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Krishnan S, Daly MP, Kipping R, Harrison C. A systematic review of interventions to improve male knowledge of fertility and fertility-related risk factors. HUM FERTIL 2024; 27:2328066. [PMID: 38497245 DOI: 10.1080/14647273.2024.2328066] [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: 10/25/2023] [Accepted: 03/02/2024] [Indexed: 03/19/2024]
Abstract
Male infertility is a global health concern. The effectiveness of interventions developed to improve males' knowledge of fertility regulation and fertility-related risk factors remains unclear. This systematic review aimed to synthesize and evaluate the evidence for these interventions. Four databases were searched from inception to June 2023. Eligible studies examined interventions to increase fertility knowledge among presumed fertile males aged ≥16 years of age. Conference abstracts, protocols and studies without sex-disaggregated results for males were excluded. A narrative synthesis without meta-analysis was performed. A total of 4884 records were identified. Five studies (reported in six publications), all conducted in high-income countries, were included. Two were randomized control trials, and three were experimental studies. Interventions were delivered in person by a health professional (n = 3), online and via a mobile app. All studies showed a significant improvement in knowledge of fertility or fertility-related risk factors from baseline to follow-up. The largest improvement was observed for secondary and vocational students. A moderate, long-term retainment of knowledge was observed at two-year follow-up in one study. Available evidence suggests interventions to improve males' fertility knowledge are effective, particularly for younger, less educated males.
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Affiliation(s)
- Srinithy Krishnan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Michael P Daly
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ruth Kipping
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - China Harrison
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, UK
- National Institute for Health and Care Research, Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Araya BM, Velez MP, Gelaye KA, Dyer S, Aldersey HM. Addressing the Rehabilitation Needs of Women Experiencing Infertility in Ethiopia: Time for Action. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:475. [PMID: 38673386 PMCID: PMC11049831 DOI: 10.3390/ijerph21040475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
The psychological, social, and financial disabilities caused by infertility are significant for women, particularly those living in low- and middle-income countries such as Ethiopia. Although rehabilitation can be an important form of support for such women, infertility is frequently overlooked as a disability or potential target of rehabilitation interventions. This study aimed to determine what rehabilitation-related services and supports are available for women experiencing infertility in Ethiopia. We used an Interpretive Description design. We purposefully selected fourteen rehabilitation, medical, and policy service providers from diverse institutions across three geographical locations. We used semi-structured questions during our in-person and telephone interviews. The data were analyzed using reflexive thematic analysis with the assistance of NVivo. We identified five main themes, including (a) policies related to infertility, (b) the concept that disabilities are physically visible fails to recognize infertility, (c) the need for rehabilitation services for women with infertility, (d) the importance of wellness services for women experiencing infertility, and (e) the role of religion in rehabilitation services. In conclusion, it is essential to strengthen the policies around infertility, incorporate rehabilitation services in fertility care, and view infertility as a disabling condition for women who experience it in Ethiopia.
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Affiliation(s)
- Bilen Mekonnen Araya
- Department of Rehabilitation Science, School of Rehabilitation Therapy, Queen’s University, 31 George St., Kingston, ON K7L 3N6, Canada
- Department of Clinical Midwifery, School of Midwifery, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Maria P. Velez
- Department of Obstetrics and Gynaecology, Queen’s University, Kingston, ON K7L 2V7, Canada;
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar P.O. Box 196, Ethiopia;
| | - Silke Dyer
- Department of Obstetrics and Gynaecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town 7701, South Africa;
| | - Heather M. Aldersey
- School of Rehabilitation Therapy, Queen’s University, 31 George St., Kingston, ON K7L 3N6, Canada;
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Buljubašić A, Švaljug D, Mudnić Pulje M, Gusar I, Jerković J, Jerončić Tomić I. Knowledge about Fertility in Croatia, Measured with the Croatian Version of the Cardiff Fertility Knowledge Scale (CFKS-Hr), in Relation to Attitudes toward Having a Child and Associated Factors in a Cross-Sectional Survey. NURSING REPORTS 2024; 14:816-828. [PMID: 38651475 PMCID: PMC11036257 DOI: 10.3390/nursrep14020063] [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: 01/16/2024] [Revised: 03/27/2024] [Accepted: 03/30/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Fertility is a crucial component of population maintenance and growth. A declining fertility trend has been observed over the past two decades, and it continues. The birth rate in the Republic of Croatia is continuously decreasing, which is insufficient to maintain its population. OBJECTIVE This research aimed to examine the level of fertility knowledge, factors influencing fertility knowledge, and the relationship between fertility knowledge and the decision to have a child. METHODS A cross-sectional study was conducted on a sample of mothers in five hospitals on the Adriatic coast of the Republic of Croatia, involving 1541 mothers, 18 years and older, from September 2021 to December 2023. The Cardiff Fertility Knowledge Scale (CFKS) was used for the research. The participants were divided into four groups according to age. The analysis was conducted using SPSS software (version 22.0). Descriptive statistics, chi-squared tests, t-tests, and Pearson's correlations were used for the data analysis. RESULTS The average percent correct score on the CFKS was 51.8% (SD 22.6), with greater knowledge being significantly related to married status and higher education status (both p < 0.05). A total of 83% of mothers who have one child want to have more children. Fewer mothers who have two children want to have more children (42%), while only 11% of mothers who have three or more children want to have more children. There is no significant relationship between the CFKS and the importance of childbearing in the future (p = 0.12). Respondents indicated that they gained most of their knowledge from the internet (31%) and from the healthcare system (33%). CONCLUSIONS The research results reveal a lack of fertility knowledge among participants, as well as an intention to have a child in the later stages of life. The lack of formal education on this topic leads to information gathering from friends, newspapers, television, and the internet. This study was not registered.
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Affiliation(s)
- Ante Buljubašić
- Department of Health Studies, University of Split, 21000 Split, Croatia; (M.M.P.); (J.J.)
| | - Deana Švaljug
- Faculty of Health Studies Rijeka, University of Rijeka, 51000 Rijeka, Croatia;
| | - Martina Mudnić Pulje
- Department of Health Studies, University of Split, 21000 Split, Croatia; (M.M.P.); (J.J.)
| | - Ivana Gusar
- Department of Health Studies, University of Zadar, 23000 Zadar, Croatia;
| | - Jelena Jerković
- Department of Health Studies, University of Split, 21000 Split, Croatia; (M.M.P.); (J.J.)
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Sylvest R, Koert E, Balslev J, Steenberg M, Schmidt L, Ziebe S. How to talk to young adults about fertility. Reprod Biomed Online 2024; 49:103937. [PMID: 38744029 DOI: 10.1016/j.rbmo.2024.103937] [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: 10/04/2023] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 05/16/2024]
Abstract
RESEARCH QUESTION How knowledgeable are Danish young adults about fertility and what are their attitudes towards learning about their reproductive biology? DESIGN The study was conducted at different educational institutions with 11 focus-group discussions that included a total of 47 participants (aged 18-29 years). Qualitative content analysis was used. The participants' fertility knowledge score was measured using the Cardiff Fertility Knowledge Scale. RESULTS The participants had an overall fertility knowledge score of 54%. Focus-group data showed that they thought it was important to learn about fertility and how to protect their fertility potential regardless of whether or not they wanted children. Providing knowledge is like planting a seed in the young adults. They wanted to hear about fertility in multifaceted ways and formats, and believed the information should be delivered by professionals, but developed in partnership with young people. The double-edged sword of knowledge and the consequence of knowledge made them hesitant or less open to learning. CONCLUSIONS Recommendations from this study are to tailor fertility information to young people, with due cognisance of their developmental stage, and ideally from an earlier age.
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Affiliation(s)
- Randi Sylvest
- Department of Gynecology, Fertility and Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Denmark.
| | - Emily Koert
- Department of Public Health, University of Copenhagen, Denmark
| | - Julie Balslev
- Department of Public Health, University of Copenhagen, Denmark
| | | | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Denmark
| | - Søren Ziebe
- Department of Gynecology, Fertility and Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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He Y, Abdul Wahab NET, Muhamad H. Factors impacting fertility anxiety among Chinese young women with marital status differences. Heliyon 2024; 10:e23715. [PMID: 38192755 PMCID: PMC10772621 DOI: 10.1016/j.heliyon.2023.e23715] [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: 07/15/2023] [Revised: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024] Open
Abstract
Background China's societal and cultural significance placed on female fertility and the changing roles of women can lead to fertility anxiety in both married and unmarried women. This anxiety is shaped by factors such as social media use, intergroup emotions, fertility risk perceptions, and national policies. This study examines the interplay of these factors in understanding fertility anxiety among Chinese women. Methods This study surveyed 607 young Chinese women using the Fertility Anxiety Scale developed by Zhang and Zhao. Mplus software was used for latent class analysis of respondents' fertility anxiety. A three-step approach with multinomial logistic regression was used to explore factors influencing fertility anxiety among married and unmarried women. Results The latent class analysis supported a two-category model: "high fertility anxiety" (65.70 % married, 53.70 % unmarried) and "low fertility anxiety" (34.30 % married, 46.30 % unmarried). Multinomial logistic regression showed that increased social media usage intensity and perception of health-family risks correlated with higher fertility anxiety in both married and unmarried women. Among unmarried women, intergroup emotions and perceptions of occupational-economic risks also influenced fertility anxiety. Attention to national policies did not significantly impact fertility anxiety among young women. Conclusion This study sheds light on the complex interplay of societal and individual factors in shaping fertility anxiety among young Chinese women. It underscores the enduring cultural significance placed on female fertility and the evolving roles of women in modern China. Regardless of their marital status, both married and unmarried women experience fertility anxiety, highlighting the pervasiveness of this concern.
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Affiliation(s)
- Yiqing He
- Department of Anthropology and Sociology, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Noor Eshah Tom Abdul Wahab
- Department of Anthropology and Sociology, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Haslina Muhamad
- Department of Anthropology and Sociology, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia
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Fujishima A, Maeda E, Sato K, Saito H, Ozeki C, Terada Y. Feasibility and effectiveness of preconception check-ups at workplaces in Japan. J Occup Health 2024; 66:uiae021. [PMID: 38684110 DOI: 10.1093/joccuh/uiae021] [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: 10/30/2023] [Revised: 03/22/2024] [Accepted: 04/08/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVES Despite the recent increase in infertility and perinatal complications, preconception care is not commonly available in Japan. Working women are considered to have the greatest need for preconception care, as increasingly they marry and have children later in life. This study aimed to assess the feasibility and effectiveness of preconception check-ups in the workplace. METHODS We provided 51 female employees aged 18-39 years with free preconception check-ups, including additional blood tests and an online medical questionnaire, during mandatory health check-ups at their workplace. A doctor provided online counseling based on the check-up results. We assessed fertility knowledge using the Cardiff Fertility Knowledge Scale (CFKS-J) and childbearing desire pre- and postintervention. RESULTS Preconception check-ups revealed various potential risk factors for future pregnancies, including underweight (12%), obesity (20%), Chlamydia trachomatis IgG antibody positivity (22%), low rubella IgG antibody levels (47%), iron deficiency (12%), and 25-hydroxyvitamin D levels <30 ng/mL (98%). Postintervention, the participants reported high satisfaction with the check-ups and significantly advanced their reproductive plans (P = .008). Furthermore, 95% of the participants indicated an intention to seek medical attention or make lifestyle changes. The postintervention CFKS-J score (mean [SD]) was higher than the preintervention score (71.7 [19.3] vs 63.0 [22.0]; P = .006). CONCLUSIONS We developed a preconception check-up package that can be integrated into workplace health examinations, complemented by tailored counseling. This novel check-up package is a feasible and effective approach for improving preconception health and fertility awareness.
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Affiliation(s)
- Akiko Fujishima
- Department of Obstetrics and Gynaecology, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita-shi, Akita 010-8543, Japan
| | - Eri Maeda
- Department of Public Health, Faculty of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Koki Sato
- Specified Non-profit Corporation FORECIA, Yamani Building 6F, 2-2-23, Nakadori, Akita-shi, Akita 010-0001, Japan
| | - Hidekazu Saito
- Umegaoka Women's Clinic, Tokyo, 1-33-3, Umegaoka, Setagaya-ku, Tokyo 154-0022, Japan
| | - Chihiro Ozeki
- Akita University School of Medicine, Department of Medicine, 1-1-1, Hondo, Akita-shi, Akita 010-8543, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynaecology, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita-shi, Akita 010-8543, Japan
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Chen L, Shen J, Jiang H, Lin H, He J, Fan S, Yang L, Yu D, Qiu R, Lin E. Incidence and influencing factors of fertility concerns in breast cancer in young women: a systematic review and meta-analysis. Front Oncol 2023; 13:1273529. [PMID: 38173831 PMCID: PMC10763242 DOI: 10.3389/fonc.2023.1273529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Objective This systematic review and meta-analysis aimed to evaluate the prevalence and influencing factors of fertility concerns in breast cancer in young women. Methods A literature search on PubMed, Embase, Web of Science, and Cochrane Library databases was conducted up to February 2023 and was analyzed (Revman 5.4 software) in this study. The papers were chosen based on inclusion standards, and two researchers independently extracted the data. The included studies' quality was evaluated using criteria set out by the Agency for Healthcare Research and Quality. To identify significant variations among the risk factors, odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were utilized. Results A total of 7 studies that included 1579 breast cancer in young women were enrolled in the study. The results showed that for breast cancer in young women, the incidence of fertility concerns 53%(95%CI [0.45,0.58]). The results showed that education (2.65, 95% CI 1.65-5.63), full-time work (0.12, 95% CI 1.03-1.93), fertility intentions (7.84, 95% CI 1.50-37.4), depression level (1.25, 95% CI 1.03-1.5), and endocrine therapy (1.32, 95% CI 1.08-1.62) were risk factors for fertility concerns in young women with BC. Having a partner (0.41, 95% CI 0.33-0.5), ≥1 child (0.3, 95% CI 0.22-0.4) were identified as protective factors against fertility concerns in young women with BC. Conclusions The incidence of fertility concerns in breast cancer in young women is at a moderately high level. We should pay more attention to the risk factors of fertility concerns to help breast cancer in young women cope with their fertility concerns and promote their psychological well-being.
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Affiliation(s)
- Lijuan Chen
- Department of General Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen, China
| | - Jiali Shen
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Hongzhan Jiang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Huihui Lin
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiaxi He
- School of Medicine, Xiamen University, Xiamen, China
| | - Siyue Fan
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Liping Yang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Doudou Yu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Rongliang Qiu
- The Third Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Ende Lin
- Department of General Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen, China
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Harrison C, Greves G, Barnard E, Davies A, McEleny K, Gordon U, Lucky M, Woodward B, Pacey A, Heatley M, Boivin J. The effect of an educational animation on knowledge of testicular health and fertility of adolescents. Hum Reprod 2023; 38:2470-2477. [PMID: 37805989 PMCID: PMC10694399 DOI: 10.1093/humrep/dead195] [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: 04/25/2023] [Revised: 07/21/2023] [Indexed: 10/10/2023] Open
Abstract
STUDY QUESTION Does the provision of an educational animation, developed with young people, about testicular health and fertility impact the knowledge of these topics among adolescents? SUMMARY ANSWER The development and provision of education on testicular health and fertility were welcomed by adolescents and associated with a significant increase in knowledge. WHAT IS KNOWN ALREADY Young people may know less than they should about testicular health and male fertility topics. Lack of knowledge can have implications for health including late medical help-seeking for signs and symptoms of scrotal disorders, such as torsion, for which late presentation frequently results in testicular damage. STUDY DESIGN, SIZE, DURATION A mixed methods experimental pre- and post-design was used with embedded qualitative data collection. High school students completed a pre-animation questionnaire, watched four animations on testicular health and fertility, and completed a post-animation questionnaire. Data were collected during Personal Social and Health Education lessons across a 2-week period. PARTICIPANTS/MATERIALS, SETTING, METHODS Four animations on testicular health and fertility, informed by andrologists, academics, designers, boys, and young men, were developed. Eligible participants were boys and girls in the UK school years 8 and 9 (age 13-14 years). Participants completed a Time 1 (T1) survey (fertility knowledge, demographics) prior to watching the animations and a Time 2 (T2) survey (fertility knowledge, perceptions of the animations) immediately after the animations. Perceptions were rated on 10-point response scales (higher scores better). Participants additionally expressed in their own words positive and negative aspects of the animations. ANOVA was used to examine the effects of the animations using a 2 (time: T1, T2)×2 (gender: male, female) design on topic knowledge, perceived importance, usefulness, and style of the animations according to gender. Regression analysis examined the associations between gender, disability, class year, and knowledge at T2 while controlling for knowledge at T1. Qualitative data on perceptions of the animations were analyzed using inductive thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE Results showed that the animations significantly increased testicular health and fertility-related knowledge from T1 (x̄=41.84 ± 24.72) to T2 (x̄=79.15, ±15.04). Boys had significantly higher levels of knowledge compared to girls at T1 (x̄=44.74, SD = 25.16 versus x̄=37.79 ± 23.49, respectively) and T2 (x̄=80.07, SD = 15.68 versus x̄=77.89 ± 14.30, respectively) but knowledge gain from T1 to T2 was not significantly different according to gender (P = 0.11) as shown by non-significant gender×time interaction. There were no significant gender differences in the perceived usefulness and importance of the animations or liking of the style of the animations, with both genders considering the animations as useful, important, and likable. Regression analysis showed only knowledge at T1 to be significantly associated with knowledge at T2. Qualitative data showed three main themes: accessibility of important and useful information; information engagement and help-seeking behaviour; and inclusivity of information. LIMITATIONS, REASONS FOR CAUTION This was a pre- and post-study with a sample of young people from a selected educational institution without a control group. Only short-term effects of the animations were recorded. WIDER IMPLICATIONS OF THE FINDINGS Adolescents are interested in and learn from the provision of engaging fertility-related information. Boys and men should be considered as being a relevant target population for fertility education, not just girls and women. STUDY FUNDING/COMPETING INTEREST(S) This research was carried out in partnership with the British Fertility Society, was financially supported by an Economic and Social Research Council Impact Acceleration Award (520792) and commercial sponsorship from iMediCare Ltd, Bayer AG, Merck Group, Cryos International given to the British Fertility Society, and a financial contribution from Orchid Cancer Appeal. The authors are fully responsible for the content of the animations and this manuscript, and the views and opinions described in the publication reflect solely those of the authors. J.B. reports a grant from Merck Serono Ltd outside the submitted work. C.H., G.G., A.D., E.B., U.G., M.L, B.W., and M.H. declare no conflict of interest. K.M. reports honoraria from Bayer and Merck. A.P. reports paid consultancy for Cryos International, Cytoswim Ltd, Exceed Health, and Merck Serono in the last 2 years, but all monies have been paid to the University of Sheffield. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
| | | | - Emma Barnard
- Ysgol Dyffryn Taf, Whitland, Carmarthenshire, UK
| | | | - Kevin McEleny
- Newcastle Fertility Centre, Times Square, Newcastle upon Tyne, UK
| | - Uma Gordon
- Bristol Fertility Clinic, Spire Bristol Hospital, Redland, Bristol, UK
| | - Marc Lucky
- Urology Department, Aintree Hospital, Liverpool, UK
| | | | - Allan Pacey
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, South Yorkshire, UK
| | | | - Jacky Boivin
- School of Psychology, Cardiff University, Cardiff, UK
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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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Ali ZE, Liperis G, Mincheva M, Serdarogullari M, Uraji J, Ammar OF, Fraire-Zamora JJ. From stress to success: exploring methods addressing psychosocial stress in couples trying to conceive. Hum Reprod 2023; 38:2277-2279. [PMID: 37558266 DOI: 10.1093/humrep/dead159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Affiliation(s)
- Zoya E Ali
- Research & Development Department, Hertility Health Limited, London, UK
| | - George Liperis
- Westmead Fertility Centre, Institute of Reproductive Medicine, University of Sydney, Westmead, NSW, Australia
| | | | - Munevver Serdarogullari
- Department of Histology and Embryology, Faculty of Medicine, Cyprus International University, Nicosia, Northern Cyprus via Mersin 10, Turkey
| | - Julia Uraji
- IVF Laboratory, TFP Düsseldorf GmbH, Düsseldorf, Germany
| | - Omar F Ammar
- Biomaterials Cluster, Bernal Institute, University of Limerick, Limerick, Ireland
- School of Engineering, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland
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Tan PL, Pan J, Xia X. Does information on age-related fertility decline and fertility policies affect university students' family and career expectations? Evidence from a randomized controlled trial. PLoS One 2023; 18:e0287526. [PMID: 37910460 PMCID: PMC10619829 DOI: 10.1371/journal.pone.0287526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/06/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Past research shows that young adults have poor knowledge of age-related fertility decline and that the provision of information can improve fertility knowledge. We provide university students with information on age-related fertility and fertility-related policies and investigate whether the provision of such information affects their family formation and career expectations. METHODS A three-armed randomized controlled trial was conducted online in Singapore between September and October 2021. A total of 1000 undergraduate students were recruited through campus advertisements to complete a 30- to 45-minute online survey, which randomly exposed participants to one of three informational brochures on age-related fertility decline, fertility policies, or diabetes (control group). Participants answered questions on family formation and career expectations both before and after the information intervention. Analysis of covariance was used to assess the effects of the information intervention. RESULTS Exposure to age-related fertility information resulted in significant reductions in the ideal age at first childbirth, significant increases in the expected probability of marriage before age 30, and (among female participants) significant increases in the expected likelihood of undergoing social egg-freezing. No difference existed in child-number ideals, educational aspirations, and income expectations between groups after exposure. No difference existed between the fertility policy information group and the control group after exposure in any of the outcomes of interest. CONCLUSIONS Information on age-related fertility decline brought forward university students' expected timing of childbearing and marriage without reducing their educational and career expectations. The provision of fertility information at early ages, such as during university, can help correct widespread inaccurate beliefs about fertility and promote realistic family formation planning without adversely affecting educational and career goals. TRIAL REGISTRATION ClinicalTrials.gov.
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Affiliation(s)
- Poh Lin Tan
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
| | - Jessica Pan
- Department of Economics, National University of Singapore, Singapore, Singapore
| | - Xing Xia
- Division of Social Sciences, Yale-NUS College, Singapore, Singapore
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12
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Arendt M, Oxlad M. Australian women's views concerning non-medical egg freezing and factors motivating freezing decisions. Br J Health Psychol 2023; 28:639-650. [PMID: 36693677 DOI: 10.1111/bjhp.12646] [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: 05/23/2022] [Revised: 12/21/2022] [Accepted: 01/12/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE We aimed to determine women's views about egg freezing for non-medical reasons and the factors motivating freezing decisions. DESIGN In this study, 514 women aged 18-44 years completed an online cross-sectional survey exploring fertility knowledge, reproductive intentions and views concerning non-medical egg freezing. METHODS Data were analysed descriptively. Additionally, 14 variables noted as potential motivators in prior literature were entered into a multinomial regression to explore factors that would motivate women to consider freezing their eggs for non-medical reasons. RESULTS Views concerning non-medical egg freezing were generally positive, with 61.3% of participants reporting that they would consider egg freezing ('Yes' or 'Maybe'). Factors motivating decisions to freeze varied among women who responded 'Yes', 'Maybe' and 'I don't know' to whether they would consider freezing. The availability of Medicare subsidization and the procedure not affecting future fertility were significant predictors for all three groups of women. CONCLUSIONS Acceptability of egg freezing for non-medical reasons was moderate to high. However, there is a need for targeted fertility information to educate women about fertility and optimal times to conceive and freeze their eggs. Future research about views concerning non-medical egg freezing among diverse populations and examining the health economics of this procedure would be beneficial.
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Affiliation(s)
- Molly Arendt
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Melissa Oxlad
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
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13
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Qiu J, Tang L, Li P, Liu G, Rong X. Psychological and reproductive decision-making experiences of young women after breast cancer diagnosis: a qualitative study. Support Care Cancer 2023; 31:423. [PMID: 37358675 DOI: 10.1007/s00520-023-07880-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/10/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Breast cancer has the highest incidence rate among malignant tumors in China, with a trend of affecting younger women. The treatment has short- and long-term adverse effects such as damage to the ovaries, which may result in infertility. Such consequences then increase patients' concerns over future reproduction. At present, nor do medical staffs continuously assess their overall well-being, or ensure that they have the knowledge necessary to manage their reproductive concerns. This qualitative study aimed to explore psychological and reproductive decision-making experiences of young women who had experienced childbirth after their diagnosis. METHODS The phenomenological research, as a kind of qualitative study, was conducted on 12 young women who experienced childbirth after breast cancer diagnosis. Data collection was from September 2021 to January 2022 and content analysis method was used to analyze the data. RESULTS Five main themes were identified: (1) desire for childbearing from individual, familial, and social aspects after the diagnosis of breast cancer; (2) emotional experiences through pregnancy till raising children; (3) support needs from professionals, family, and peer; (4) self and doctors' influencing factors on reproductive decision-making; and (5) satisfaction with the outcome of reproductive decision-making. CONCLUSIONS The desire for childbearing of young women should be considered during the reproductive decision-making process. A multidisciplinary team is suggested to be set up to provide professional support. During the reproductive process, professional and peer support should be strengthened to improve decision-making abilities, alleviate negative emotional experience, and smoothen the process of reproductive experience for young patients.
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Affiliation(s)
- Jiajia Qiu
- Department of Nursing Administration, Shanghai Cancer Center, Fudan University, Shanghai, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Lichen Tang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Ping Li
- Department of Nursing Administration, Shanghai Cancer Center, Fudan University, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Guangyu Liu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Xinyi Rong
- School of Nursing, Fudan University, Shanghai, China
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14
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Martins MV, Fernandes J, Pedro J, Barros A, Xavier P, Schmidt L, Costa ME. Effects of trying to conceive using an every-other-day strategy versus fertile window monitoring on stress: a 12-month randomized controlled trial. Hum Reprod 2022; 37:2845-2855. [PMID: 36272105 DOI: 10.1093/humrep/deac228] [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: 02/17/2022] [Revised: 09/23/2022] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Can animation videos on how to optimize the chances of pregnancy influence stress, anxiety, depression and sexual functioning of individuals trying to conceive (TTC)? SUMMARY ANSWER There were no differences between those educated to have intercourse every other day, on the fertile window and a control group (CG), and depression and sexual dysfunction significantly increased over time for all arms. WHAT IS KNOWN ALREADY Recent findings indicate that time to pregnancy can be significantly shortened by targeting the fertile period, but some reproductive care guidelines recommend instead the practice of intercourse every other day on the basis that it is less stressful to the couple. Evidence to support guidelines on how to preserve well-being and psychosocial adjustment and optimize pregnancy chances is lacking. STUDY DESIGN, SIZE, DURATION We conducted a prospective, double-blinded, three-arm randomized controlled trial between July 2016 and November 2019. Participants were randomized to either not having any stimulus (CG) or visualizing a short animated video explaining how to improve chances of pregnancy by having intercourse every other day (EOD group), or by monitoring the fertile window (FWM group). Assessments were made before the intervention (T0), and 6 weeks (T1), 6 months (T2) and 12 months after (T3), with follow-ups censored in case of pregnancy. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were childless individuals of reproductive age actively TTC and not diagnosed or unaware of a condition that could prevent spontaneous pregnancy. Individuals were excluded from recruitment if they had previous children or had a condition preventing spontaneous pregnancy. Our primary outcome was stress and secondary outcomes included anxiety, depression, sexual functioning and pregnancy. Primary analyses were performed according to intention-to-treat principle. MAIN RESULTS AND THE ROLE OF CHANCE Of the 450 randomized participants 127 were educated to use an every-other-day strategy, 135 to monitor the fertile window, and 134 received no intervention. Groups were similar regarding demographics and months TTC. Repeated measures analysis revealed that there were no significant interaction effects of psychological and sexual well-being between groups over time (P > 0.05). Significant time effects were revealed for stress (F(3,855) = 4.94, P < 0.01), depression (F(3,855) = 14.22, P < 0.01) and sexual functioning (time effects P values <0.001 for female sexual functioning dimensions and <0.002 for male dimensions), but not for anxiety (F(2,299) = 0.51, P > 0.05). Stress levels lowered after 6 months (P < 0.001) and returned to baseline levels at the 1-year follow-up. Depressive symptomatology significantly increased at 6 weeks (P = 0.023), and again 1 year after (P = 0.001). There were also significant decreases in all female sexual functioning dimensions (desire, satisfaction, arousal, pain, orgasm and lubrication). In men, there were significant variations in orgasm, intercourse satisfaction and erectile function, but not desire and sexual satisfaction. Revealed pregnancy rates were 16% for participants in the EOD group, 30% for the FWM group and 20% for the CG. Pregnancies were not significantly different between arms: EOD vs FWM (odds ratio (OR) 2.32; 95% CI 0.92-5.83); EOD vs CG (OR 0.74; 95% CI 0.30-1.87); and FWM vs CG (OR 1.71; 95% CI 0.70-4.18). LIMITATIONS, REASONS FOR CAUTION Participants were recruited after transitioning to procreative sex. The study might be prone to bias as almost 30% of our sample fulfilled the chronological criterion for infertility, and other reproductive strategies could have been tried over time before recruitment. WIDER IMPLICATIONS OF THE FINDINGS Our data suggest that stress does not arise from feeling pressured on the fertile period and that advice on timing of intercourse might have to be personalized. The increasing levels of depression and sexual dysfunction over a year emphasize the crucial role of preconception care and fertility counseling in promoting psychological and sexual well-being. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by European Union Funds (FEDER/COMPETE-Operational Competitiveness Programme) and by national funds (FCT-Portuguese Foundation for Science and Technology) under the projects PTDC/MHC-PSC/4195/2012 and SFRH/BPD/85789/2012. TRIAL REGISTRATION NUMBER NCT02814006. TRIAL REGISTRATION DATE 27 June 2016. DATE OF FIRST PATIENT’S ENROLLMENT 19 July 2016.
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Affiliation(s)
- Mariana V Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology at University of Porto, Porto, Portugal
| | - Joana Fernandes
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology at University of Porto, Porto, Portugal
| | - Juliana Pedro
- Centre for Psychology at University of Porto, Porto, Portugal.,Centre for Reproductive Genetics A. Barros, Porto, Portugal
| | - Alberto Barros
- Centre for Reproductive Genetics A. Barros, Porto, Portugal.,Department of Genetics, Faculty of Medicine, University of Porto, Institute of Health Research and Innovation I3S, 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
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Maria E Costa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology at University of Porto, Porto, Portugal
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15
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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] [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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16
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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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17
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Bakkensen JB, Goldman KN. Women's preventive services initiative: fertility counseling overlooked. Am J Obstet Gynecol 2022; 226:524-528. [PMID: 34228971 DOI: 10.1016/j.ajog.2021.06.100] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/19/2021] [Accepted: 06/30/2021] [Indexed: 11/29/2022]
Abstract
The 2021 Women's Preventive Services Initiative Well-Woman Chart outlines a framework for incorporating preventive health services recommended by the Women's Preventive Services Initiative, the US Preventive Services Task Force, and Bright Futures based on age, health status, and risk factors. Following the previous guidelines for preventive care, this document failed to offer recommendations or guidelines for infertility screening and fertility counseling in the course of well-woman care. Healthcare providers may be less likely to address fertility with their patients in the absence of clear, evidence-based recommendations, potentially resulting in underinformed reproductive choices and compromised reproductive potential. Given the devastating consequences of infertility and unintended childlessness, we, herein, propose that infertility screening and fertility counseling should become an integral part of well-woman care and that organizations, such as the Women's Preventive Services Initiative, put forth guidelines to assist providers in addressing fertility throughout a woman's reproductive lifespan.
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Affiliation(s)
- Jennifer B Bakkensen
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
| | - Kara N Goldman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL
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18
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Iino K, Fukuhara R, Yokota M, Yokoyama Y. Fertility awareness and subclinical infertility among women trying to get pregnant at home. BMC Womens Health 2022; 22:43. [PMID: 35184726 PMCID: PMC8859874 DOI: 10.1186/s12905-022-01626-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Recent studies on fertility awareness among the reproductive population have reported the lack of accurate knowledge about fertility and assisted reproductive technologies. However, there has been little information regarding women trying to get pregnant at home. The aim of this study was to explore the prevalence of subclinical infertility among women trying to get pregnant at home, and to evaluate awareness regarding infertility and reasons for not visiting infertility clinics among women who use pregnancy-assist mobile applications to help them conceive. Methods A total of 2084 Japanese women responded to this online survey. We selected 1541 women according to the study criteria. Based on the results of 61 questions, we evaluated knowledge regarding fertility, prevalence of subclinical infertility, and reasons for not visiting the clinic among the participants. Results Despite the desire to conceive, the participants had an apparent tendency to overestimate the age limit for childbearing. A total of 338 (21.9%) women answered that in general women aged > 45 years could get pregnant. Approximately 40% of the women had possible subclinical infertility and were unaware of the fact. Additionally, about 70% of the women considered themselves to have infertility problems. Women who were aware of the possibility of infertility hesitated to visit the clinic due to unfamiliarity with a gynecologist or clinic, and apprehensions about the gynecologic examination. Conclusions In our study, some women required treatment for infertility. Nonetheless, they hesitated to visit an infertility clinic. Sexual health education, together with proper accessibility to gynecology clinics, are necessary to reduce involuntary childlessness.
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Affiliation(s)
- Kaori Iino
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5 Zaifu Hirosaki, Hirosaki, Aomori, 036-8562, Japan. .,National Hospital Organization Hirosaki National Hospital, 1 Tominotyo, Hirosaki, Aomori, 036-8545, Japan.
| | - Rie Fukuhara
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5 Zaifu Hirosaki, Hirosaki, Aomori, 036-8562, Japan
| | - Megumi Yokota
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5 Zaifu Hirosaki, Hirosaki, Aomori, 036-8562, Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5 Zaifu Hirosaki, Hirosaki, Aomori, 036-8562, Japan
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19
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Chan SL, Thumboo J, Boivin J, Saffari SE, Yin S, Yeo SR, Chan JKY, Ng KC, Chua KH, Yu SL. Effect of fertility health awareness strategies on fertility knowledge and childbearing in young married couples (FertStart): study protocol for an effectiveness-implementation hybrid type I multicentre three-arm parallel group open-label randomised clinical trial. BMJ Open 2022; 12:e051710. [PMID: 34980614 PMCID: PMC8724708 DOI: 10.1136/bmjopen-2021-051710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Birth rates have been declining in many advanced societies including Singapore. We designed two interventions with vastly different resource requirements, which include fertility education, personalised fertility information and a behavioural change component targeting modifiable psychological constructs to modify fertility awareness and childbearing intentions. We aim to evaluate the effect of these two interventions on knowledge, attitudes and practice around childbearing compared with a control group among young married couples in Singapore and understand the implementation factors in the setting of an effectiveness-implementation hybrid type 1 three-arm randomised trial. METHODS AND ANALYSIS We will randomise 1200 young married couples to no intervention (control), Fertility Health Screening group (FHS) or Fertility Awareness Tools (FAT) in a 7:5:5 ratio. Couples in FHS will undergo an anti-Mullerian hormone test and semen analysis, a doctor's consultation to explain the results and standardised reproductive counselling by a trained nurse. Couples in FAT will watch a standardised video, complete an adapted fertility status awareness (FertiSTAT) tool and receive an educational brochure. The attitudes, fertility knowledge and efforts to achieve pregnancy of all couples will be assessed at baseline and 6 months post-randomisation. Birth statistics will be tracked using administrative records at 2 and 3 years. The primary outcome is the change in the woman's self-reported intended age at first birth between baseline and 6 months post-randomisation. In addition, implementation outcomes and cost-effectiveness of the two interventions will be assessed. ETHICS AND DISSEMINATION This study has been reviewed and approved by the Centralized Institutional Review Board of SingHealth (2019/2095). Study results will be reported to the study funder and there are plans to disseminate them in scientific conferences and publications, where authorship will be determined by the International Committee of Medical Journal Editors guidelines. TRIAL REGISTRATION NUMBER NCT04647136; ClinicalTrails.gov Identifier.
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Affiliation(s)
- Sze Ling Chan
- Health Services Research Centre, Singhealth, Singapore
| | - Julian Thumboo
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore
| | - Jacky Boivin
- School of Psychology, Cardiff University, Cardiff, UK
| | | | - Shanqing Yin
- Chairman Medical Board Office, KK Women's and Children's Hospital, Singapore
| | - Samantha Rachel Yeo
- Division of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore
| | - Jerry Kok Yen Chan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - Kee Chong Ng
- Chairman Medical Board Office, KK Women's and Children's Hospital, Singapore
| | - Ka-Hee Chua
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - Su Ling Yu
- Department of Obstetrics & Gynaecology, Singapore General Hospital, Singapore
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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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Kruglova K, Gelgoot EN, Chan P, Lo K, Rosberger Z, Bélanger E, Kazdan J, Robins S, Zelkowitz P. Risky Business: Increasing Fertility Knowledge of Men in the General Public Using the Mobile Health Application Infotility XY. Am J Mens Health 2021; 15:15579883211049027. [PMID: 34697968 PMCID: PMC8552396 DOI: 10.1177/15579883211049027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Male infertility presents a public health concern. As most men wish to become fathers, it is important to increase men’s awareness of infertility risk factors. We developed a mobile health application (mHealth app), Infotility XY, to promote men’s reproductive health. This study evaluates whether use of the app led to increased knowledge of infertility risk factors, and whether knowledge change was associated with participants’ sociodemographic characteristics and/or app usage. Participants were recruited between August and October 2020. Eligibility criteria included: identified as male; 18–45 years old; childless; no infertility history; able to read and write in English/French; had internet access. We assessed participants’ fertility knowledge before and after app use. App usage data were captured during the 2-week intervention period. Our sample included 49 men aged 18–45. Seventy-eight percent of participants had not previously sought fertility information. Participants viewed on average 75% of the app’s articles, and 96% of participants said the app increased their fertility knowledge. Before app use, 55% of men said they were aware of infertility risk factors, compared to 96% after app use. Men correctly identified more risk factors after app use compared to before, t(48) = 8.28, p < .001. Participants’ sociodemographic characteristics and amount of app usage were not associated with knowledge change. This study provides evidence of the feasibility of an mHealth app to improve men’s awareness of infertility risk factors. Given the positive relationship between male reproductive health and overall health, increased awareness of infertility risk factors may lead to men’s improved overall health.
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Affiliation(s)
- Katya Kruglova
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montréal, QC, Canada
| | - Eden Noah Gelgoot
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montréal, QC, Canada
| | - Peter Chan
- McGill University Health Centre, Montréal, QC, Canada.,Department of Surgery, McGill University, Montréal, QC, Canada
| | - Kirk Lo
- Department of Surgery, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Surgery, University of Toronto, Toronto, Canada
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Psychiatry, McGill University, Montréal, QC, Canada.,Department of Psychology, McGill University, Montréal, QC, Canada.,Department of Oncology, McGill University, Montréal, QC, Canada
| | - Emilie Bélanger
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montréal, QC, Canada
| | - Jordana Kazdan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montréal, QC, Canada
| | - Stephanie Robins
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, Montréal, QC, Canada
| | - Phyllis Zelkowitz
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Psychiatry, McGill University, Montréal, QC, Canada
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22
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Saya GK, Premarajan KC, Roy G, Sarkar S, Kar SS, Ulaganeethi R, Olickal JJ. Current fertility desire and its associated factors among currently married eligible couples in urban and rural area of Puducherry, south India. Afr Health Sci 2021; 21:1385-1395. [PMID: 35222604 PMCID: PMC8843305 DOI: 10.4314/ahs.v21i3.50] [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] [Indexed: 11/28/2022] Open
Abstract
Background There are paucity of studies on current fertility desire at community level. Objective To assess current fertility desire and its associated factors among eligible couples of reproductive age group in Puducherry, India. Methods A community-based cross-sectional study from 2016 to 2017 among 2228 currently married eligible couples assessed socio-demographic and fertility-related factors associated with fertility desire. Data were collected based on the National Family Health Survey questionnaire. Association of fertility desire was assessed by univariate and generalised linear regression analysis. Results Out of 1979 respondents, current fertility desire within two years was 13.7% (95% CI, 12.3%–15.3%). Mean number of children (SD) currently living and preferred was 1.77(0.851) and 2.11 (0.528) respectively. After adjusting for confounders, the significant factors positively associated with fertility desire include woman's age of 18–24 (APR = 2.91), 25–29 years (APR=2.48), 30–34 (APR=2.47), 35–39(APR=2.06), high socioeconomic status (APR=2.02), those without child (APR=52.35) and those with one child (APR=35.60). Conclusion The fertility desire is comparatively lesser than other areas. Those without or with a single child and high socioeconomic status group had comparatively more fertility desire.
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Affiliation(s)
- Ganesh Kumar Saya
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Kariyarath Cheriyath Premarajan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Gautam Roy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Sonali Sarkar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Revathi Ulaganeethi
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Jeby Jose Olickal
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Pearson L, Holton S, McLachlan R, Hammarberg K. Australian men's fertility information seeking attitudes and behaviour: A qualitative investigation. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 29:100621. [PMID: 33894435 DOI: 10.1016/j.srhc.2021.100621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/21/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Most women and men want and expect to have children but increasing maternal and paternal ages reduce their ability to achieve this. Most research relating to childbearing has focused on women. The aim of this study was to explore reproductive-aged men's fertility information-seeking attitudes and behaviours. METHODS Focus group discussions were conducted with younger (18-30 years, 3 groups) and older (31-45 years, 3 groups) men, residing in urban, peri-urban or rural settings in Victoria, Australia. The topics covered included men's fatherhood aspirations and intentions, and their attitudes and behaviours relating to seeking information about fertility. Focus group discussions were audio-recorded and transcribed, and transcripts analyzed thematically. RESULTS Six focus group discussions were conducted with a total of 39 participants. Four key themes were identified: 1. 'No need for fertility-related information'; 2. 'Knowledge and awareness of fertility'; 3. 'Fertility is women's business'; and 4. 'Fertility and manhood'. Fertility and fertility information seeking was perceived by many participants as women's domain. While men did not seek information about fertility unless they experienced fertility difficulties, they reported learning about fertility through the lived experiences of others, predominantly family and friends who experienced infertility. CONCLUSION Fertility-related health promotion initiatives and reproductive health information targeting men are needed to encourage men to be active participants in reproductive decision making to optimize the chance of both women and men achieving their parenthood goals. Narrative health messages may be a successful way to convey fertility information to men.
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Affiliation(s)
- Lauren Pearson
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, 4/553 St Kilda Road, Melbourne 3004, Victoria, Australia
| | - Sara Holton
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, 4/553 St Kilda Road, Melbourne 3004, Victoria, Australia; School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, 1 Geringhap Street, Geelong 3220, Victoria, Australia.
| | - Robert McLachlan
- Healthy Male, Melbourne, Vic 3004, Australia; Monash IVF Group Pty Ltd, Richmond 3121, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton 3168, Australia
| | - Karin Hammarberg
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, 4/553 St Kilda Road, Melbourne 3004, Victoria, Australia; Victorian Assisted Reproductive Treatment Authority, Level 30/570 Bourke Street Melbourne, Victoria 3000, Australia
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24
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Gharacheh M, Khalajabadi Farahani F, Mirghafourvand M, Janani L, Ranjbar F. A multicenter randomized controlled trial protocol to evaluate the effectiveness of an educational intervention on fertility knowledge, intention and behavior among Iranian new couples. BMC Public Health 2020; 20:1917. [PMID: 33334330 PMCID: PMC7745471 DOI: 10.1186/s12889-020-10029-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/09/2020] [Indexed: 11/29/2022] Open
Abstract
Background Recent evidence shows that men and women have inadequate fertility knowledge which may negatively affect their childbearing decisions in future. Given the fact that decision making for fertility needs accurate information, targeted educational interventions especially through media are needed to improve knowledge regarding the best age of fertility, factors affecting fertility potential and fertility options available for sub-fertile couples. Aim of the study is to evaluate whether a fertility educational program can be effective in increasing fertility knowledge, childbearing intention and the planned pregnancy rate among couples referring to premarital counselling centers. Methods This study is a parallel randomised clinical trial with pre-test/post-test design. We will recruit 1240 marrying couples referring for compulsory premarital counselling in public health centers through stratified sampling in five metropolitan cities of Iran. The intervention group will receive both the typical premarital counselling training and a fertility knowledge package containing verbal and virtual educational package at five time episodes (one verbal session and four virtual sessions) within 4 weeks. The primary outcomes are fertility knowledge, childbearing intention and the first planned pregnancy rate (positive pregnancy test) and the secondary outcomes include contraception method use, miscarriage and unplanned pregnancy. Participants will respond to a self-administered demographic/reproductive characteristics questionnaire, the Cardiff Fertility Knowledge Scale (CFKS) and the childbearing intention questionnaire. Data will be collected through online questionnaires at baseline and 3, 12 and 18 months after the intervention. Data will be analyzed using Chi-square or Fisher-exact test for categorical variables, Independent sample t-test for normally distributed quantitative variables and Mann–Whitney U test for non-normally distributed quantitative variables. To compare the outcomes between the two groups over the time, repeated measures ANOVA will be used. We hypothesize that the positive impact of increasing the fertility knowledge is the reduced involuntarily childlessness. Discussion The findings are proposed to inform government policies and public education strategies aiming at supporting childbearing among young couples who postpone their first pregnancy while they might not have any important social and economic obstacles. Trial registration This study was approved by Iranian Registry of Clinical Trials (IRCT), Number: IRCT20201005048925N1, Date of registration: 2020-10-12.
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Affiliation(s)
- Maryam Gharacheh
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Farideh Khalajabadi Farahani
- Department of Population & Health, National Population Studies & Comprehensive Management Institute, Tehran, Iran
| | - Mojgan Mirghafourvand
- Midwifery Department, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Janani
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute (PHRI) & Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ranjbar
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
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25
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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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26
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Koert E, Sylvest R, Vittrup I, Hvidman HW, Birch Petersen K, Boivin J, Nyboe Andersen A, Schmidt L. Women's perceptions of fertility assessment and counselling 6 years after attending a Fertility Assessment and Counselling clinic in Denmark. Hum Reprod Open 2020; 2020:hoaa036. [PMID: 33043154 PMCID: PMC7533526 DOI: 10.1093/hropen/hoaa036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/13/2020] [Indexed: 12/18/2022] Open
Abstract
STUDY QUESTION What are women's perceptions and experience of fertility assessment and counselling 6 years after attending a Fertility Assessment and Counselling (FAC) clinic in Denmark? SUMMARY ANSWER Women viewed the personalized fertility knowledge and advice they received as important aids to decision-making and they felt the benefits outweighed the risks of receiving personalized fertility information. WHAT IS KNOWN ALREADY Many young people wish to become parents in the future. However, research demonstrates there is a gap in women's and men's knowledge of fertility and suggests they may be making fertility decisions based on inaccurate information. Experts have called for the development of interventions to increase fertility awareness so that men and women can make informed fertility decisions and achieve their family-building goals. Since 2011, the FAC clinic in Copenhagen, Denmark has provided personalized fertility assessment and guidance based on clinical examination and evaluation of individual risk factors. Available qualitative research showed that attending the FAC clinic increased fertility awareness and knowledge and was experienced as a catalyst for change (e.g. starting to conceive, pursuing fertility treatment, ending a relationship) in women 1-year post-consultation. STUDY DESIGN SIZE DURATION The study was a 6-year follow-up qualitative study of 24 women who attended the FAC clinic between January and June 2012. All women were interviewed during a 2-month period from February to March 2018 at Rigshospitalet, their home or office, in Copenhagen, Denmark. Interviews were held in English and ranged between 60 and 94 min (mean 73 min). PARTICIPANTS/MATERIALS SETTING METHODS Invitations to participate in an interview-based follow-up study were sent to 141 women who attended the FAC clinic in 2012. In total, 95 women read the invitation, 35 confirmed interest in participating and 16 declined to participate. Twenty-five interviews were booked and 24 interviews held. Interviews followed a semi-structured format regarding reasons for attending the FAC clinic, if/how their needs were met, and perceptions of fertility assessment and counselling. Data were analysed using thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE At the follow-up interview, women were on average 39.5 years old. Ten were currently single or dating and 14 were married/cohabiting. All were childless when they attended the FAC clinic. At the follow-up interview, 21 women were parents (14 women with one child; 6 with two children; 1 with three children) and the remaining three women intended to have children in the future. The most common reason for originally attending the FAC clinic was to determine how long they could delay childbearing. Most of the women now believed their needs for attending had been met. Those who were dissatisfied cited a desire for more exact ('concrete') information as to their remaining years of fertility, although acknowledged that this was likely not realistic. Women stated that they had felt reassured as to their fertility status after attending the FAC clinic whilst receiving the message that they could not delay childbearing 'too long'. Women viewed personalized fertility knowledge as an important aid to decision-making but cautioned about developing a false sense of security about their fertility and chance of conceiving in the future based on the results. Although women were generally satisfied with their experience, they wished for more time to discuss options and to receive additional guidance after their initial meeting at the FAC clinic. LIMITATIONS REASONS FOR CAUTION Participants were from a group of Danish women attending the FAC clinic and interviews were conducted in English, which means they are not representative of all reproductive-aged women. Nevertheless, the study group included a broad spectrum of women who achieved parenthood through different means (heterosexual/lesbian relationship, single parent with donor, co-parent) with various family sizes, and women who were currently childless. WIDER IMPLICATIONS OF THE FINDINGS Our study provides support for an individualized approach to fertility education, assessment and counselling provided at a time when the information is relevant to the individual and their current fertility decision-making. The findings suggest that although satisfied with their visit to the FAC clinic, the women wished for more information and guidance after this visit, suggesting that the current intervention may need to be expanded or new interventions developed to meet these additional needs. STUDY FUNDING/COMPETING INTERESTS E.K. was funded by an ESHRE Travel/Training grant by ReproUnion, co-financed by the European Union, Interreg V OKS. J.B. reports that the risk evaluation form used at the Fertility Assessment Clinic was inspired by the Fertility Status Awareness Tool FertiSTAT that was developed at Cardiff University for self-assessment of reproductive risk. J.B. also reports personal fees from Merck KGaA, Merck AB, Theramex, Ferring Pharmaceuticals A/S and a research grant from Merck Serono Ltd outside the submitted work. A.N.A. has received personal fees from both Merck Pharmaceuticals and Ferring and grants from Roche Diagnostics outside the submitted work. The other authors report no conflicts of interest.
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Affiliation(s)
- E Koert
- Copenhagen University Hospital, Rigshospitalet, Fertility Clinic, 4071, Blegdamsvej 9, Copenhagen DK-2100 Ø, Denmark.,Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, Copenhagen DK-1014 K, Denmark
| | - R Sylvest
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, Copenhagen DK-1014 K, Denmark
| | - I Vittrup
- Copenhagen University Hospital, Rigshospitalet, Fertility Clinic, 4071, Blegdamsvej 9, Copenhagen DK-2100 Ø, Denmark
| | - H W Hvidman
- Copenhagen University Hospital, Rigshospitalet, Fertility Clinic, 4071, Blegdamsvej 9, Copenhagen DK-2100 Ø, Denmark
| | - K Birch Petersen
- StorkKlinik, The Fertility Partnership, St. Kongensgade 40G, 1264 Copenhagen, Denmark
| | - J Boivin
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, UK
| | - A Nyboe Andersen
- Copenhagen University Hospital, Rigshospitalet, Fertility Clinic, 4071, Blegdamsvej 9, Copenhagen DK-2100 Ø, Denmark
| | - L Schmidt
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, Copenhagen DK-1014 K, Denmark
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Pedro J, Brandão T, Fernandes J, Barros A, Xavier P, Schmidt L, Costa ME, Martins MV. Perceived Threat of Infertility and Women’s Intention to Anticipate Childbearing: The Mediating Role of Personally Perceived Barriers and Facilitators. J Clin Psychol Med Settings 2020; 28:457-467. [DOI: 10.1007/s10880-020-09743-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 01/22/2023]
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28
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Maeda E, Miyata A, Boivin J, Nomura K, Kumazawa Y, Shirasawa H, Saito H, Terada Y. Promoting fertility awareness and preconception health using a chatbot: a randomized controlled trial. Reprod Biomed Online 2020; 41:1133-1143. [PMID: 33039321 DOI: 10.1016/j.rbmo.2020.09.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/21/2020] [Accepted: 09/08/2020] [Indexed: 01/25/2023]
Abstract
RESEARCH QUESTION What are the effects of using a fertility education chatbot, i.e. automatic conversation programme, on knowledge, intentions to improve preconception behaviour and anxiety? DESIGN A three-armed, randomized controlled trial was conducted using an online social research panel. Participants included 927 women aged 20-34 years who were randomly allocated to one of three groups: a fertility education chatbot (intervention group), a document about fertility and preconception health (control group 1) or a document about an irrelevant topic (control group 2). Participants' scores on the Cardiff Fertility Knowledge Scale and the State-Trait Anxiety Inventory, their intentions to optimize preconception behaviours, e.g. taking folic acid, and the free-text feedback provided by chatbot users were assessed. RESULTS A repeated-measures analysis of variance showed significant fertility knowledge gains after the intervention in the intervention group (+9.1 points) and control group 1 (+14.9 points) but no significant change in control group 2 (+1.1 points). Post-test increases in the intentions to optimize behaviours were significantly higher in the intervention group than in control group 2, and were similar to those in control group 1. Post-test state anxiety scores were significantly lower in the intervention group than in control group 1 and control group 2. User feedbacks about the chatbot suggested technical limitations, e.g. low comprehension of users' words, and pros and cons of using the chatbot, e.g. convenient versus coldness. CONCLUSIONS Providing fertility education using a chatbot improved fertility knowledge and intentions to optimize preconception behaviour without increasing anxiety, but the improvement in knowledge was small. Further technical development and exploration of personal affinity for technology is required.
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Affiliation(s)
- Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita 010-8543, Japan.
| | - Akane Miyata
- Reproduction Center, Dokkyo Medical University, Saitama 343-8555, Japan
| | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Yukiyo Kumazawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Hiromitsu Shirasawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | | | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
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Place JM, Peterson BD, Horton B, Sanchez M. Fertility awareness and parenting intentions among Mexican undergraduate and graduate university students. HUM FERTIL 2020; 25:397-406. [PMID: 32896180 DOI: 10.1080/14647273.2020.1817577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
An online, cross-sectional survey was carried out between November 2017 and January 2018 to assess fertility awareness among students attending the National Autonomous University of Mexico (UNAM) in Mexico City. A total of 371 students participated in the survey (n = 228 females, 143 males). 75% of females and 74% of males believed a woman's fertility begins to decline markedly after age 40. Over 75% of all participants overestimated the probability of couples having a live birth after undergoing one cycle of IVF. With regard to parenting intentions, only 48% of females wished to have children compared to 59% of males (p = 0.037) and men were more likely to have their first child at age 30 or later (71% men vs 55% women). In the event of infertility, participants had a higher preference not to have children or to pursue adoption rather than use in vitro fertilisation (IVF). In summary, university students in Mexico City demonstrated low levels of fertility awareness and a smaller proportion indicated a wish to have children than has been reported by young people elsewhere in the world.
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Affiliation(s)
- J M Place
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
| | - B D Peterson
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA, USA
| | - B Horton
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
| | - M Sanchez
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
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30
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Yokota R, Okuhara T, Ueno H, Okada H, Furukawa E, Kiuchi T. Online Japanese-Language Information on Lifestyle Factors Associated With Reduced Fertility: Content Analysis. J Med Internet Res 2020; 22:e19777. [PMID: 32840486 PMCID: PMC7479583 DOI: 10.2196/19777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/23/2020] [Accepted: 07/07/2020] [Indexed: 01/16/2023] Open
Abstract
Background Approximately one-third of Japanese couples currently worry or previously worried about infertility. To develop strategies for the primary prevention of infertility as a population approach, it is important for the general population to be knowledgeable about fertility and infertility. The internet may contribute to the dissemination of information regarding infertility and fertility. However, few studies have examined online information about fertility. Objective This study aimed to quantitatively examine online Japanese-language information about lifestyle factors associated with reduced fertility. Methods We conducted online searches, using the 10 search terms with the highest numbers of searches that people hoping to conceive are likely to input in two major search engines in Japan (Google Japan and Yahoo! Japan). From the 2200 retrieved websites, 1181 duplicates and 500 websites unrelated to our objective were excluded, resulting in a final dataset of 519 websites. Coding guidelines were developed for the following lifestyle factors associated with reduced fertility: sexually transmitted diseases, psychological stress, cigarette smoking, alcohol use, nutrition and diet, physical activity and exercise, underweight, overweight and obesity, and environmental pollutants. Results In terms of the website author’s professional expertise, 69.6 % of the coding instances for the selected lifestyle factors were mentioned by hospitals, clinics, or the media, whereas only 1.7% were mentioned by laypersons. Psychological stress (20.1%) and sexually transmitted diseases (18.8%) were the most frequently mentioned lifestyle factors associated with reduced fertility. In contrast, cigarette smoking, alcohol use, nutrition and diet, physical activity and exercise, underweight, overweight and obesity, and environmental pollutants were mentioned relatively infrequently. The association between reduced fertility and sexually transmitted diseases was mentioned significantly more frequently by hospitals and clinics than by the media (P<.001). The association between reduced fertility and nutrition and diet was mentioned significantly more frequently by the media than by hospitals and clinics (P=.008). With regard to the sex of the target audience for the information, female-specific references to psychological stress, sexually transmitted diseases, nutrition and diet, underweight, physical activity and exercise, and overweight and obesity were significantly more frequent than were male-specific references to these lifestyle factors (psychological stress: P=.002, sexually transmitted diseases: P<.001, nutrition and diet: P<.001, underweight: P<.001, physical activity and exercise: P<.001, overweight and obesity: P<.001). Conclusions Of the lifestyle factors known to be related to reduced fertility, cigarette smoking, alcohol use, and male-specific lifestyle factors are mentioned relatively infrequently in online information sources in Japan, and these factors should be discussed more in information published on websites.
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Affiliation(s)
- Rie Yokota
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Haruka Ueno
- Department of Health and Dietetics, Faculty of Health and Medical Science, Teikyo Heisei Unievrsity, Toshima-ku, Tokyo, Japan
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Emi Furukawa
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Zhou Y, Luo Y, Wang T, Cui Y, Chen M, Fu J. College students responding to the Chinese version of Cardiff fertility knowledge scale show deficiencies in their awareness: a cross-sectional survey in Hunan, China. BMC Public Health 2020; 20:810. [PMID: 32471393 PMCID: PMC7260846 DOI: 10.1186/s12889-020-08937-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 05/17/2020] [Indexed: 01/30/2023] Open
Abstract
Background Fertility knowledge is vital to the fertility health of young people and greatly impacts their fertility choices. Delayed childbearing has been increasing in high-income countries, accompanied by the risk of involuntary childlessness or having fewer children than desired. The aim of this study was to investigate knowledge about fertility issues, the related influencing factors, the method of acquiring fertility knowledge, and the relationship between fertility knowledge and fertility intentions among college students. Methods An online cross-sectional survey of Chinese college students was conducted in Hunan Province from March to April 2018. A total of 867 college students from three comprehensive universities responded to a poster invitation utilizing the Chinese version of the Cardiff Fertility Knowledge Scale (CFKS-C). Data were explored and analysed by SPSS (version 22.0) software. Descriptive statistics, chi-squared tests, T-tests, and Pearson’s correlations were used for the measurements. Results The average percent-correct score on the CFKS-C was 49.9% (SD = 20.8), with greater knowledge significantly related to living in a city district, being not single status, majoring in medicine, being in year 4 or above of study, and intention to have children (all p<0.05). A total of 81.9% of the participants reported that they would like to have children, the average score of the importance of childbearing was 6.3 (SD = 2.7), and the female score was lower than the male score (p = 0.001). A small positive relationship was observed between the CFKS-C and the importance of childbearing (r = 0.074, p = 0.035). Respondents indicated that they gained most of their knowledge from the media and internet (41.4%) and from schools (38.2%). Conclusion Yong people in college have a modest level of fertility knowledge, a relatively low intention to have a child, and deficiencies in fertility health education. There is a need to improve the accessibility of fertility health services by developing a scientific and reliable fertility health promotion strategy.
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Affiliation(s)
- Yanhui Zhou
- Xiangya Nursing School, Central South University, 172 Tongzipo Road Yuelu District, Changsha, 410013, Hunan, China.,The first affiliated Hospital of University of South China, 69 Chuanshan Road Shigu District, Hengyang, 421001, Hunan, China
| | - Yang Luo
- Xiangya Nursing School, Central South University, 172 Tongzipo Road Yuelu District, Changsha, 410013, Hunan, China.
| | - Ting Wang
- Xiangya Nursing School, Central South University, 172 Tongzipo Road Yuelu District, Changsha, 410013, Hunan, China
| | - Yanhui Cui
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, 172 Tongzipo Road Yuelu District, Changsha, 410013, Hunan, China
| | - Mingzhu Chen
- Xiangya Nursing School, Central South University, 172 Tongzipo Road Yuelu District, Changsha, 410013, Hunan, China
| | - Jingxia Fu
- Xiangya Nursing School, Central South University, 172 Tongzipo Road Yuelu District, Changsha, 410013, Hunan, China
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Maeda E, Boivin J, Toyokawa S, Murata K, Saito H. Two-year follow-up of a randomized controlled trial: knowledge and reproductive outcome after online fertility education. Hum Reprod 2019; 33:2035-2042. [PMID: 30265305 PMCID: PMC6195802 DOI: 10.1093/humrep/dey293] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 09/10/2018] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION What are the long-term effects of fertility education on knowledge and reproductive outcome? SUMMARY ANSWER Participants in the intervention group retained some knowledge after 2 years and the partnered women had a new child more quickly than the comparison group. WHAT IS KNOWN ALREADY Fertility education improves knowledge, at least in the short-term. Attitudes toward childbearing and its timing can change after exposure to educational materials. STUDY DESIGN, SIZE, DURATION Participants were recruited via an online social research panel. In the original randomized controlled trial (RCT), knowledge of reproductive-aged participants was assessed before (T1) and immediately after (T2) receiving one of three information brochures: fertility (intervention group), healthy pre-pregnancy (focused on intake of folic acid during pregnancy, control group 1), or family policies in Japan (childcare provision, control group 2). The present follow-up study was conducted 2 years later in January 2017 (T3) with the same participants. PARTICIPANTS/MATERIALS, SETTING, METHODS Of the T1 participants (n = 1455), 383 men and 360 women (51%) responded to the T3 survey. Fertility knowledge measured with the Japanese version of the Cardiff Fertility Knowledge Scale (CFKS-J) and fertility status (e.g. new births, new medical consultations, and the timing of new birth) was assessed. MAIN RESULTS AND THE ROLE OF CHANCE Baseline (T1) characteristics of the T3 participants were well balanced between groups, but T3 participants were older, married, and more educated compared to those lost to follow-up. A repeated-measures analysis of variance showed significant knowledge gains among the intervention group from T1 to T3 (11.2% and 7.0% among men and women, respectively) but no significant change over time for the control groups. There were no differences between groups in the incidence of new births or new medical consultations. However, subgroup analysis showed that timing of new births was accelerated for partnered individuals in the intervention group. Specifically, the proportion of partnered participants at T1 who had a new birth in the first year subsequent to presentation of information was higher in the intervention group versus control group 1 (folic acid): 8.8% versus 1.4% (P = 0.09) among men and 10.6% versus 2.3% (P = 0.03) among women, respectively. The odds ratios (adjusted for age) were 7.8 (95% CI: 0.86-70.7) and 5.2 (95% CI: 1.09-25.0) among men and women, respectively. The timing of births and the proportion of new births during the 2-year follow-up period in the intervention group were similar to that of control group 2 (family policy). The incidence of new medical consultation was higher in the male intervention group (12.0%) than in male control group 2 (family policy, 1.5%, P = 0.04) but similar among women in all groups. LIMITATIONS REASONS FOR CAUTION First, the high attrition rate may limit the generalizability of these findings for longer-term acquisition of fertility knowledge, especially when applied to younger people who were more likely to be lost to follow-up. Second, this is a 2-year follow-up study and the results may change in the longer-term. Finally, we relied on self-reported questionnaire data and there is a possibility that some women were unknowingly pregnant at T1 but this risk should be distributed equally in the three groups through randomization. WIDER IMPLICATIONS OF THE FINDINGS Effects of one-time education were limited but retained beyond baseline levels. Importantly, education was found to potentially accelerate decision-making about achieving births in partnered subgroups compared to receiving healthy pre-pregnancy information. However, this finding should be confirmed in future stratified RCTs designed to evaluate effects in these subgroups. Follow-up 'booster' education sessions might help people retain knowledge and facilitate reproductive decisions for longer. In view of the high attrition rate, especially among young populations, novel educational strategies to retain young people in fertility education cohorts should be explored. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by National Center for Child Health and Development, the Daiwa Anglo-Japanese Foundation, Pfizer Health Research Foundation, and the Japan Society for the Promotion of Science. E.M. reports joint research funds from a public interest incorporated foundation '1 more Baby Ohendan.'
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Affiliation(s)
- Eri Maeda
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, Akita, Japan
| | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Satoshi Toyokawa
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuyuki Murata
- Department of Environmental Health Sciences, Akita University Graduate School of Medicine, Akita, Japan
| | - Hidekazu Saito
- Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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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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Nomura K, Karita K, Araki A, Nishioka E, Muto G, Iwai-Shimada M, Nishikitani M, Inoue M, Tsurugano S, Kitano N, Tsuji M, Iijima S, Ueda K, Kamijima M, Yamagata Z, Sakata K, Iki M, Yanagisawa H, Kato M, Inadera H, Kokubo Y, Yokoyama K, Koizumi A, Otsuki T. For making a declaration of countermeasures against the falling birth rate from the Japanese Society for Hygiene: summary of discussion in the working group on academic research strategy against an aging society with low birth rate. Environ Health Prev Med 2019; 24:14. [PMID: 30836940 PMCID: PMC6402135 DOI: 10.1186/s12199-019-0768-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/14/2019] [Indexed: 12/15/2022] Open
Abstract
In 1952, the Japanese Society for Hygiene had once passed a resolution at its 22nd symposium on population control, recommending the suppression of population growth based on the idea of cultivating a healthier population in the area of eugenics. Over half a century has now passed since this recommendation; Japan is witnessing an aging of the population (it is estimated that over 65-year-olds made up 27.7% of the population in 2017) and a decline in the birth rate (total fertility rate 1.43 births per woman in 2017) at a rate that is unparalleled in the world; Japan is faced with a "super-aging" society with low birth rate. In 2017, the Society passed a resolution to encourage all scientists to engage in academic researches to address the issue of the declining birth rate that Japan is currently facing. In this commentary, the Society hereby declares that the entire text of the 1952 proposal is revoked and the ideas relating to eugenics is rejected. Since the Society has set up a working group on the issue in 2016, there have been three symposiums, and working group committee members began publishing a series of articles in the Society's Japanese language journal. This commentary primarily provides an overview of the findings from the published articles, which will form the scientific basis for the Society's declaration. The areas we covered here included the following: (1) improving the social and work environment to balance between the personal and professional life; (2) proactive education on reproductive health; (3) children's health begins with nutritional management in women of reproductive age; (4) workplace environment and occupational health; (5) workplace measures to counter the declining birth rate; (6) research into the effect of environmental chemicals on sexual maturity, reproductive function, and the children of next generation; and (7) comprehensive research into the relationship among contemporary society, parental stress, and healthy child-rearing. Based on the seven topics, we will set out a declaration to address Japan's aging society with low birth rate.
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Affiliation(s)
- Kyoko Nomura
- Department of Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Kanae Karita
- Department of Public Health, Kyorin University Gender Equality Promotion Office, Kyorin University School of Medicine, Tokyo, Japan
| | - Atsuko Araki
- Hokkaido University Center for Environmental and Health Sciences, Sapporo, Japan
| | - Emiko Nishioka
- Department of Maternal Nursing, Division of Nursing, National Defense Medical College, Saitama, Japan
| | - Go Muto
- Department of Hygiene, Kitasato University School of Medicine, Kanagawa, Japan
| | - Miyuki Iwai-Shimada
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Ibaragi, Japan
| | - Mariko Nishikitani
- Institute of Decision Science for a Sustainable Society, Kyushu University, Fukuoka, Japan
| | - Mariko Inoue
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - Shinobu Tsurugano
- Health Care Center, The University of Electro-Communications, Tokyo, Japan
| | - Naomi Kitano
- Research Center for Community Medicine and Department of Public Health, Wakayama Medical University School of Medicine, Wakayama, Japan
| | - Mayumi Tsuji
- Department of Environmental Health, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Sachiko Iijima
- Graduate School of Health Care and Nursing, Juntendo University, Chiba, Japan
| | - Kayo Ueda
- Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate medical University, Iwate, Japan
| | - Masayuki Iki
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Hiroyuki Yanagisawa
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Masashi Kato
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazuhito Yokoyama
- Department of Epidemiology and Environmental Health, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | | | - Takemi Otsuki
- Department of Hygiene, Kawasaki Medical School, Okayama, Japan
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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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Hartnett CS, Margolis R. Births that are Later-than-Desired: Correlates and Consequences. POPULATION RESEARCH AND POLICY REVIEW 2019. [DOI: 10.1007/s11113-019-09513-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Farquhar CM, Bhattacharya S, Repping S, Mastenbroek S, Kamath MS, Marjoribanks J, Boivin J. Female subfertility. Nat Rev Dis Primers 2019; 5:7. [PMID: 30679436 DOI: 10.1038/s41572-018-0058-8] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Subfertility is common and affects one in six couples, half of whom lack an explanation for their delay in conceiving. Developments in the diagnosis and treatment of subfertility over the past 50 years have been truly remarkable. Indeed, current generations of couples with subfertility are more fortunate than previous generations, as they have many more opportunities to become parents. The timely access to effective treatment for subfertility is important as many couples have a narrow window of opportunity before the age-related effects of subfertility limit the likelihood of success. Assisted reproduction can overcome the barriers to fertility caused by tubal disease and low sperm count, but little progress has been made in reducing the effect of increasing age on ovarian function. The next 5-10 years will likely see further increases in birth rates in women with subfertility, a greater awareness of lifestyle factors and a possible refinement of current assisted reproduction techniques and the development of new ones. Such progress will bring challenging questions regarding the potential benefits and harms of treatments involving germ cell manipulation, artificial gametes, genetic screening of embryos and gene editing of embryos. We hope to see a major increase in fertility awareness, access to safe and cost-effective fertility care in low-income countries and a reduction in the current disparity of access to fertility care.
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Affiliation(s)
- Cynthia M Farquhar
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
| | - Siladitya Bhattacharya
- College of Biomedical and Life Sciences, Cardiff University School of Medicine, Cardiff, UK
| | - Sjoerd Repping
- Amsterdam UMC, University of Amsterdam, Center for Reproductive Medicine, Amsterdam Reproduction & Development research institute, Amsterdam, Netherlands
| | - Sebastiaan Mastenbroek
- Amsterdam UMC, University of Amsterdam, Center for Reproductive Medicine, Amsterdam Reproduction & Development research institute, Amsterdam, Netherlands
| | - Mohan S Kamath
- Department of Reproductive Medicine, Christian Medical College, Vellore, India
| | - Jane Marjoribanks
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Jacky Boivin
- School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Nomura K, Karita K, Araki A, Nishioka E, Muto G, Iwai-Shimada M, Nishikitani M, Inoue M, Tsurugano S, Kitano N, Tsuji M, Iijima S, Ueda K, Kamijima M, Yamagata Z, Sakata K, Iki M, Yanagisawa H, Kato M, Yokoyama K, Koizumi A, Otsuki T. [Toward a Declaration to Address Japan's Aging Society with Low Birth Rate: Summary of the Japanese Society for Hygiene's Working Group on Academic Research Strategy against an Aging Society with Low Birth Rate]. Nihon Eiseigaku Zasshi 2019; 74. [PMID: 30647203 DOI: 10.1265/jjh.18034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kyoko Nomura
- Department of Public Health, Akita University Graduate School of Medicine
| | - Kanae Karita
- Department of Public Health, Kyorin University, School of Medicine/Kyorin University Gender Equality Promotion Office
| | - Atsuko Araki
- Hokkaido University Center for Environmental and Health Sciences
| | - Emiko Nishioka
- National Defense Medical College Division of Nursing Maternal Nursing
| | - Go Muto
- Department of Epidemiology and Environmental Health, Juntendo University Graduate School of Medicine
| | - Miyuki Iwai-Shimada
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies
| | - Mariko Nishikitani
- Institute of Decision Science for a Sustainable Society, Kyushu University
| | - Mariko Inoue
- Graduate School of Public Health, Teikyo University
| | | | - Naomi Kitano
- Research Center for Community Medicine and Department of Public Health, Wakayama Medical University School of Medicine
| | - Mayumi Tsuji
- Department of Industrial Hygiene, University of Occupational and Environmental Health, Japan
| | - Sachiko Iijima
- Graduate School of Health Care and Nursing, Juntendo University Graduate School of Medicine
| | - Kayo Ueda
- Graduate School of Global Environmental Studies, Kyoto University
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences
| | - Zentaro Yamagata
- Department of Health Sciences, School of Medicine, University of Yamanashi
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University
| | - Masayuki Iki
- Department of Public Health, Kinki University Faculty of Medicine
| | - Hiroyuki Yanagisawa
- Department of Public Health & Environmental Medicine, The Jikei University School of Medicine
| | - Masashi Kato
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine
| | - Kazuhito Yokoyama
- Department of Epidemiology and Environmental Health, Juntendo University Graduate School of Medicine
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Bodin M, Tydén T, Käll L, Larsson M. Can Reproductive Life Plan-based counselling increase men's fertility awareness? Ups J Med Sci 2018; 123:255-263. [PMID: 30541376 PMCID: PMC6327788 DOI: 10.1080/03009734.2018.1541948] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 10/23/2018] [Accepted: 10/25/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Many men have limited knowledge about reproductive health and fertility. The aim of the study was to evaluate if Reproductive Life Plan (RLP)-based counselling during a sexual health visit could increase men's fertility awareness. MATERIAL AND METHODS The study was a randomized controlled trial including 201 men aged 18-50 who visited either of two participating sexual health clinics in Sweden for sexually transmitted infection testing during 2014-2016. All men received standard care, and men in the intervention group (IG) also received oral and written RLP-based information about lifestyle and fertility. Awareness about fertility and lifestyle-related factors were the main outcomes, measured through a questionnaire before the intervention and through a telephone survey after three months. Impressions from the counselling were also assessed at follow-up. RESULTS A majority (71%) of men wanted children in the future. General fertility awareness increased from a mean score of 4.6 to 5.5 out of 12 (P = 0.004) in the IG. The mean number of accurate lifestyle factors (that could affect fertility) mentioned increased from 3.6 to 4.4 (P < 0.001) in the IG. There were no improvements in the control group. Among the men in the IG, 76% had a positive experience of the counselling, and 77% had received new information. CONCLUSION The intervention managed to increase different aspects of men's fertility awareness. In the future, the format for preconception care for men needs further development. Including men in preconception health policy guidelines and identifying suitable actors for care provision would be important first steps.
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Affiliation(s)
- Maja Bodin
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Centre for Gender Research, Uppsala University, Uppsala, Sweden
| | - Tanja Tydén
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Lisa Käll
- Centre for Gender Research, Uppsala University, Uppsala, Sweden
| | - Margareta Larsson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Sylvest R, Koert E, Vittrup I, Birch Petersen K, Nyboe Andersen A, Pinborg A, Schmidt L. Status one year after fertility assessment and counselling in women of reproductive age-a qualitative study. Ups J Med Sci 2018; 123:264-270. [PMID: 30539672 PMCID: PMC6327567 DOI: 10.1080/03009734.2018.1546243] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Over the past 50 years women and men have postponed family formation in high-income societies. Fertility assessment and counselling has been suggested as a method to reduce delayed childbearing and its consequences. This study explored women's perceptions of how attending a fertility assessment intervention influenced their decisions and choices regarding family formation and childbearing. MATERIAL AND METHODS Follow-up data from a longitudinal semi-structured qualitative interview study including 20 women aged 35-40 years seeking individual fertility counselling at the Fertility Assessment and Counselling Clinic at Rigshospitalet, Copenhagen, Denmark. The interviews were conducted one year after their consultation. Data were analysed by qualitative content analysis. RESULTS The women perceived an increase in their knowledge after they had attended the counselling. The women saw the counselling as a catalyst for change-they changed their behaviour and relationship status. The women stopped thinking about the pros and cons of childbearing and acted instead. The women did not experience any regrets about acting. Some of the women felt that they were still in limbo as they were still in doubt concerning childbearing. The consultation had not given them an answer with a clear deadline in terms of delaying attempts to become pregnant, and this frustrated them. CONCLUSIONS Our study highlights the impact of a fertility assessment and counselling intervention which included a perceived increase in knowledge. The clinic allows for an individualized approach to fertility awareness which is necessary given the unique nature of childbearing decisions.
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Affiliation(s)
- Randi Sylvest
- Department of Obstetrics and Gynecology, Fertility Clinic, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
- CONTACT Randi Sylvest Fertility Clinic, Hvidovre, University Hospital of Copenhagen, Kettegård Allé 30, Section 455, DK-2650Hvidovre, Denmark
| | - Emily Koert
- Fertility Clinic, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Ida Vittrup
- Fertility Clinic, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | | | - Anders Nyboe Andersen
- Fertility Clinic, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Anja Pinborg
- Fertility Clinic, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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García D, Rodríguez A, Vassena R. Actions to increase knowledge about age-related fertility decline in women. EUR J CONTRACEP REPR 2018; 23:371-378. [PMID: 30354690 DOI: 10.1080/13625187.2018.1526895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE There is a strong body of published data corroborating the current lack of awareness of age-related fertility decline (ARFD), but few studies have evaluated specific interventions aimed at increasing ARFD knowledge. Here, we review the literature examining the instruments developed and the educational interventions performed to date. METHODS We carried out a narrative review based on a literature search in PubMed, Web of Science, PsycINFO and Scopus between January 2010 and December 2017. RESULTS The instruments available comprise websites, paper brochures, slide presentations and tailored information, mainly developed with the input of university students. The eight interventions reviewed include surveys before and/or after a specific intervention, with and without a control group, in randomised and non-randomised designs. Overall, the interventions were effective in increasing ARFD knowledge and lowering the desired age for childbearing in the short term. These results were not always maintained, however, in the long term, possibly due to a lack of perceived risk of future infertility among those studied. CONCLUSION Further interventions need to be targeted to both young people and health care providers, and should be as personalised as possible. A greater number of validated instruments are also needed to reliably measure the effectiveness of any intervention.
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Blanchet C, Babineau V, Boivin J, Ruchat SM. Cross-Cultural Adaptation of the Cardiff Fertility Knowledge Scale and the Fertility Status Awareness Tool for the French-Canadian Population. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2018; 41:204-209. [PMID: 30316711 DOI: 10.1016/j.jogc.2018.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/03/2018] [Accepted: 04/04/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The Cardiff Fertility Knowledge Scale (CFKS) and the Fertility Status Awareness Tool (FertiSTAT) are validated tools allowing the evaluation of fertility knowledge and raising awareness about risk indicators for reduced fertility. Their use by health care professionals practicing in the field of reproductive health might optimize fertility of the Canadian population. However, there currently is no version of these questionnaires for the French-Canadian population. The objective of this study was to translate and culturally adapt the CFKS and FertiSTAT to the French-Canadian population. METHODS The translation and adaptation of the questionnaires was completed following a four-stage approach: (1) forward translation, (2) synthesis, (3) expert committee review, and (4) testing of the prefinal version of the questionnaires. The testing stage was conducted with a sample of 30 women and 10 men. RESULTS During the translation process, linguistic difficulties were met for some items of both questionnaires but were resolved by consensus of the expert committee. Thirty women and 10 men tested the prefinal version of the CFKS-F and FertiSTAT-F. On a 5-point Likert scale, the global comprehension was 4.8 ± 0.5 and 4.6 ± 0.6, respectively. Based on the comments of the participants, the expert committee made minor modifications in the final version of the questionnaires to clarify the formulation of questions and adapt to one medical term. CONCLUSION Tools to assess fertility knowledge and the presence of risk indicators for reduced fertility are now available for health care professionals practicing in the field of reproductive health.
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Affiliation(s)
- Claudine Blanchet
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC
| | - Véronique Babineau
- Department of Obstetrics and Gynaecology, Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec, University of Montréal, Trois-Rivières, QC
| | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Stephanie-May Ruchat
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC.
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Knowledge of age-related fertility decline in women: A systematic review. Eur J Obstet Gynecol Reprod Biol 2018; 230:109-118. [PMID: 30248536 DOI: 10.1016/j.ejogrb.2018.09.030] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 08/23/2018] [Accepted: 09/12/2018] [Indexed: 01/18/2023]
Abstract
Age-related fertility decline (ARFD) knowledge has been evaluated in the past decade, showing that there is a general knowledge of the reduction of fertility with age. Here we review the studies published up to date which quantitatively measure this ARFD knowledge, to answer the question: how aware about ARFD is our society? We searched the terms "age", "fertility knowledge", "fertility awareness", "reproduction knowledge", "reproductive knowledge" and "reproductive health knowledge" in PubMed, Web of Science, PsychINFO and Scopus, within January 2000 and December 2016. We found 41 studies that quantitatively measured ARFD knowledge by asking for the most fertile age for a woman and/or when there are a slight and a marked decrease in female fertility. We obtained this searching for the questions: What is the most fertile age for a woman? (Q1). When there is a slight decrease in female fertility? (Q2) and, When there is a marked decrease in female fertility? (Q3). We further evaluated the knowledge increase in the 6 studies assessing an educational intervention, 4 of them randomized controlled trials (RCT). Participants reporting the most fertile age for women to be at 20-24 y.o. ranged 16%-89.4% (Q1); participants reporting a slight decrease in female fertility at 25-29 y.o. ranged 5.1%-83% (Q2), and those reporting that a marked decrease occurs between 35-39 y.o. ranged 5.6%-60% (Q3). On the whole, the studies included in this review conclude that ARFD knowledge is insufficient, particularly in determining when female fertility markedly decreases. ARFD knowledge can be increased through targeted campaigns, but few interventional studies have been performed up to date. In view of these results, ARFD campaigns targeted to reproductive age people and healthcare providers are necessary; this would help the society to make informed reproductive decisions throughout life.
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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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Pedro J, Brandão T, Schmidt L, Costa ME, Martins MV. What do people know about fertility? A systematic review on fertility awareness and its associated factors. Ups J Med Sci 2018; 123:71-81. [PMID: 29957086 PMCID: PMC6055749 DOI: 10.1080/03009734.2018.1480186] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 06/01/2017] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Recent evidence indicates that reproductive-age people have inadequate fertility awareness (FA) concerning fertility, infertility risk factors, and consequences of delaying childbearing. However, no study has tried to summarize these studies and to clarify the variables associated with FA, namely the role of gender, age, education, and reproductive status on FA. METHODS A literature search up to February 2017 was conducted using the EBSCO, Web of Science, Scielo, and Scopus electronic databases with combinations of keywords and MeSH terms (e.g. 'awareness' OR 'health knowledge, attitudes, practice' AND 'fertility'; 'fertile period'; 'assisted reprod*'). RESULTS Seventy-one articles met the eligibility criteria and were included. The main results showed that participants report low-to-moderate FA. Higher levels of FA were shown by women, highly educated individuals, people who reported difficulties with conceiving, and those who had planned their pregnancies. Having or desiring to have children was not related to FA level. An inconsistent association between study participant age and FA was observed, with some studies indicating that older participants had higher FA, but others found an opposite result or did not find any association. CONCLUSION The current findings suggest that interventions to increase FA are warranted, especially those targeting men, people with low education, and in family planning settings. Interventions and campaigns should be customized to meet individuals' needs regarding FA. Because of the high heterogeneity regarding the assessment of FA, these conclusions must be interpreted with caution.
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Affiliation(s)
- Juliana Pedro
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Tânia Brandão
- Centre for Research in Psychology (CIP-UAL), Universidade Autónoma de Lisboa, Lisboa, Portugal
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Maria E. Costa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Mariana V. Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Centre for Psychology, University of Porto, Porto, Portugal
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Fehring RJ, Mu Q. Current medical research: Summer/Fall 2016. LINACRE QUARTERLY 2017; 84:74-92. [PMID: 28392600 PMCID: PMC5375648 DOI: 10.1080/00243639.2017.1278350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Qiyan Mu
- Marquette University College of Nursing, Milwaukee, WI, USA
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Abstract
PURPOSE OF REVIEW Elective oocyte cryopreservation for deferred childbearing has gained popularity worldwide, commensurate with increased knowledge regarding age-related fertility decline. The purpose of this review is to summarize recent data regarding trends in delayed childbearing, review recent findings surrounding age-related fertility decline, acknowledge significant gaps in knowledge among patients and providers regarding fertility decline and review outcomes following elective oocyte cryopreservation. RECENT FINDINGS Despite an inevitable decline in fertility and increase in miscarriage with increasing female age, there is a growing worldwide trend to delay childbearing. Patients and providers alike demonstrate large gaps in knowledge surrounding age-related fertility decline. Oocyte cryopreservation is clinically approved for medically indicated fertility preservation, but a growing number of women are using oocyte cryopreservation to defer childbearing and maintain reproductive autonomy. Mounting data support the efficacy and safety of oocyte cryopreservation when used to electively defer childbearing, with recent studies demonstrating rates of euploidy, implantation and live birth rates equivalent to in-vitro fertilization (IVF) with fresh oocytes. SUMMARY Oocyte cryopreservation provides women with an option to defer childbearing and maintain reproductive autonomy, with IVF success rates on par with fresh IVF. However, it is critical that patients understand the limitations of oocyte cryopreservation. Greater education regarding age-related fertility decline should be geared toward patients and providers to prevent unintended childlessness.
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Affiliation(s)
- Kara N Goldman
- New York University Fertility Center (NYUFC), NYU Langone Medical Center, New York, New York, USA
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