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Szcześniak M, Falewicz A, Meisner M, Grodecka K. The mediating effect of maturity on anxiety and the motives for postponing parenthood. Sci Rep 2024; 14:20258. [PMID: 39217228 PMCID: PMC11365949 DOI: 10.1038/s41598-024-71043-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024] Open
Abstract
Postponed parenthood is considered one of the most extensive changes in the process of family formation. Among the many reasons for deferred parenthood, those related to greater feelings of incompetence as a potential parent, self-focus, perceiving parenthood as a burden, fearing the changes that the birth of a child may bring to a person's life, financial insecurity, and worrying about the child's future seem particularly important. Since little is known about the motives for delayed parenthood in relation to anxiety and psychological maturity, the main goal of our study was to verify how these variables may be related to each other and whether maturity for parenthood mediates the direct association between anxiety and the motives for delayed parenthood. The sample consisted of 223 Polish adults (the age range of the participants was 18-44 years). The respondents completed the State-Trait Anxiety Inventory (STAI), the Maturity to Parenthood Scale (MPS), and the Multidimensional Scale of Motives for Postponing Parenthood (MSMPP-18). The results showed positive correlations between anxiety and four (uncertainty, burden, change, and finance) of the six motives for postponing parenthood and postponed parenthood overall. Maturity for parenting and all its dimensions correlated negatively with anxiety and all factors of postponed parenthood, except worry about the child's future. In all six of the seven models (except "worry"), at least one of the factors of maturity to parenthood mediated the relationship between trait anxiety and motives for postponing parenthood/total score. Based on the results it can be assumed that a tendency to direct attention to a threat related to the context of child-bearing and child-rearing may lead to lower maturity to parenthood, which in turn may result in various motives for postponing parenthood.
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Affiliation(s)
- Małgorzata Szcześniak
- Faculty of Social Sciences, Institute of Psychology, University of Szczecin, Szczecin, Poland.
| | - Adam Falewicz
- Faculty of Social Sciences, Institute of Psychology, University of Szczecin, Szczecin, Poland
| | | | - Katarzyna Grodecka
- Faculty of Social Sciences, Institute of Psychology, University of Szczecin, Szczecin, Poland
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2
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Weibring K, Lundberg FE, Cohn-Cedermark G, Rodriguez-Wallberg KA. Sperm Quality in 1252 Adolescents and Young Adults (AYAs) Undergoing Fertility Preservation Due to Cancer or Nonmalignant Diseases. J Adolesc Young Adult Oncol 2024. [PMID: 39069896 DOI: 10.1089/jayao.2024.0068] [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: 07/30/2024] Open
Abstract
Purpose: To investigate the quality of emergency-collected semen samples aimed at sperm cryopreservation provided by adolescents and young adults (AYAs) presenting with cancer or nonmalignant diseases. Methods: This is a prospective cohort study of postpubertal males referred for sperm cryopreservation who provided at least one semen sample for fertility preservation at the Reproductive Medicine Clinic of Karolinska University Hospital, Stockholm, Sweden, between January 2009 and January 2020. Sperm quality was assessed by total sperm count, concentration, and motility. Sperm quality by disease groups was compared with the reference population data of fertile men defined by the World Health Organization (WHO). Results: Among the 1252 patients who provided samples for cryopreservation, 1063 had cancer and 189 had nonmalignant diseases. The most common malignant indications included testicular cancers (n = 501) and Hodgkin lymphoma (n = 102). Among those with nonmalignant disease, 35% (n = 66) had testicular disease. Sperm quality was significantly lower in all groups of patients with cancer compared with the reference population. In total, azoospermia was found in 8% of the patients with cancer, in 9% of those with nonmalignant testicular disease, and in 3% of the remaining men with nonmalignant disease. Conclusion: Sperm quality in adult patients with cancer was significantly impaired compared with the WHO reference population standards for fertile men. For adolescent patients, standard reference values are lacking. AYAs wishing to preserve fertility should receive individualized counseling regarding sperm quality at the time of cryopreservation, and in selected cases, banking of additional samples should be recommended depending on the sperm quality parameters.
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Affiliation(s)
- Kristina Weibring
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Frida E Lundberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gabriella Cohn-Cedermark
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Kenny A Rodriguez-Wallberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Laboratory of Translational Fertility Preservation, Karolinska Institutet, Stockholm, Sweden
- Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, Stockholm, Sweden
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3
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Järdmo C, Frisén A, Wängqvist M. Experiences of romantic relationships among early adults who do not turn to their long-term partner when in need of love and support. Scand J Psychol 2023; 64:133-141. [PMID: 36255139 DOI: 10.1111/sjop.12878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/26/2022] [Accepted: 09/27/2022] [Indexed: 11/28/2022]
Abstract
As most early adults in long-term romantic relationships rely on their partner to fulfill their relational needs, relationships with romantic partners are very important to many people at this time of life. However, there is a group of individuals for whom their long-term partner is not the most important person when they need love and support. This study explored experiences of romantic relationships among early adults who do not turn to their long-term partner to meet these needs. Twelve individuals in early adulthood (Mage = 33.3 years; SD = 0.54) were selected from a larger community sample (N = 124) based on their answers on a questionnaire about who they turn to when in need of love and support. A thematic analysis of their answers in interviews about romantic relationships resulted in three main themes: Distancing attitudes toward romantic relationships, Desirable aspects of romantic relationships, and Not thinking about romantic relationships. The results show that these early adults' reflections on romantic relationships were characterized by ambivalence, striving toward independence, and relating to their partner as a person to have fun with rather than someone to share a deep connection with. Participants also expressed disagreement with what they perceived as norms concerning romantic relationships. Taken together, this study illustrates that the experiences of early adults who do not turn to their long-term partner to meet needs of love and support are characterized by a complex interaction between contradictory feelings, values, and behaviors.
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Affiliation(s)
- Caroline Järdmo
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Ann Frisén
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Maria Wängqvist
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
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4
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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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Noroozi M, Safdari-Dehcheshmeh F, Taleghani F, Memar S. Factors influencing the delay in childbearing: A narrative review. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:10-19. [DOI: 10.4103/ijnmr.ijnmr_65_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 09/03/2022] [Accepted: 09/20/2022] [Indexed: 01/26/2023]
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Compans MC, Beaujouan É. De la mise en couple à la première naissance. Le rôle de l’âge à la première cohabitation dans l’entrée en maternité et en paternité. POPULATION 2022. [DOI: 10.3917/popu.2203.0439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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7
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Bodin M, Holmström C, Plantin L, Schmidt L, Ziebe S, Elmerstig E. Preconditions to parenthood: changes over time and generations. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2021; 13:14-23. [PMID: 34136667 PMCID: PMC8178081 DOI: 10.1016/j.rbms.2021.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/16/2021] [Accepted: 03/24/2021] [Indexed: 06/12/2023]
Abstract
Reproductive decision-making and fertility patterns change with time and place, and are influenced by contemporary societal factors. In this paper, we have studied biosocial aspects of reproductive decision-making over time and generations in a Nordic setting. The aim was to explore intergenerational changes and influences on decision-making, especially regarding preconditions to first birth. Twenty-six focus group interviews were conducted in southern Sweden, including a total of 110 participants aged 17-90 years. The analysis of the interviews resulted in six themes: (i) 'Providing security - an intergenerational precondition'; (ii) 'A growing smorgasbord of choices and requirements'; (iii) 'Parenthood becoming a project'; (iv) 'Stretched out life stages'; (v) '(Im)possibilities to procreate'; and (vi) 'Intergenerational pronatalism'. Our findings reflect increasing expectations on what it means to be prepared for parenthood. Despite increasing awareness of the precariousness of romantic relationships, people still wish to build new families but try to be as prepared as possible for adverse events. The findings also show how increasing life expectancy and medical advancements have come to influence people's views on their reproductive timeline.
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Affiliation(s)
- Maja Bodin
- Centre for Sexology and Sexuality Studies, Malmö University, Sweden
| | | | - Lars Plantin
- Centre for Sexology and Sexuality Studies, Malmö University, Sweden
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Denmark
| | - Søren Ziebe
- Fertility Clinic, Copenhagen University Hospital, Denmark
| | - Eva Elmerstig
- Centre for Sexology and Sexuality Studies, Malmö University, Sweden
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Couture V, Delisle S, Mercier A, Pennings G. The other face of advanced paternal age: a scoping review of its terminological, social, public health, psychological, ethical and regulatory aspects. Hum Reprod Update 2020; 27:305-323. [PMID: 33201989 DOI: 10.1093/humupd/dmaa046] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/25/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is a global tendency for parents to conceive children later in life. The maternal dimension of the postponement transition has been thoroughly studied, but interest in the paternal side is more recent. For the moment, most literature reviews on the topic have focused on the consequences of advanced paternal age (APA) on fertility, pregnancy and the health of the child. OBJECTIVE AND RATIONALE The present review seeks to move the focus away from the biological and medical dimensions of APA and synthesise the knowledge of the other face of APA. SEARCH METHODS We used the scoping review methodology. Searches of interdisciplinary articles databases were performed with keywords pertaining to APA and its dimensions outside of biology and medicine. We included scientific articles, original research, essays, commentaries and editorials in the sample. The final sample of 177 documents was analysed with qualitative thematic analysis. OUTCOMES We identified six themes highlighting the interdisciplinary nature of APA research. The 'terminological aspects' highlight the lack of consensus on the definition of APA and the strategies developed to offer alternatives. The 'social aspects' focus on the postponement transition towards reproducing later in life and its cultural dimensions. The 'public health aspects' refer to attempts to analyse APA as a problem with wider health and economic implications. The 'psychological aspects' focus on the consequences of APA and older fatherhood on psychological characteristics of the child. The 'ethical aspects' reflect on issues of APA emerging at the intersection of parental autonomy, children's welfare and social responsibility. The 'regulatory aspects' group different suggestions to collectively approach the implications of APA. Our results show that the field of APA is still in the making and that evidence is lacking to fully address the issues of APA. The review suggests promising avenues of research such as introducing the voice of fathers of advanced age into the research agenda. WIDER IMPLICATIONS The results of this review will be useful for developing policies and preconception health interventions that consider and include prospective fathers of advanced age.
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Affiliation(s)
- Vincent Couture
- Faculty of Nursing, Université Laval, Québec G1V 0A6, Canada.,Research Center of the CHU de Québec-Université Laval, Québec G1L 3L5, Canada
| | - Stéphane Delisle
- Research Center of the CHU de Québec-Université Laval, Québec G1L 3L5, Canada
| | - Alexis Mercier
- Faculty of Nursing, Université Laval, Québec G1V 0A6, Canada
| | - Guido Pennings
- Department of Philosophy and Moral Sciences, Bioethics Institute Ghent, Ghent University, Gent 9000, Belgium
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Adachi T, Endo M, Ohashi K. Uninformed decision-making and regret about delaying childbearing decisions: A cross-sectional study. Nurs Open 2020; 7:1489-1496. [PMID: 32802369 PMCID: PMC7424464 DOI: 10.1002/nop2.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/01/2020] [Indexed: 11/10/2022] Open
Abstract
Aim The aim of this study was to examine regret over the timing of the childbearing decision and reasons for its delay. Design A cross-sectional study. Methods This cross-sectional study included 219 women and 169 men referred to fertility facilities in Japan from July-December 2018. Participants completed a questionnaire on the reasons for their delay in childbearing decision and the degree of regret regarding their decision. Multiple linear regression was used to analyse the association between degree of regret and the reasons for the delay. Results The top three reasons for the delay in childbearing decision in women were "Establishing the relationship," "Health problems," and "Financial security." The top three reasons in men were "Establishing the relationship," "Financial security," and "Lack of fertility knowledge." Multiple linear regression showed that lack of fertility knowledge was associated with regret over the timing of childbearing decisions in women and men.
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Affiliation(s)
- Tomoko Adachi
- Division of Health ScienceGraduate School of MedicineOsaka UniversitySuitaJapan
| | - Masayuki Endo
- Division of Health ScienceGraduate School of MedicineOsaka UniversitySuitaJapan
| | - Kazutomo Ohashi
- Division of Health ScienceGraduate School of MedicineOsaka UniversitySuitaJapan
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10
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Bodin M, Plantin L, Elmerstig E. A wonderful experience or a frightening commitment? An exploration of men's reasons to (not) have children. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2019; 9:19-27. [PMID: 31938736 PMCID: PMC6953767 DOI: 10.1016/j.rbms.2019.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/29/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
Research on reproductive decision-making mainly focuses on women's experiences and desire for children. Men included in this type of research usually represent one-half of a heterosexual couple and/or men who are involuntarily childless. Perspectives from a broader group of men are lacking. This study is based on the results of a baseline questionnaire answered by 191 men aged 20-50 years who attended two sexual health clinics in two major Swedish cities. The questionnaire included questions about sociodemographic background, reproductive history and fertility, but also two open-ended questions focusing on reasons for having or not having children. The results of these two questions were analysed by manifest content analysis and resulted in five categories: '(non-)ideal images', 'to pass something on', 'personal development and self-image', 'the relationship with the (potential) co-parent' and 'practical circumstances and prerequisites'. Reasons for having children were mainly based on ideal images of children, family and parenthood. Meanwhile, reasons for not having children usually concerned practical issues. The type of answer given was related to men's procreative intentions but not to background characteristics. In conclusion, men raised many different aspects for and against having children. Therefore, reproductive decision-making should not be considered a non-choice among men.
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Affiliation(s)
- Maja Bodin
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Centre for Sexology and Sexuality Studies, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Lars Plantin
- Centre for Sexology and Sexuality Studies, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Eva Elmerstig
- Centre for Sexology and Sexuality Studies, Faculty of Health and Society, Malmö University, Malmö, Sweden
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Vichinsartvichai P, Limvorapitux P, Traipak K. What Took You So Long? A Public Health Approach to Mitigate the Delayed Childbearing. FERTILITY & REPRODUCTION 2019. [DOI: 10.1142/s2661318219500208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: The delayed childbearing has doubled in prevalence during the last decade. It affects reproductive health, population distribution and economy. We use the public health approach to survey among women aged at least 35 years seeking fertility treatment. Methods: A self-administered questionnaire-based survey was conducted in women aged at least 35 years attending an infertility clinic in a university hospital. The questionnaire consisted of background information and three domains: (1) reasons for delayed childbearing, (2) required social policy incentives, and (3) acceptability toward infertility treatment. Each domain was scored from ‘5 — most important’ to ‘1 — least important’. Results: A total of 590 women (median age 38.0 years) were recruited; 86.4% of them held at least a bachelor degree and 93.2% had higher income than Thailand’s GDP per capita. They thought that the most appropriate age to have the first child was 28.7 years. The top three reasons for delayed childbearing were “I need more financial security”, “no spouse”, and “I need progress on my career”. The participants thought that “paid paternity leave”, “increase paid maternity leave”, and “good quality childcare” were essential for them to make an earlier fertility decision. The most acceptable infertility treatments were IUI, IVF/ICSI, and social oocyte banking. Conclusions: Women who delayed childbearing focus on financial and career security or finding the proper partner before fertility decision making. However, they have greater concerns over family welfare than money when it comes to domestic issues. The social policy and the related fertility treatment should adapt to serve the needs of the people and promote national fertility rate.
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Affiliation(s)
- Patsama Vichinsartvichai
- Infertility Unit, Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd, Dusit, Bangkok 10300, Thailand
| | - Pawan Limvorapitux
- Infertility Unit, Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd, Dusit, Bangkok 10300, Thailand
| | - Khanitta Traipak
- Infertility Unit, Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd, Dusit, Bangkok 10300, Thailand
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12
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Trends in Childlessness Among Highly Educated Men in Sweden. EUROPEAN JOURNAL OF POPULATION-REVUE EUROPEENNE DE DEMOGRAPHIE 2019; 35:939-958. [PMID: 31832031 PMCID: PMC6883008 DOI: 10.1007/s10680-018-9511-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 12/06/2018] [Indexed: 11/30/2022]
Abstract
Among men with post-secondary degrees in Sweden, one in four are childless by age 45, and this level has been constant over time (in this study, for men born 1956–1972). This high level of childlessness is somewhat surprising in the context of a significant gender imbalance among the highly educated (and thus the relative scarcity of highly educated men). In this study, I examine differences in childlessness among the highly educated by studying how educational prestige, social class, and income are associated with the likelihood of becoming a father. Higher income and social class background are positively associated with fatherhood, and this association has not changed over time. Educational prestige (higher degrees, or degrees from traditional universities) is not positively associated with fatherhood, while 2-year degrees have become more positively associated with fatherhood over time. The findings of this study suggest that socioeconomic resources are important for men's family formation in Sweden compared to educational resources, contrary to expectations from educational homophily and partner market perspectives.
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Sylvest R, Koert E, Birch Petersen K, Malling G, Hald F, Nyboe Andersen A, Schmidt L. Attitudes towards family formation among men attending fertility counselling. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2018; 6:1-9. [PMID: 30182067 PMCID: PMC6120434 DOI: 10.1016/j.rbms.2018.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/06/2018] [Accepted: 06/18/2018] [Indexed: 05/08/2023]
Abstract
Men and women are increasingly postponing childbearing until an age where fertility has decreased, meaning that they might have difficulties in achieving their desired family size. This study explored childless men's attitudes towards family formation. Data were collected through semi-structured qualitative interviews with 21 men attending the Fertility Assessment and Counselling Clinic in Copenhagen or Horsens, Denmark. Data were analysed using content analysis. The men envisioned a nuclear family with their own biological children, but they experienced doubts and ambivalence about parenthood and feeling 'ready'. Their lack of readiness was linked to their awareness of the sacrifices and costs involved with parenthood, and their belief that they could safely delay parenthood. The men did not consider that they may be unable to have their own biological children. This study highlights the importance of considering men's attitudes and preferences towards family formation when understanding couples' decision-making. Contrary to common understanding, the findings show that men are as concerned with the planning and timing of parenthood as women, but their knowledge of the age-related decline in fertility is poor. Men need to gain more awareness of the limitations of fertility and the impact of female and male age on the ability to achieve parenthood aspirations.
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Affiliation(s)
- R. Sylvest
- Fertility Clinic, Department of Obstetrics and Gynaecology, Hvidovre Hospital, University Hospital of Copenhagen, 2650 Hvidovre, Denmark
- Corresponding author.
| | - E. Koert
- Fertility Clinic, University Hospital of Copenhagen, Rigshospitalet, 2100 Copenhagen Ø, Denmark
| | - K. Birch Petersen
- Fertility Clinic, University Hospital of Zealand, 4300 Holbæk, Denmark
| | - G.M.H. Malling
- Department of Public Health, University of Copenhagen, 1014 Copenhagen K, Denmark
| | - F. Hald
- Fertility Clinic, Region Hospital Horsens, 8700, Horsens, Denmark
| | - A. Nyboe Andersen
- Fertility Clinic, University Hospital of Copenhagen, Rigshospitalet, 2100 Copenhagen Ø, Denmark
| | - L. Schmidt
- Department of Public Health, University of Copenhagen, 1014 Copenhagen K, Denmark
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14
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O'Brien Y, Wingfield MB. Reproductive ageing-turning back the clock? Ir J Med Sci 2018; 188:161-167. [PMID: 29500731 DOI: 10.1007/s11845-018-1769-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/15/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Unintended childlessness is a distressing, and often unintended, consequence of delayed childbearing and reproductive ageing. The average maternal age at first birth has risen steadily in many industrialised countries since the 1980s. There are many societal factors involved in the decision to postpone motherhood. As a result, many women are postponing having children until it is too late. In this review, we aim to summarise the reasons behind delayed childbearing, the impact of delayed childbearing and the scientific advances that seek to reverse reproductive ageing and ensure reproductive autonomy for women. METHODS An extensive literature search of PubMed was conducted to include all published articles on delayed childbearing and the consequences of reproductive ageing. Secondary articles were identified from key paper reference listings. CONCLUSION If the current reproductive trends continue, many women will find themselves in the harrowing position of being unintentionally childless. In addition, many will inevitably turn to assisted reproductive technologies in an effort to protect and preserve their reproductive autonomy. However, it is not always possible to reverse the effects of reproductive ageing.
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Affiliation(s)
- Yvonne O'Brien
- Merrion Fertility Clinic, National Maternity Hospital, 60 Lower Mount Street, Dublin 2, D02 NH93, Ireland.
- National Maternity Hospital, Holles Street, Dublin 2, Ireland.
- School of Medicine, University College Dublin, Dublin 4, Ireland.
| | - Mary B Wingfield
- Merrion Fertility Clinic, National Maternity Hospital, 60 Lower Mount Street, Dublin 2, D02 NH93, Ireland
- National Maternity Hospital, Holles Street, Dublin 2, Ireland
- School of Medicine, University College Dublin, Dublin 4, Ireland
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15
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Hammarberg K, Collins V, Holden C, Young K, McLachlan R. Men's knowledge, attitudes and behaviours relating to fertility. Hum Reprod Update 2017; 23:458-480. [PMID: 28333354 DOI: 10.1093/humupd/dmx005] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/26/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The increasingly common practice in high-income countries to delay childbearing to the fourth and fifth decades of life increases the risk of involuntary childlessness or having fewer children than desired. Older age also increases the risk of age-related infertility, the need for ART to conceive, and obstetric and neonatal complications. Existing research relating to childbearing focusses almost exclusively on women, and in public discourse declining fertility rates are often assumed to be the result of women delaying childbearing to pursue other life goals such as a career and travel. However, evidence suggests that the lack of a partner or a partner willing to commit to parenthood is the main reason for later childbearing. OBJECTIVE AND RATIONALE To better understand men's contributions to childbearing decisions and outcomes, the literature pertaining to men's fertility-related knowledge, attitudes and behaviours was reviewed. SEARCH METHODS The electronic databases of Medline, Embase and PsycINFO were searched to identify investigations of men's knowledge, attitudes and behaviours relating to fertility, infertility, reproductive health or childbearing using relevant fertility keyword search terms. Studies were included if they had investigated factors associated with men's fertility-related knowledge, attitudes and behaviours, had been conducted in a high-income country and were published in an English language peer-reviewed journal between January 2005 and August 2016. OUTCOMES The search yielded 1349 citations. Of these, 47 papers representing 43 unique studies were included in the review. Where response rate was reported, it ranged between 13 and 94%. Studies varied in terms of research design; inclusion and exclusion criteria; recruitment strategies; adequacy of sample size; recruitment and retention rates and data collection tools. However, findings were consistent and indicate that men almost universally value parenthood, want and expect to become fathers, and aspire to have at least two children. Yet most men have inadequate knowledge about the limitations of female and male fertility and overestimate the chance of spontaneous and assisted conception. Perceptions of ideal circumstances in which to have children included being in a stable and loving relationship, having completed studies, secured a permanent job and a dependable income, having achieved personal maturity, and having a partner who desires children and is 'suitable' as a potential co-parent. Although all studies were conducted in high-income countries, between-country social and cultural differences may have influenced the findings relating to attitudes. WIDER IMPLICATIONS Men aspire to parenthood as much as women do but have limited knowledge about the factors that influence fertility. The gap between ideal biological and ideal social age for having children appears to be widening, narrowing the time frame in which parenthood can be achieved. This may lead to unfulfilled parenthood aspirations. The findings can inform government policies and public education strategies aimed to support childbearing during the most fertile years, reduce the personal and societal cost of infertility and ART use, and allow people to fulfil their parenthood goals.
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Affiliation(s)
- Karin Hammarberg
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne 3004, Australia.,Victorian Assisted Reproductive Treatment Authority, Level 30, 570 Bourke Street, Melbourne 3000, Australia
| | - Veronica Collins
- Andrology Australia, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne 3004, Australia
| | - Carol Holden
- Andrology Australia, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne 3004, Australia
| | - Kate Young
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne 3004, Australia
| | - Robert McLachlan
- Andrology Australia, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne 3004, Australia.,Hudson Institute of Medical Research, 27-31 Wright Street, Clayton 3168, Australia
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Simoni MK, Mu L, Collins SC. Women's career priority is associated with attitudes towards family planning and ethical acceptance of reproductive technologies. Hum Reprod 2017; 32:2069-2075. [DOI: 10.1093/humrep/dex275] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 08/02/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Michael K. Simoni
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, 310 Cedar St., New Haven, CT 06510, USA
| | - Lin Mu
- Yale School of Medicine, 333 Cedar St., New Haven, CT 06510, USA
| | - Stephen C. Collins
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, 310 Cedar St., New Haven, CT 06510, USA
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Schick M, Sexty R, Ditzen B, Wischmann T. Attitudes towards Social Oocyte Freezing from a Socio-cultural Perspective. Geburtshilfe Frauenheilkd 2017; 77:747-755. [PMID: 28729744 DOI: 10.1055/s-0043-111412] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/15/2017] [Accepted: 05/15/2017] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION The tendency to delay parenthood is increasing. It is partly driven by the availability of early reproductive technologies such as social oocyte freezing, the cryopreservation of oocytes for non-medical purposes. The goal of this study was to investigate relationships between attitudes towards social oocyte freezing and different socio-cultural backgrounds in a German sample cohort. MATERIALS AND METHODS A quantitative online questionnaire was compiled. A total of 643 participants completed the questionnaire which included items on attitudes toward social oocyte freezing, socio-demographics and items, obtained from the German DELTA Institute for Social and Ecological Research, devised to indicate specific milieus. Data were analyzed using parametric and non-parametric methods. RESULTS There were clear correlations between attitudes towards social oocyte freezing and socio-cultural background, gender, cohort age, fertility problems, and attitudes to fertility. Positive attitudes towards social oocyte freezing were linked to struggles with fertility, a current or general wish to have a child, and flexible, progressive and self-oriented values. Participants who preferred to become parents at a younger age tended to reject cryopreservation. CONCLUSIONS The huge number of university graduates, persons with fertility problems, and persons from specific socio-cultural backgrounds in our sample point to distinct groups interested in reproductive technologies such as social oocyte freezing. The investigated differences as a function of socio-cultural background suggest that more research into the desire to have children in German society is needed. In conclusion, it may be necessary to develop targeted family planning interventions to prevent affected women from buying into a false sense of security, thereby risking unwanted childlessness.
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Affiliation(s)
- Maren Schick
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University Hospital, Heidelberg, Germany
| | - Réka Sexty
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University Hospital, Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University Hospital, Heidelberg, Germany
| | - Tewes Wischmann
- Institute of Medical Psychology, Centre for Psychosocial Medicine, University Hospital, Heidelberg, Germany
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Brehmer L, Alexanderson K, Schytt E. Days of sick leave and inpatient care at the time of pregnancy and childbirth in relation to maternal age. Scand J Public Health 2017; 45:222-229. [PMID: 28443491 DOI: 10.1177/1403494817693456] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS To explore whether older women differ from younger women with respect to sick leave and inpatient care at the time around their first pregnancy and delivery. METHODS This was a descriptive population-based cohort study. The study population included all 236,176 nulliparous women registered as living in Sweden who gave birth to their first singleton infant in 2006-2010. Data from nationwide Swedish registers were used. Maternal age was categorized in five-year intervals. Time was calculated in years with the delivery date as the starting point, from two years before and up to three years after delivery. Descriptive statistics were used to calculate mean values and ANOVA tables were used to obtain the 95% confidence intervals of the means. Restriction was used to reduce potential confounding. RESULTS Women aged ⩾35 years had a higher annual mean number of sick leave days from two years before to one year after their delivery date compared with younger women. The range for all age categories in the year before the delivery date, including pregnancy, was 15.3-37.4 mean sick leave days. The mean number of inpatient days increased with each age category during the year after the date of delivery in the range 1.4-4.3 days. CONCLUSIONS This first explorative study indicates the need for more knowledge on morbidity among older primiparous women. They had a higher number of days with sick leave and hospitalization in the year before and after their delivery date. This might reflect higher health risks during pregnancy and childbirth among older women; however, social factors and reverse causation might also be influential.
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Affiliation(s)
- Lovisa Brehmer
- 1 Center for Clinical Research Dalarna, Sweden.,2 Division of Insurance Medicine, Department of Neuroscience, Karolinska Institutet, Sweden
| | - Kristina Alexanderson
- 2 Division of Insurance Medicine, Department of Neuroscience, Karolinska Institutet, Sweden
| | - Erica Schytt
- 1 Center for Clinical Research Dalarna, Sweden.,3 Bergen University College, Norway
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Pritchard N, Kirkman M, Hammarberg K, McBain J, Agresta F, Bayly C, Hickey M, Peate M, Fisher J. Characteristics and circumstances of women in Australia who cryopreserved their oocytes for non-medical indications. J Reprod Infant Psychol 2017. [DOI: 10.1080/02646838.2016.1275533] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Natasha Pritchard
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Maggie Kirkman
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Karin Hammarberg
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - John McBain
- Melbourne IVF, East Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | | | | | - Martha Hickey
- Royal Women’s Hospital, Parkville, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Michelle Peate
- Royal Women’s Hospital, Parkville, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Jane Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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20
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McAllister LS, Pepper GV, Virgo S, Coall DA. The evolved psychological mechanisms of fertility motivation: hunting for causation in a sea of correlation. Philos Trans R Soc Lond B Biol Sci 2016; 371:20150151. [PMID: 27022078 DOI: 10.1098/rstb.2015.0151] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2016] [Indexed: 11/12/2022] Open
Abstract
Cultural, ecological, familial and physiological factors consistently influence fertility behaviours, however, the proximate psychological mechanisms underlying fertility decisions in humans are poorly understood. Understanding the psychological mechanisms underlying human fertility may illuminate the final processes by which some of these known predictors have their influence. To date, research into the psychological mechanisms underlying fertility has been fragmented. Aspects of reproductive psychology have been examined by researchers in a range of fields, but the findings have not been systematically integrated in one review. We provide such a review, examining current theories and research on psychological mechanisms of fertility. We examine the methods and populations used in the research, as well as the disciplines and theoretical perspectives from which the work has come. Much of the work that has been done to date is methodologically limited to examining correlations between ecological, social and economic factors and fertility. We propose, and support with examples, the use of experimental methods to differentiate causal factors from correlates. We also discuss weaknesses in the experimental research, including limited work with non-WEIRD (western, educated, industrialized, rich and democratic) populations.
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Affiliation(s)
- Lisa S McAllister
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA 93106, USA
| | - Gillian V Pepper
- Evolutionary Demography Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Sandra Virgo
- Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK
| | - David A Coall
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA 6009, Australia
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Abstract
The aim of the Postponing Parenthood project was to investigate several aspects of the delaying of childbearing phenomenon in Sweden and Norway, such as medical risks and parental experiences. Data were retrieved from the Swedish and Norwegian Medical Birth Registers and three different cohorts: the Swedish Young Adult Panel Study, the Norwegian Mother and Child Cohort, and the Swedish Women's Experiences of Childbirth cohort. Postponing childbirth to age 35 years and later increased the risk of rare but serious pregnancy outcomes, such as stillbirth and very preterm birth. Older first-time parents were slightly more anxious during pregnancy, and childbirth overall was experienced as more difficult, compared with younger age groups. First-time mothers' satisfaction with life decreased from about age 28 years, both when measured during pregnancy and early parenthood. Delaying parenthood to mid-30 or later was more related to lifestyle than socioeconomic factors, suggesting that much could be done in terms of informing young persons about the limitations of fertility and assisted reproductive techniques, and the risks associated with advanced parental age.
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Affiliation(s)
- Ulla Waldenström
- CONTACT Ulla Waldenström Bastugatan 42, 118 25 Stockholm, Sweden
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22
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Kariman N, Amerian M, Jannati P, Salmani F. Factors influencing first childbearing timing decisions among men: Path analysis. Int J Reprod Biomed 2016. [DOI: 10.29252/ijrm.14.9.589] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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23
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Heywood W, Pitts MK, Patrick K, Mitchell A. Fertility knowledge and intentions to have children in a national study of Australian secondary school students. Aust N Z J Public Health 2016; 40:462-467. [PMID: 27524176 DOI: 10.1111/1753-6405.12562] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 02/01/2016] [Accepted: 04/01/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This paper reports on fertility knowledge and intentions to have children among a national sample of students in years 10-12. METHOD Data were from the Fifth National Survey of Australian Secondary Students and Sexual Health. Students identified factors that could affect fertility, if they wanted children and at what age. RESULTS Most students wanted to have children (77%). Of those who wanted children or were unsure (n=1,780), 54% were able to identify six of eight factors that could affect fertility. Male students had poorer knowledge than females. Poorer knowledge was also reported by male students who were born overseas or used marijuana and by female students who were sexually active or religious. More than half the students (59%) wanted their first child aged 25-29, while 19% wanted their first child after 30. Intentions to have children at an earlier age were associated with being religious, sexually active (females), and using marijuana (males). Students not exclusively attracted to the opposite sex were more likely to want children at an older age. CONCLUSIONS AND IMPLICATIONS Most students typically want children in their late 20s. Many were unaware of factors that could affect their fertility and there was a mismatch between intentions and likely behaviour. These factors could be addressed as part of relationship education.
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Affiliation(s)
- Wendy Heywood
- Australian Research Centre in Sex, Health and Society, La Trobe University, Victoria.
| | - Marian K Pitts
- Australian Research Centre in Sex, Health and Society, La Trobe University, Victoria
| | - Kent Patrick
- Australian Research Centre in Sex, Health and Society, La Trobe University, Victoria
| | - Anne Mitchell
- Australian Research Centre in Sex, Health and Society, La Trobe University, Victoria
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Birch Petersen K, Sylvest R, Nyboe Andersen A, Pinborg A, Westring Hvidman H, Schmidt L. Attitudes towards family formation in cohabiting and single childless women in their mid- to late thirties. HUM FERTIL 2016; 19:48-55. [PMID: 27006139 DOI: 10.3109/14647273.2016.1156171] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study aimed to explore attitudes towards family formation in single or cohabiting childless women of advanced age. The design comprised semi-structured qualitative interviews of 20 women aged 34-39 years attending the Fertility Assessment and Counselling Clinic, Rigshospitalet, Copenhagen. A sample of 10 single women and 10 cohabiting women was chosen with equal distribution of postgraduate education length. Data were analysed using content analysis following the method of Graneheim and Lundman and consolidated criteria for reporting qualitative research (COREQ). The general attitude towards family formation was characterized by a fear of the consequences of choosing motherhood on one hand, and a 'ticking biological clock' and a wish to establish a nuclear family on the other. The women idealized the perception of perfect mothering in terms of uncompromising expectations of child rearing and showed an increasing awareness of solo motherhood as a possible solution to advanced age, the wish of a child and single status compared to earlier studies. Our study contributes to knowledge and understanding of personal considerations related to childbearing in nullipara women in their mid- to late 30s and may be useful in a fertility assessment and counselling setting.
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Affiliation(s)
- Kathrine Birch Petersen
- a Fertility Clinic, Rigshospitalet , University Hospital of Copenhagen , Copenhagen , Denmark
| | - Randi Sylvest
- a Fertility Clinic, Rigshospitalet , University Hospital of Copenhagen , Copenhagen , Denmark
| | - Anders Nyboe Andersen
- a Fertility Clinic, Rigshospitalet , University Hospital of Copenhagen , Copenhagen , Denmark
| | - Anja Pinborg
- b Department of Obstetrics and Gynecology, Fertility Clinic , Hvidovre Hospital, University of Copenhagen , Hvidovre , Denmark
| | - Helene Westring Hvidman
- a Fertility Clinic, Rigshospitalet , University Hospital of Copenhagen , Copenhagen , Denmark
| | - Lone Schmidt
- c Department of Public Health , University of Copenhagen , Copenhagen , Denmark
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Birch Petersen K, Hvidman HW, Sylvest R, Pinborg A, Larsen EC, Macklon KT, Andersen AN, Schmidt L. Family intentions and personal considerations on postponing childbearing in childless cohabiting and single women aged 35-43 seeking fertility assessment and counselling. Hum Reprod 2015; 30:2563-74. [PMID: 26401054 DOI: 10.1093/humrep/dev237] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/27/2015] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What characterizes childless women aged 35 years and above seeking fertility assessment and counselling in relation to their reproduction and are there significant differences between single and cohabiting women? SUMMARY ANSWER Despite the women's advanced age and knowledge of the age-related decline in fecundity, 70% of the single women sought fertility assessment and counselling to gain knowledge regarding the possibility of postponing pregnancy. WHAT IS KNOWN ALREADY Recent studies have indicated an increasing demand for ovarian reserve testing in women without any known fertility problem to obtain knowledge on their reproductive lifespan and pro-fertility advice. Women postpone their first pregnancy, and maternal age at first birth has increased in western societies over the past two to four decades. Postponed childbearing implies a higher rate of involuntary childlessness, smaller families than desired and declining fertility rates. STUDY DESIGN, SIZE, AND DURATION Baseline data from a cross-sectional cohort study of 340 women aged 35-43 years examined at the Fertility Assessment and Counselling (FAC) Clinic at Copenhagen University Hospital from 2011 to 2014. The FAC Clinic was initiated to provide individual fertility assessment and counselling. PARTICIPANTS/MATERIALS, SETTING, METHODS Eligible women were childless and at least 35 years of age. All completed a web-based questionnaire before and after the consultation including socio-demographic, reproductive, medical, lifestyle and behavioural factors. Consultation by a fertility specialist included transvaginal ultrasound, full reproductive history and AMH measurement. MAIN RESULTS AND THE ROLE OF CHANCE The study comprised 140 cohabiting and 200 single women. The majority (82%) were well-educated and in employment. Their mean age was 37.4 years. Nonetheless, the main reasons for attending were to obtain knowledge regarding the possibility of postponing pregnancy (63%) and a concern about their fecundity (52%). The majority in both groups (60%) wished for two or more children. The women listed their ideal age at birth of first child and last child as 33 (±4.7) years and 39 (±3.5) years, respectively. Of the single women, 70% would accept use of sperm donation compared with 25% of the cohabiting women (P < 0.001). In general, 45% considered oocyte vitrification for social reasons, yet only 15% were positive towards oocyte donation. The two groups were comparable regarding lifestyle factors, number of previous sexual partners, pregnancies, and ovarian reserve parameters. LIMITATIONS, REASONS FOR CAUTION The women in the present study were conscious of the risk of infertility with increasing age and attended the FAC Clinic due to a concern about their remaining reproductive lifespan, which in combination with their high educational level could impair the generalizability to the background population. WIDER IMPLICATIONS OF THE FINDINGS The results indicate that in general women overestimate their own reproductive capacity and underestimate the risk of future childlessness with the continuous postponement of pregnancies.
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Affiliation(s)
- K Birch Petersen
- Fertility Clinic, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - H W Hvidman
- Fertility Clinic, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - R Sylvest
- Fertility Clinic, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - A Pinborg
- Department of Gynaecology/Obstetrics, Copenhagen University Hospital Hvidovre Hospital, Kettegård Alle 30, DK-2650 Hvidovre, Copenhagen, Denmark
| | - E C Larsen
- Fertility Clinic, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - K T Macklon
- Fertility Clinic, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - A Nyboe Andersen
- Fertility Clinic, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - L Schmidt
- Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, PO Box 2099, DK-1071 Copenhagen K, Denmark
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Nilsen ABV, Waldenström U, Espehaug B, Schytt E. Still childless at the age of 32: An investigation of predictors in 22-year-old women and men. Scand J Public Health 2015; 43:481-9. [DOI: 10.1177/1403494815576269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2015] [Indexed: 11/16/2022]
Abstract
Aim: The aim of this study was to investigate if family background and attitudes in early adulthood contribute to postponement of parenthood. Postponement of parenthood is associated with increased need for artificial reproductive techniques, increased risk for adverse pregnancy outcomes and reduced fertility rates. Methods: This was a cohort study including 1000 women and men aged 22 years from the Swedish Young Adult Panel Study. Questionnaire data were linked to information from the Swedish Total Population Register 10 years later. Logistic regression analyses were conducted. Results: Background factors associated with being childless were: being second-generation Polish or Turkish (odds ratio [OR] 1.5; 95% confidence intervals [CI] 1.2–2.0), growing up in a large city (OR 1.5; 95% CI 1.1–2.0), well-educated mother (OR 1.5; 95% CI 1.1–1.9) or father (OR 1.4; 95% CI 1.1–1.9), no siblings (OR 1.9; 95% CI 1.1–3.2), living in parental home (OR 2.2; 95% CI 1.6–3.1), less than good assessment of own mother (OR 1.8; 95% CI 1.2–2.7) or father (OR 1.4; 95% CI 1.0–1.9) as a parent, and less than satisfactory relationship with own mother (OR 1.5; 95% CI 1.1–2.1). Attitudes associated with being childless were: not enjoying children (OR 2.7; 95% CI 2.0–3.6), finding that one could be satisfied in life without being a good parent (OR 2.3; 95% CI 1.7–3.0) and not assuming that one will have children in the future (OR 2.9; 95% CI 2.1–3.9). Conclusions: The findings suggest that postponement of parenthood to the age of 32 could partly be explained by family background and negative or ambivalent attitudes to children and parenthood in early adulthood.
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Affiliation(s)
- Anne Britt Vika Nilsen
- Department of Women’s and Children’s Health, Karolinska Institutet, Sweden
- Centre for Evidence-Based Practice, Bergen University College, Norway
| | - Ulla Waldenström
- Department of Women’s and Children’s Health, Karolinska Institutet, Sweden
| | - Birgitte Espehaug
- Centre for Evidence-Based Practice, Bergen University College, Norway
| | - Erica Schytt
- Department of Women’s and Children’s Health, Karolinska Institutet, Sweden
- Centre for Clinical Research Dalarna, Sweden
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Abstract
PURPOSE OF REVIEW To review the most important and interesting articles in infertility published in the last year. RECENT FINDINGS This systematic review covers 60 studies published in journals or dissertations in Science Direct and PubMed in the last year, including those related to prevention and treatment as well as related psychosocial services in infertility. We also propose some suggestions about coping with infertility in China. SUMMARY Infertility is a multidisciplinary problem that requires medical, social, and political efforts to prevent and offer infertile patients the best diagnostic, therapeutic, and psychosocial services. Cultural factors should be taken into consideration when designing coping strategies.
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Aasheim V, Waldenström U, Rasmussen S, Espehaug B, Schytt E. Satisfaction with life during pregnancy and early motherhood in first-time mothers of advanced age: a population-based longitudinal study. BMC Pregnancy Childbirth 2014; 14:86. [PMID: 24564871 PMCID: PMC3975966 DOI: 10.1186/1471-2393-14-86] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 02/18/2014] [Indexed: 12/11/2022] Open
Abstract
Background The trend to delay motherhood to the age of 30 and beyond is established in most high-income countries but relatively little is known about potential effects on maternal emotional well-being. This study investigates satisfaction with life during pregnancy and the first three years of motherhood in women expecting their first baby at an advanced and very advanced age. Methods The study was based on the National Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Data on 18 565 nulliparous women recruited in the second trimester 1999–2008 were used. Four questionnaires were completed: at around gestational weeks 17 and 30, and at six months and three years after the birth. Medical data were retrieved from the national Medical Birth Register. Advanced age was defined as 32–37 years, very advanced age as ≥38 years and the reference group as 25–31 years. The distribution of satisfaction with life from age 25 to ≥40 years was investigated, and the mean satisfaction with life at the four time points was estimated. Logistic regression analyses based on generalised estimation equations were used to investigate associations between advanced and very advanced age and satisfaction with life when controlling for socio-demographic factors. Results Satisfaction with life decreased from around age 28 to age 40 and beyond, when measured in gestational weeks 17 and 30, and at six months and three years after the birth. When comparing women of advanced and very advanced age with the reference group, satisfaction with life was slightly reduced in the two older age groups and most of all in women of very advanced age. Women of very advanced age had the lowest scores at all time points and this was most pronounced at three years after the birth. Conclusion First-time mothers of advanced and very advanced age reported a slightly lower degree of satisfaction with life compared with the reference group of younger women, and the age-related effect was greatest when the child was three years of age.
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Affiliation(s)
- Vigdis Aasheim
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
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