility. This prioritization of a medico-legal model of infertility in turn marginalizes alternative means of family creation such as adoption, fostering, traditional surrogacy, and childlessness. This paper argues that this binary model masks the impact of medicalization upon reproductive choice and limits opportunity for infertile individuals to create families. While medical technology should be available to enhance reproductive opportunity, infertile individuals will benefit from regulatory change which disentangles the medico-legal construct of infertility as a disease from the desire to create a family. This paper suggests that the medico-legal model of infertility should be reframed to support all opportunities for family creation equally, including non-medical opportunities such as adoption, fostering, and childlessness.
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Affiliation(s)
- Anita Stuhmcke
- Faculty of Law, University of Technology Sydney, Broadway, Sydney, NSW, 2007, Australia.
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Barcroft JF, Galazis N, Jones BP, Getreu N, Bracewell-Milnes T, Grewal KJ, Sorbi F, Yazbek J, Lathouras K, Smith JR, Hardiman P, Thum MY, Ben-Nagi J, Ghaem-Maghami S, Verbakel J, Saso S. Fertility treatment and cancers-the eternal conundrum: a systematic review and meta-analysis. Hum Reprod 2021; 36:1093-1107. [PMID: 33586777 DOI: 10.1093/humrep/deaa293] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/28/2020] [Indexed: 12/29/2022] Open
Abstract
STUDY QUESTION Does fertility treatment (FT) significantly increase the incidence of breast, ovarian, endometrial or cervical cancer? SUMMARY ANSWER Overall, FT does not significantly increase the incidence of breast, ovarian or endometrial cancer and may even reduce the incidence of cervical cancer. WHAT IS KNOWN ALREADY Infertility affects more than 14% of couples. Infertility and nulliparity are established risk factors for endometrial, ovarian and breast cancer, yet the association with FT is more contentious. STUDY DESIGN, SIZE, DURATION A literature search was carried out using Cochrane Library, EMBASE, Medline and Google Scholar up to December 2019. Peer-reviewed studies stating cancer incidence (breast, ovarian, endometrial or cervical) in FT and no-FT groups were identified. Out of 128 studies identified, 29 retrospective studies fulfilled the criteria and were included (n = 21 070 337). PARTICIPANTS/MATERIALS, SETTING, METHODS In the final meta-analysis, 29 studies were included: breast (n = 19), ovarian (n = 19), endometrial (n = 15) and cervical (n = 13), 17 studies involved multiple cancer types and so were included in each individual cancer meta-analysis. Primary outcome of interest was cancer incidence (breast, ovarian, endometrial and cervical) in FT and no-FT groups. Secondary outcome was cancer incidence according to specific fertility drug exposure. Odds ratio (OR) and random effects model were used to demonstrate treatment effect and calculate pooled treatment effect, respectively. A meta-regression and eight sub-group analyses were performed to assess the impact of the following variables, maternal age, infertility, study size, outliers and specific FT sub-types, on cancer incidence. MAIN RESULTS AND THE ROLE OF CHANCE Cervical cancer incidence was significantly lower in the FT group compared with the no-FT group: OR 0.68 (95% CI 0.46-0.99). The incidences of breast (OR 0.86; 95% CI 0.73-1.01) and endometrial (OR 1.28; 95% CI 0.92-1.79) cancers were not found to be significantly different between the FT and no-FT groups. Whilst overall ovarian cancer incidence was not significantly different between the FT and no-FT groups (OR 1.19; 95% CI 0.98-1.46), separate analysis of borderline ovarian tumours (BOT) revealed a significant association (OR 1.69; 95% CI 1.27-2.25). In further sub-group analyses, ovarian cancer incidence was shown to be significantly higher in the IVF (OR 1.32; 95% CI 1.03-1.69) and clomiphene citrate (CC) treatment group (OR 1.40; 95% CI 1.10-1.77), respectively when compared with the no-FT group. Conversely, the incidences of breast (OR 0.75; 95% CI 0.61-0.92) and cervical cancer (OR 0.58; 95% CI 0.38-0.89) were significantly lower in the IVF treatment sub-group compared to the no-FT group. LIMITATIONS, REASONS FOR CAUTION The large, varied dataset spanning a wide study period introduced significant clinical heterogeneity. Thus, results have to be interpreted with an element of caution. Exclusion of non-English citations, unpublished work and abstracts, in order to ensure data accuracy and reliability was maintained, may have introduced a degree of selection bias. WIDER IMPLICATIONS OF THE FINDINGS The results for breast, ovarian, endometrial and cervical cancer are reassuring, in line with previously published meta-analyses for individual cancers but the association between IVF and CC treatment and an increase in ovarian cancer incidence requires additional work to understand the potential mechanism driving this association. In particular, focusing on (i) discriminating specific treatments effects from an inherent risk of malignancy; (ii) differential risk profiles among specific patient sub-groups (refractory treatment and obesity); and (iii) understanding the impact of FT outcomes on cancer incidence. STUDY FUNDING/COMPETING INTEREST(S) This study did not receive any funding. The authors have no financial, personal, intellectual and professional conflicts of interest to declare. PROSPERO REGISTRATION NUMBER CRD42019153404.
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Affiliation(s)
- Jennifer Frances Barcroft
- Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - Nicolas Galazis
- Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - Benjamin P Jones
- Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - Natalie Getreu
- Institute of Women's Health, University College London, London, UK
| | - Timothy Bracewell-Milnes
- Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, Imperial College London, London, UK
| | - Karen J Grewal
- Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - Flavia Sorbi
- Division of Obstetrics and Gynaecology, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Joseph Yazbek
- West London Gynaecological Cancer Centre, Queen Charlotte's Hospital, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - Kostas Lathouras
- West London Gynaecological Cancer Centre, Queen Charlotte's Hospital, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - J Richard Smith
- West London Gynaecological Cancer Centre, Queen Charlotte's Hospital, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - Paul Hardiman
- Department of Obstetrics and Gynaecology, Royal Free and University College Medical School, NW3 2PF London, UK
| | - Meen-Yau Thum
- The Lister Fertility Clinic, Chelsea Bridge Road, London, UK
| | - Jara Ben-Nagi
- Centre for Reproductive and Genetic Health, London, UK
| | - Sadaf Ghaem-Maghami
- West London Gynaecological Cancer Centre, Queen Charlotte's Hospital, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - Jan Verbakel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Srdjan Saso
- Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, Hammersmith Hospital Campus, London, UK
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Chauhan D, Jackson E, Harper JC. Childless by circumstance - Using an online survey to explore the experiences of childless women who had wanted children. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2021; 12:44-55. [PMID: 33336089 PMCID: PMC7732864 DOI: 10.1016/j.rbms.2020.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 08/08/2020] [Accepted: 09/29/2020] [Indexed: 05/23/2023]
Abstract
Childlessness is increasing globally. This study aimed to explore the experiences of childless women who had wanted children. An online survey study was promoted through social media to recruit women aged ≥46 years who were childless by circumstance. The survey remained open for 15 days. In total, 303 survey responses were collected, 176 of which were complete surveys. In total, 15.3% (27/176) of women who had wanted children reported that they had not tried to have children, most commonly due to the lack of a partner (40.7%, 11/27). Of the 139 women who had tried to have children, 70.5% (98/139) had used calendar-based menstrual cycle tracking methods to identify their fertile window, and many had undergone fertility checks including hormone tests (75.5%, 105/139) and ultrasound scans (71.2%, 99/139). A significant proportion of women had experienced a miscarriage (40.2%, 56/139). Many women had decided not to have any fertility treatment (43.2%, 60/139). For those who did, the majority had tried in-vitro fertilization (74.6%, 59/79). The most common reason that women gave for stopping fertility treatment was due to emotional reasons (74.7%, 59/79). When asked how women felt now about their childlessness, the most common issues identified were unhappiness (85/158, 54%), acceptance (43/158, 27%) and happiness (30/158, 19%). There should be more support for unsuccessful fertility patients and other childless women, and more emphasis should be placed upon fertility education in order to ensure that women are better informed about fertility issues.
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Affiliation(s)
- Dilan Chauhan
- Institute for Women’s Health, University College London, London, UK
| | - Emily Jackson
- Department of Law, London School of Economics, London, UK
| | - Joyce C Harper
- Institute for Women’s Health, University College London, London, UK
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Perceived likelihood of becoming pregnant and contraceptive use: Findings from population-based surveys in Côte d'Ivoire, Nigeria, and Rajasthan, India. Contraception 2021; 103:431-438. [PMID: 33587907 PMCID: PMC8129551 DOI: 10.1016/j.contraception.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/21/2021] [Accepted: 02/08/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Advancing reproductive autonomy requires targeted strategies and interventions that address barriers to contraceptive use. The primary objective of this study is to investigate whether perceptions of low pregnancy likelihood are associated with lower likelihood of using contraception among presumably fecund, sexually active women. STUDY DESIGN We used population-based survey data of reproductive age women at risk of pregnancy collected in 2018 from Côte d'Ivoire (N = 1447), Nigeria (N = 4110), and Rajasthan, India (N = 1994). To assess one's perceived biological likelihood of pregnancy, we used 2 measures: likelihood following a single act of sex without contraception and likelihood following 1 year of regular sex without contraception. Response options included: definitely yes, maybe yes, maybe no, definitely no, and do not know. We conducted multivariable logistic regression to assess the relationship between each perception measure with odds of contraceptive use separately by country. RESULTS Perceived chance of definitely or maybe becoming pregnant after one act of sex without contraception ranged from 54.0% to 55.0% in Nigeria and Rajasthan to 80.0% in Côte d'Ivoire, while it was higher for regular sex without contraception (76.0%-85.1%). Multivariable results indicate that perceptions of pregnancy likelihood were associated with contraceptive use among presumably fecund women, with a stronger relationship observed in relation to cumulative likelihood (odds ratio 0.1-0.6) than likelihood after one act (odds ratio 0.4-0.8) and a dose-response pattern by strength of perceived chance. CONCLUSIONS Results indicate that women's use of contraception in low-resource settings is associated with their perceived likelihood of becoming pregnant after unprotected sex. IMPLICATIONS Findings suggest that understanding women's perceived likelihood of pregnancy may aid in the development of interventions to help women achieve their reproductive goals.
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Grenfell P, Tilouche N, Shawe J, French RS. Fertility and digital technology: narratives of using smartphone app 'Natural Cycles' while trying to conceive. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:116-132. [PMID: 33147647 PMCID: PMC7894554 DOI: 10.1111/1467-9566.13199] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 08/20/2020] [Accepted: 09/09/2020] [Indexed: 05/23/2023]
Abstract
Fertility awareness apps, which help to identify the 'fertile window' when conception is most likely, have been hailed as 'revolutionising' women's reproductive health. Despite rapidly growing popularity, little research has explored how people use these apps when trying to conceive and what these apps mean to them. We draw on in-depth, qualitative interviews, adopting a critical digital health studies lens (a sub-field of science and technology studies), to explore the experiences of cisgender women and partners with one such app, Natural Cycles, in the context of their daily lives. We found that many women valued the technology as a 'natural', inobtrusive alternative to biomedical intervention, and a means of controlling and knowing their bodies, amid a dearth of fertility-related education and care. Yet this technology also intervened materially and affectively into the spaces of their lives and relationships and privileged disembodied metrics (temperature) over embodied knowledge. Meanwhile, app language, advertising and cost have contributed to characterising 'typical' users as white, heterosexual, affluent, cisgender women without disabilities. In the context of neoliberal shifts towards bodily self-tracking, technologies appealing as novel, liberating and 'natural' to individuals who can access them may nevertheless reproduce highly gendered reproductive responsibilities, anxieties and broader health and social inequalities.
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Affiliation(s)
- Pippa Grenfell
- Department of Public Health, Environments & SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Nerissa Tilouche
- Department of Public Health, Environments & SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Jill Shawe
- School of Nursing and MidwiferyUniversity of PlymouthPlymouthUK
| | - Rebecca S. French
- Department of Public Health, Environments & SocietyLondon School of Hygiene and Tropical MedicineLondonUK
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Trawick E, Pecoriello J, Quinn G, Goldman KN. Guidelines informing counseling on female age-related fertility decline: a systematic review. J Assist Reprod Genet 2021; 38:41-53. [PMID: 33188440 PMCID: PMC7822973 DOI: 10.1007/s10815-020-01967-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/04/2020] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To identify, appraise, and assess clinical practice guidelines informing patient counseling on female age-related fertility decline. METHODS Searched electronic database records from January 1, 2006, to September 10, 2018, and professional society websites. The search terms included iterations of "guideline," "counseling," "preconception," "age-related fertility decline," and "reproductive life planning." English-language professional organization guidelines addressing patient counseling on age-specific reproductive health topics were included. Assessed the methodological quality of included guidelines using the AGREE II instrument. Guidelines were categorized as high quality or low quality based on AGREE II scores. Extracted age-specific reproductive health recommendations of high-quality guidelines. RESULTS The search identified 2918 records. Nineteen records addressed counseling on age-related fertility decline; only 6 focused only on reproductive aging, with the remaining 13 covering related topics. Eleven met criteria for high quality. All high-quality guidelines had high "rigor of development" scores on AGREE II. Ten high-quality guidelines stated an age at which female fertility declines, ranging from 30 to "late 30s." One recommended a specific age at which patients should be counseled. Five of eleven high-quality guidelines did not discuss the obstetric and perinatal risks of advanced maternal age. CONCLUSIONS Few high-quality guidelines address counseling on female age-related fertility decline, and existing guidance on reproductive aging counseling is inconsistent and incomplete. Greater rigor of development and incorporation of age-specific counseling recommendations into clinical practice guidelines could lead to improved patient anticipatory guidance and more informed reproductive choices.
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Affiliation(s)
- Emma Trawick
- Department of Obstetrics and Gynecology, NYU School of Medicine, 462 First Avenue, NBV 9N1-C, New York, NY, 10016, USA
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 676 North Saint Clair Street, Suite 2300, Chicago, IL, 60611, USA
| | - Jillian Pecoriello
- Department of Obstetrics and Gynecology, NYU School of Medicine, 462 First Avenue, NBV 9N1-C, New York, NY, 10016, USA
| | - Gwendolyn Quinn
- Department of Obstetrics and Gynecology, NYU School of Medicine, 462 First Avenue, NBV 9N1-C, New York, NY, 10016, USA
| | - Kara N Goldman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 676 North Saint Clair Street, Suite 2300, Chicago, IL, 60611, USA.
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Pedro J, Fernandes J, Barros A, Xavier P, Almeida V, Costa ME, Schmidt L, Martins MV. Effectiveness of a video-based education on fertility awareness: a randomized controlled trial with partnered women. HUM FERTIL 2020; 25:522-533. [DOI: 10.1080/14647273.2020.1854482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Juliana Pedro
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Joana Fernandes
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Alberto Barros
- Department of Genetics, Faculty of Medicine, Institute of Health Research and Innovation I3S, University of Porto, Porto, Portugal
- Centre for Reproductive Genetics A. Barros, Porto, Portugal
| | - Pedro Xavier
- Centre for Reproductive Genetics A. Barros, Porto, Portugal
- Department of Gynaecology and Obstetrics, São João Hospital, University of Porto, Porto, Portugal
| | - Vasco Almeida
- Faculty of Sciences, University of Porto, Porto, Portugal
| | - Maria E. Costa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - 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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Bernabeu A, Carratala-Munuera C, Quesada JA, Llacer J, Lopez-Pineda A, Sellers F, Gil-Guillen VF, Bernabeu R, Cheikh-Moussa K, Orozco-Beltran D. Expert consensus for primary management of reproductive health: a Delphi study. Ir J Med Sci 2020; 190:677-684. [PMID: 32989655 DOI: 10.1007/s11845-020-02380-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/22/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The main barrier for an appropriate primary management of the reproductive health was lack of knowledge about the risk factors and prevention measures for infertility and the main recommendations was to involve primary care physicians in reproductive health. AIMS To reach a consensus around barriers and enablers for appropriate primary management of the reproductive health. METHODS An observational study was performed using the modified Delphi technique, from October 2017 to April 2018 in private and public assisted reproduction clinics in Spain. A questionnaire consisted of 58 items, divided into four blocks to explore consensus among a group of experts by synthesizing opinions. RESULTS In the first Delphi round, the response rate was 50% and panelists reached a 72.4% of consensus. In second round, the response rate was 55% and panelists reached a 25% of consensus. To minimize limitations related to the use of a structured questionnaire, a space for free text responses was provided. The following items yielded unanimous agreement: "It is necessary to promote reproductive planning-not just contraception-from secondary school," "The media should not trivialize pregnancies in women aged over 50," "Postponing family formation is the main cause of the increase in assisted reproduction treatments in Spain," and "Postponing motherhood implies an inherently decreased probability of having children." CONCLUSIONS These recommendations could set the basis for a public health action plan for primary management of reproductive health. The findings may be applicable to any country whose health services system provides primary healthcare.
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Affiliation(s)
- Andrea Bernabeu
- Chair of Reproductive and Community Medicine, Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550, Alicante, San Juan de Alicante, Spain.,Bernabeu Institute of Fertility and Gynecology, 03016, Alicante, Spain
| | - Concepcion Carratala-Munuera
- Chair of Reproductive and Community Medicine, Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550, Alicante, San Juan de Alicante, Spain
| | - Jose A Quesada
- Chair of Reproductive and Community Medicine, Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550, Alicante, San Juan de Alicante, Spain
| | - Joaquin Llacer
- Chair of Reproductive and Community Medicine, Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550, Alicante, San Juan de Alicante, Spain.,Bernabeu Institute of Fertility and Gynecology, 03016, Alicante, Spain
| | - Adriana Lopez-Pineda
- Chair of Reproductive and Community Medicine, Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550, Alicante, San Juan de Alicante, Spain.
| | - Francisco Sellers
- Chair of Reproductive and Community Medicine, Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550, Alicante, San Juan de Alicante, Spain.,Bernabeu Institute of Fertility and Gynecology, 03016, Alicante, Spain
| | - Vicente F Gil-Guillen
- Chair of Reproductive and Community Medicine, Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550, Alicante, San Juan de Alicante, Spain
| | - Rafael Bernabeu
- Chair of Reproductive and Community Medicine, Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550, Alicante, San Juan de Alicante, Spain.,Bernabeu Institute of Fertility and Gynecology, 03016, Alicante, Spain
| | - Kamila Cheikh-Moussa
- Chair of Reproductive and Community Medicine, Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550, Alicante, San Juan de Alicante, Spain
| | - Domingo Orozco-Beltran
- Chair of Reproductive and Community Medicine, Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550, Alicante, San Juan de Alicante, Spain
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Ali R, Gürtin ZB, Harper JC. Do fertility tracking applications offer women useful information about their fertile window? Reprod Biomed Online 2020; 42:S1472-6483(20)30509-5. [PMID: 34756400 DOI: 10.1016/j.rbmo.2020.09.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/01/2020] [Accepted: 09/08/2020] [Indexed: 11/19/2022]
Abstract
RESEARCH QUESTION To characterize mobile fertility tracking applications (apps) to determine the use of such apps for women trying to conceive by identifying the fertile window. DESIGN An exploratory cross-sectional audit study was conducted of fertility tracking applications. Ninety out of a possible total 200 apps were included for full review. The main outcome measures were the underlying app method for predicting ovulation, the fertile window, or both, price to download and use the app, disclaimers and cautions, information and features provided and tracked, and app marketing strategies. RESULTS All the apps except one monitored the women's menstrual cycle dates. Most apps only tracked menstrual cycle dates (n = 49 [54.4%]). The remainder tracked at least one fertility-based awareness method (basal body temperature, cervical mucus, LH) (n = 41 [45.6%]). Twenty-five apps measured dates, basal body temperature, LH and cervical mucus (27.8%). Seventy-six per cent of apps were free to download with free apps having more desirable features, tracking more measures and having more and better quality educational insights than paid apps. Seventy per cent of apps were classified as feminine apps, 41% of which were pink in colour. CONCLUSIONS Mobile fertility tracking apps are heterogenous in their underlying methods of predicting fertile days, the price to obtain full app functionality, and in content and design. Unreliable calendar apps remain the most commonly available fertility apps on the market. The unregulated nature of fertility apps is a concern that could be addressed by app regulating bodies. The possible benefit of using fertility apps to reduce time to pregnancy needs to be evaluated.
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Affiliation(s)
- Roshonara Ali
- Reproductive Science and Society Group, Institute for Women's Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK
| | - Zeynep B Gürtin
- Reproductive Science and Society Group, Institute for Women's Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK
| | - Joyce C Harper
- Reproductive Science and Society Group, Institute for Women's Health, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK.
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Gameiro S, El Refaie E, de Guevara BB, Payson A. Women from diverse minority ethnic or religious backgrounds desire more infertility education and more culturally and personally sensitive fertility care. Hum Reprod 2020; 34:1735-1745. [PMID: 31411328 DOI: 10.1093/humrep/dez156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/15/2019] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION What are the views, experiences and healthcare needs of infertile women from a minority ethnic or religious background living in Wales? SUMMARY ANSWER Women from ethnic and religious minority backgrounds consider that their communities have highly pronatalistic attitudes and stigmatize infertility, and express the need for more infertility education (for themselves and their communities), as well as more socio-culturally and interpersonally sensitive fertility care. WHAT IS ALREADY KNOWN Some people from minority ethnic or religious groups perceive pressure to conceive from their communities, experience social costs when they are unable to have children and stressful interactions with the fertility healthcare system while attempting to conceive. STUDY DESIGN, SIZE, DURATION This study was based on a one-day drawing workshop to collect visual (artwork produced by participants) and textual (all conversations and discussions during the workshop) data about the participants' views and experiences of infertility and their fertility care needs. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were nine adult women with a minority ethnic or religious status living in Wales, UK, who were experiencing or had experienced infertility in the past. The workshop comprised five activities: (i) small and large group discussion of infertility-related drawings, (ii) lide-based lecture consisting of an introduction to the basics of drawing objects and people and (iii) thoughts and feelings, (iv) free drawing session and (v) group sharing. Audio recordings of the workshop were transcribed verbatim. Textual data was analysed with thematic analysis. Risk for bias was addressed via individual coding by two authors followed by joint presentation and discussion of results with the research team and participants. MAIN RESULTS AND THE ROLE OF CHANCE Forty-one themes were identified and grouped into eight distinct higher order themes. These themes described the emotional, relational and social burden of infertility experienced by women, which they perceived to result from their communities' highly pronatalistic attitudes and stigmatization of infertility. Themes also captured women's adaptive coping strategies and critical attitude towards pronatalist ideologies. Lastly, themes captured their overall positive evaluation of their fertility health care, their desire for more infertility education (for themselves and their communities) and for culturally competent and interpersonally sensitive care. LIMITATIONS, REASONS FOR CAUTION Our participants were a small, non-random sample recruited in collaboration with a local charity, which may mean that all participants were well integrated in their communities. Analysis focused on capturing commonalities in participants' experiences and this may sometimes result in homogenising diverse experiences. WIDER IMPLICATIONS OF THE FINDINGS More education about the infertility experiences of minority ethnic and religious groups at the community and healthcare delivery level may translate into lessened negative attitudes towards infertility and more culturally competent care, which can be beneficial for women. STUDY FUNDING/COMPETING INTEREST(S) This research was funded by Welsh Crucible. The authors have no conflict of interests to declare.
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Affiliation(s)
- Sofia Gameiro
- School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Elisabeth El Refaie
- School of English, Communication and Philosophy, Cardiff University, Cardiff, United Kingdom
| | | | - Alida Payson
- School of Journalism, Media and Cultural Studies, Cardiff University, Cardiff, United Kingdom
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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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Dash SR, Ray R. Predicting Seminal Quality and its Dependence on Life Style Factors Through Ensemble Learning. INTERNATIONAL JOURNAL OF E-HEALTH AND MEDICAL COMMUNICATIONS 2020. [DOI: 10.4018/ijehmc.2020040105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The awareness related to fertility is of great importance due to the change in lifestyle habits. Semen analysis is a reliable confirmatory test to check the fertility in men. The supervised machine learning models of base classifiers include Decision Tree, Logistic Regression and Naive Bayes classifiers in which logistic regression shows a promising accuracy of 88%. Comparing with the bagging ensemble method for the weakest classifier, the results show a leap in accuracy from 78.80% to 90.02%. The authors have also attempted to design a novel voting classifier which votes over the ensemble learners and creates a more complex model to give an accuracy of 89%. Apart from this, the authors have also analyzed the receiver operating characteristic (ROC) curve for Extra Tree classifier which shows a 66% of area under the curve (AUC). The validation procedure used is a 5 fold cross-validation. The authors have further analyzed the lifestyle habits responsible for contributing to this problem based on impurity-based feature selection and have obtained ‘Age' as the most crucial factor in declining seminal quality.
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40
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Newton VL, Dickson J, Hoggart L. Young women's fertility knowledge: partial knowledge and implications for contraceptive risk-taking. BMJ SEXUAL & REPRODUCTIVE HEALTH 2020; 46:147-151. [PMID: 31941769 DOI: 10.1136/bmjsrh-2019-200473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/17/2019] [Accepted: 12/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND There is a lack of research on young women's fertility knowledge and awareness. This has implications for contraceptive risk-taking, including the use of emergency hormonal contraception (EHC). By drawing on two research studies, this article shows how greater fertility knowledge could benefit young women in terms of pregnancy prevention. METHODS We draw on two qualitative research studies ('fertility study' and 'abortion study') resulting in a composite sample of 46 interviews with women aged 16-24 years. Focused secondary analysis was undertaken looking specifically at fertility knowledge in relation to contraceptive behaviour. FINDINGS A lack of accurate knowledge about the menstrual cycle was evident in two ways. Young women drew conclusions about their invulnerability to pregnancy if previous unprotected sexual intercourse (UPSI) had not resulted in pregnancy. Additionally, although participants were aware of EHC, there was no awareness of when it might fail other than after a certain time limit. CONCLUSIONS Young women would benefit from a more nuanced understanding of fertility. Episodes of UPSI that do not result in pregnancy can encourage a belief that 'it won't happen to me', and this has implications for taking chances with contraception. Partial knowledge about the effectiveness of EHC may also lead to unintended pregnancy. Calculating the number of hours following UPSI generates overreliance on what is only one of the factors determining the effectiveness of EHC. Information regarding the link between EHC and failure rates near the day of ovulation needs to be more widely publicised.
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Affiliation(s)
- Victoria Louise Newton
- School of Health, Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
| | - Jane Dickson
- Sexual and Reproductive Health, Aneurin Bevan University Health Board, Newport, UK
| | - Lesley Hoggart
- School of Health, Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
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41
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Sousa-Leite M, Figueiredo B, Ter Keurst A, Boivin J, Gameiro S. Women's attitudes and beliefs about using fertility preservation to prevent age-related fertility decline-A two-year follow-up. PATIENT EDUCATION AND COUNSELING 2019; 102:1695-1702. [PMID: 31003877 DOI: 10.1016/j.pec.2019.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The health belief and transtheoretical model were used to describe how women make decisions about fertility preservation (FP) and identify factors that predict their decisions. METHODS This is a two-year prospective study with 107 childless women aged 30-37. Women filled anonline survey assessing individual factors, intentions to do FP, variables of the health belief model, FP decisional stage and FP behaviour. RESULTS Women´s intentions, desire and number of children wanted decreased, fertility knowledge and perceived susceptibility to infertility increased and perceived severity of infertility decreased. A low number of women progressed through the stages of the decision-making process. Only 14% reached a decision and all decided not to do FP. Women's baseline intentions to do FP predicted their decision. CONCLUSION Women at the optimal age range to do FP (28-35 years) do not engage in decision-making about it, which reflects their initial low intentions to do FP. Women's decision about FP is influenced by their perceptions about the technique. PRATICAL IMPLICATIONS Women with a high desire for parenthood and within the optimal age range to do FP should receive accurate information about it and could benefit from prompts to engage in active decision-making about doing it.
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Affiliation(s)
- Mariana Sousa-Leite
- School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.
| | - Bárbara Figueiredo
- School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.
| | - Anne Ter Keurst
- Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, the Netherlands.
| | - Jacky Boivin
- Cardiff Fertility Studies Group, School of Psychology, Cardiff University, 70 Park Place, CF10 3AT, Cardiff, UK.
| | - Sofia Gameiro
- Cardiff Fertility Studies Group, School of Psychology, Cardiff University, 70 Park Place, CF10 3AT, Cardiff, UK.
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42
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Bull JR, Rowland SP, Scherwitzl EB, Scherwitzl R, Danielsson KG, Harper J. Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles. NPJ Digit Med 2019; 2:83. [PMID: 31482137 PMCID: PMC6710244 DOI: 10.1038/s41746-019-0152-7] [Citation(s) in RCA: 183] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/17/2019] [Indexed: 12/21/2022] Open
Abstract
The use of apps that record detailed menstrual cycle data presents a new opportunity to study the menstrual cycle. The aim of this study is to describe menstrual cycle characteristics observed from a large database of cycles collected through an app and investigate associations of menstrual cycle characteristics with cycle length, age and body mass index (BMI). Menstrual cycle parameters, including menstruation, basal body temperature (BBT) and luteinising hormone (LH) tests as well as age and BMI were collected anonymously from real-world users of the Natural Cycles app. We analysed 612,613 ovulatory cycles with a mean length of 29.3 days from 124,648 users. The mean follicular phase length was 16.9 days (95% CI: 10-30) and mean luteal phase length was 12.4 days (95% CI: 7-17). Mean cycle length decreased by 0.18 days (95% CI: 0.17-0.18, R 2 = 0.99) and mean follicular phase length decreased by 0.19 days (95% CI: 0.19-0.20, R 2 = 0.99) per year of age from 25 to 45 years. Mean variation of cycle length per woman was 0.4 days or 14% higher in women with a BMI of over 35 relative to women with a BMI of 18.5-25. This analysis details variations in menstrual cycle characteristics that are not widely known yet have significant implications for health and well-being. Clinically, women who wish to plan a pregnancy need to have intercourse on their fertile days. In order to identify the fertile period it is important to track physiological parameters such as basal body temperature and not just cycle length.
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Affiliation(s)
| | | | | | | | - Kristina Gemzell Danielsson
- Division of Obstetrics and Gynecology, Department of Women’s and Children’s Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Joyce Harper
- Department of Reproductive Health, Institute for Women’s Health, University College London, London, UK
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43
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Baldwin K. The biomedicalisation of reproductive ageing: reproductive citizenship and the gendering of fertility risk. HEALTH RISK & SOCIETY 2019. [DOI: 10.1080/13698575.2019.1651256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Kylie Baldwin
- Centre for Reproduction Research, De Montfort University Leicester, Leicester, UK
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Grace B, Shawe J, Johnson S, Stephenson J. You did not turn up… I did not realise I was invited…: understanding male attitudes towards engagement in fertility and reproductive health discussions. Hum Reprod Open 2019; 2019:hoz014. [PMID: 31218265 PMCID: PMC6573469 DOI: 10.1093/hropen/hoz014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/15/2019] [Indexed: 12/17/2022] Open
Abstract
STUDY QUESTION What are the underlying reasons for low male engagement in fertility and reproductive health discussions and decision-making? SUMMARY ANSWER The perception of women's primacy in fertility and reproductive health limits the extent to which men believe their engagement is important. WHAT IS KNOWN ALREADY Active participation of men in the process of informed decision-making regarding childbearing is beneficial for mother, father, and child. However, in research studies in these areas, little attention has been given to men. Additionally, there is poor engagement by men, as well as a dearth of information from, and on, the male perspective. STUDY DESIGN SIZE DURATION In total, 35 semi-structured telephone and face-to-face interviews were conducted in an office setting with three groups: 13 lay women, 13 lay men, and 9 (2 male and 7 female) healthcare professionals. Interviews took place between October 2016 and February 2017. PARTICIPANTS/MATERIALS SETTING METHODS Participants were men and women of reproductive age from the general population and healthcare professionals who had completed an online fertility awareness survey and agreed to follow-up interviews. Interviews were audio recorded and lasted ~1 hour, during which participants were asked to provide their views on childbearing decision-making, and male and female representation in fertility and reproductive health. Data was transcribed verbatim and analysed qualitatively via framework analysis. MAIN RESULTS AND THE ROLE OF CHANCE Both men and women saw fertility as a woman's issue, but from different viewpoints. Women saw it from the perspective of societal stereotypes regarding male and female roles, whereas men tended to defer to the woman's primacy in reproductive decisions. Men generally wanted to be involved in childbearing discussions and improve their fertility knowledge. However, they felt they did not have a voice on the topic because discussions have traditionally focused on women. The notion that men are not expected to be interested and engaged thus becomes a self-fulfilling prophecy. Healthcare professionals agreed that fertility was perceived as the woman's domain, but also highlighted that poor male involvement is typically observed across healthcare needs and is not necessarily unique to fertility and reproductive health. LIMITATIONS REASONS FOR CAUTION Due to the online recruitment method, there is a potential bias towards respondents of higher, rather than lower, socioeconomic status within the general population. WIDER IMPLICATIONS OF THE FINDINGS Fertility tends to be seen as a private topic. Additional concerted effort by reproductive health researchers, charity organisations, educators, healthcare service providers, and policy makers is needed to proactively encourage male involvement in reproductive decision-making. This can be achieved through normalising and breaking taboos around the topic, male-friendly research study design approaches, male-inclusive reproductive healthcare services, implementation of health policies that recognise the needs of men, encouraging male research staff representation, and age-appropriate educational programmes on sexual and reproductive health, which include boys and adolescents from a young age. STUDY FUNDING/COMPETING INTERESTS Research funding was received from SPD Development Co. Ltd. B.G. and S.J. are employed by SPD Development Co. Ltd. None of the other authors have any conflict of interest related to the discussed topic. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- B Grace
- Research Department of Reproductive Health, UCL Institute for Women’s Health, Faculty of Population Health Sciences, University College London, London, UK
- SPD Development Company Limited, Bedford, UK
| | - J Shawe
- The Institute of Health and Community, Faculty of Health & Human Sciences, the University of Plymouth, Plymouth, UK
| | - S Johnson
- SPD Development Company Limited, Bedford, UK
| | - J Stephenson
- Research Department of Reproductive Health, UCL Institute for Women’s Health, Faculty of Population Health Sciences, University College London, London, UK
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45
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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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Harper JC, Hepburn J, Vautier G, Callander E, Glasgow T, Balen A, Boivin J. Feasibility and acceptability of theatrical and visual art to deliver fertility education to young adults. HUM FERTIL 2019; 24:129-135. [PMID: 30821537 DOI: 10.1080/14647273.2019.1570354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The Fertility Education Initiative was established in 2016 to provide education on fertility, modern families and reproductive science for young adults, teachers, health professionals, parents and adults. We report on our study to determine the feasibility and acceptability of using the arts to delivery fertility education in schools. The evaluation was mixed methods: (i) two focus groups with young people aged 14-16 and 16-18 were conducted to investigate attitudes to fertility awareness; and (ii) seventeen 16-22 year olds were divided into two groups and each undertook a day of art workshops that consisted of two visual and two theatrical workshops and then completed questionnaires at the end of each workshop and at the end of the day. The artists were interviewed using a semi-structured interview. Young adults confirmed they were interested in learning about fertility, but current understanding varied. The majority thought that fertility education should be delivered in schools at ages 16-18. During the art workshops they learnt some facts but asked for more science and discussion. They felt using art was powerful and they wanted to hear the artists personal stories. Tools using a number of platforms need to be developed that can be taken into schools nationally and evaluated for their engagement.
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Affiliation(s)
- Joyce C Harper
- Institute for Women's Health, University College London, London, UK
| | | | | | | | | | - Adam Balen
- Leeds Fertility, Seacroft Hospital, Leeds, UK
| | - Jacky Boivin
- School of Psychology, Cardiff University, Cardiff, UK
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Affiliation(s)
- Hitomi Miura Nakagawa
- GENESIS - Center for Assistance in Human Reproduction, Brasília, DF, Brazil.,President of SBRA - Brazilian Society of Assisted Reproduction
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Mahey R, Gupta M, Kandpal S, Malhotra N, Vanamail P, Singh N, Kriplani A. Fertility awareness and knowledge among Indian women attending an infertility clinic: a cross-sectional study. BMC WOMENS HEALTH 2018; 18:177. [PMID: 30373587 PMCID: PMC6206860 DOI: 10.1186/s12905-018-0669-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/16/2018] [Indexed: 11/10/2022]
Abstract
Background To evaluate fertility knowledge and awareness among infertile women attending an Indian assisted fertility clinic and their understanding of the menstrual cycle, how age affects fertility and need for assisted fertility treatment. Methods A cross sectional study was conducted including 205 women seeking fertility treatment at an assisted reproductive unit between March 2017 to August 2017. Patients were interviewed with the help of structured questionnaire by a fertility counsellor. The previous studies were reviewed and a questionnaire was made according to our patient profile and sociodemographic characteristics. Knowledge and awareness was stratified according to socioeconomic status (SES). Results Most women (59%) were aged between 20 to 30 years indicating concern about their fertility and need for evaluation. More than half (63%) women were from the middle socio-economic strata. Knowledge about fertility and reproduction was low: 85% were not aware of the ovulatory period in the menstrual cycle, only 8% considered age more than 35 years as the most significant risk factor for infertility and most were unaware of when to seek treatment for infertility after trying for pregnancy. Less than half of women understood the need for assisted fertility treatment and donor oocytes in advanced age. Conclusions Most Indian women across different SES are unaware of the effect of age on fertility. Targeted educational interventions are needed to improve knowledge regarding ideal age of fertility, factors affecting fertility potential and fertility options available for sub-fertile couples. Fertility counselling and information should be provided to young people at every contact with health care professionals.
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Affiliation(s)
- Reeta Mahey
- Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Monica Gupta
- Department of Obstetrics & Gynecology, Fellow Reproductive Medicine, All India Institute of Medical Sciences, Room no3076, Third Floor, Teaching Block, Ansari Nagar-, New Delhi, 110029, India.
| | - Shobha Kandpal
- Department of Obstetrics & Gynecology, Medical Social Service Officer, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Malhotra
- Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Perumal Vanamail
- Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Neeta Singh
- Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Alka Kriplani
- Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India
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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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