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  • the importance of the family clock women s lived experience of Fertility Decision making 6 years after attending the Fertility assessment and counselling clinic
    2021
    Co-Authors: Jacky Boivin, Emily Koert, Randi Sylvest, Ida Vittrup, Helene Westring Hvidman, Kathrine Birch Petersen, Anders Nyboe Andersen, Lone Schmidt
    Abstract:

    This study explored women's lived experience of making Fertility Decisions six years after attending the Fertility Assessment and Counselling (FAC) clinic in Copenhagen, Denmark, which is a personalised Fertility awareness intervention. We conducted a qualitative interview study with 24 women who attended the FAC clinic 6 years earlier. Interviews were semi-structured and broadly examined the women's perceptions and experience of the intervention during follow-up. Data was analysed using a phenomenological framework and themes were identified related to women's experience of making Fertility Decisions after attending the FAC clinic. The overarching theme regarding the women's lived experience of making Fertility Decisions after attending the FAC clinic was: Fertility Decisions were guided by the 'family clock'. There were four themes: (i) Deciding to 'get started' by attending the FAC clinic; (ii) Sense of making informed and empowered Decisions; (iii) Influence of partner status on Fertility Decisions; and (iv) Decisions dictated by circumstance over preference and knowledge. At follow-up, the majority (21 women, 88%) had become parents. More than half of the women said that they had not achieved their desired family size. Consideration of women's 'family clock' is necessary in personalised Fertility awareness interventions to enable women to achieve their family goals.

  • women s perceptions of Fertility assessment and counselling 6 years after attending a Fertility assessment and counselling clinic in denmark
    2020
    Co-Authors: Jacky Boivin, Emily Koert, Randi Sylvest, Ida Vittrup, Helene Westring Hvidman, Birch K Petersen, Nyboe A Andersen, Lone Schmidt
    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.

  • what makes people ready to conceive findings from the international Fertility Decision making study
    2018
    Co-Authors: Jacky Boivin, Laura Buntin, Natasha Kalebic, C Harrison
    Abstract:

    This study investigated Fertility Decision-making in people currently trying to conceive, and examined whether factors that make people ready to conceive differ by gender and country. The study used data from the International Fertility Decision-Making Study, a cross-sectional study of 10,045 participants (1690 men and 8355 women) from 79 countries. Respondents were aged 18–50 years (mean 31.8 years), partnered and had been trying to conceive for >6 months (mean 2.8 years). Respondents indicated their need for parenthood; their own/partner's desire for a child; and the influence of certain preconditions, motivational forces and subjective norms in relation to readiness to conceive. Factor analysis of preconditions and motivational forces revealed four Decisional factors: social status of parents, economic preconditions, personal and relational readiness, and physical health and child costs. Significant gender differences were found for desire for a child, Decisional factors and subjective norms. Compared with men, women had higher personal desire for a child, and rated economic and personal and relational readiness as more influential. Men were more likely to rate subjective norms and social status of parents as more influential. Country comparisons found significant differences in personal desire for a child, partner's desire for a child, need for parenthood, preconditions, motivational forces and subjective norms. The results demonstrate that some Decisional factors have a universal association with starting families (e.g. desire for a child), whilst the influence of others (e.g. personal and relational readiness) is dependent on contextual factors. These findings support the need for contemporary, prospective and international research on reproductive Decision-making, and emphasize the need for effective Fertility policies to take contextual factors into account.

  • the role of knowledge and perceived susceptibility in intentions to optimize Fertility findings from the international Fertility Decision making study ifdms
    2013
    Co-Authors: Bethan Fulford, I Tsibulsky, Laura Elizabeth Bunting, Jacky Boivin
    Abstract:

    STUDY QUESTION What is the role of knowledge, perceived vulnerability and level of risk of inFertility in women's intentions to take action to improve their chance of becoming pregnant (i.e. by seeking medical and/or non-medical help and making lifestyle changes)? SUMMARY ANSWER Women younger than age 35 were more likely to intend to take measures to improve their chance of conceiving when they were knowledgeable about Fertility and felt susceptible to inFertility; however, there was no such association in older women. WHAT IS KNOWN ALREADY The majority of young adults wish to become parents but many are jeopardizing their chances by engaging in behaviours that decrease Fertility (e.g. smoking, not seeking timely medical advice when faced with problems conceiving). Research is needed to establish what motivates people to take steps to optimize their chances of pregnancy. The Health Belief Model (HBM) postulates that knowledge and beliefs about susceptibility to inFertility are critical in whether people will engage in Fertility-optimizing behaviours. STUDY DESIGN, SIZE AND DURATION This cross-sectional survey included 1345 childless women (trying to conceive and having never engaged in Fertility medical treatment) from the International Fertility Decision-Making Study (IFDMS). PARTICIPANTS/MATERIALS, SETTING, METHODS InFertility risk factors were determined using the FertiSTAT. The Cardiff Fertility Knowledge Scale (CFKS) assessed Fertility knowledge. Perceived susceptibility was defined as whether a Fertility problem was suspected. The outcome measure was intentions to optimize one's Fertility by making lifestyle changes and/or seeking help. MAIN RESULTS AND THE ROLE OF CHANCE In this study, 75.5% of women had an inFertility risk factor and 60.3% suspected a Fertility problem. The average correct score on the CFKS was 51.9%. Intentions to optimize Fertility were lower among women who were heavy smokers (P < 0.05) and who had been trying to conceive for a year or over (P < 0.01), while intentions to optimize Fertility were greater among those with a higher body mass index or greater knowledge and those who suspected a Fertility problem (all P < 0.001). These overall effects were qualified in some subgroups. Heavy smokers were more likely to intend to seek medical help when they had greater knowledge (P < 0.001) and women having difficulty conceiving were more likely to intend to seek medical help if they felt susceptible to inFertility (P < 0.001). Heavy smokers who were knowledgeable intended to change their lifestyle only when they felt they had a Fertility problem (P < 0.01). Intentions to change were not dependent on knowledge and perceived susceptibility in older women. LIMITATIONS, REASONS FOR CAUTION The data were cross-sectional and thus we cannot infer causality. The results may have been affected by the sample profile, which was biased towards high levels of perceived susceptibility and low levels of knowledge. WIDER IMPLICATIONS OF THE FINDINGS To maximize impact, educational campaigns should take into account the presence and type of inFertility risk factors in the target audience.

  • Fertility knowledge and beliefs about Fertility treatment findings from the international Fertility Decision making study
    2013
    Co-Authors: Laura Elizabeth Bunting, I Tsibulsky, Jacky Boivin
    Abstract:

    STUDY QUESTION How good is Fertility knowledge and what are treatment beliefs in an international sample of men and women currently trying to conceive? SUMMARY ANSWER The study population had a modest level of Fertility knowledge and held positive and negative views of treatment. WHAT IS KNOWN ALREADY Few studies have examined general Fertility treatment attitudes but studies of specific interventions show that attitudes are related to characteristics of the patient, doctor and context. Further, research shows that Fertility knowledge is poor. However, the majority of these studies have examined the prevalence of inFertility, the optimal fertile period and/or age-related inFertility in women, in university students and/or people from high-resource countries making it difficult to generalize findings. STUDY DESIGN, SIZE, DURATION A cross-sectional sample completed the International Fertility Decision-making Study (IFDMS) over a 9-month period, online or via social research panels and in Fertility clinics. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were 10 045 people (8355 women, 1690 men) who were on average 31.8 years old, had been trying to conceive for 2.8 years with 53.9% university educated. From a total of 79 countries, sample size was >100 in 18 countries. All 79 countries were assigned to either a very high Human Development Index (VH HDI) or a not very high HDI (NVH HDI). The IFDMS was a 45-min, 64-item English survey translated into 12 languages. The inclusion criteria were the age between 18 and 50 years and currently trying to conceive for at least 6 months. Fertility knowledge was assessed using a 13-item correct/incorrect scale concerned with risk factors, misconceptions and basic Fertility facts (range: 0–100% correct). Treatment beliefs were assessed with positive and negative statements about Fertility treatment rated on a five-point agree/disagree response scale. MAIN RESULTS AND THE ROLE OF CHANCE Average correct score for Fertility Knowledge was 56.9%, with greater knowledge significantly related to female gender, university education, paid employment, VH HDI and prior medical consultation for inFertility (all P 0.001). People who had given birth/fathered a child, been trying to conceive for less than 12 months, who had never consulted for a Fertility problem and who lived in a country with an NVH HDI agreed less with negative beliefs. HDI, duration of trying to conceive and help-seeking were also correlates of higher positive beliefs, alongside younger age, living in an urban area and having stepchildren. Greater Fertility knowledge was associated with stronger agreement on negative treatment beliefs items (P < 0.001) but was unrelated to positive treatment beliefs items. LIMITATIONS, REASONS FOR CAUTION There was volunteer bias insofar as more women, people of higher education and people with Fertility problems (i.e. met criteria for inFertility, had consulted a medical doctor, had conceived with Fertility treatment) participated and this was true in VH and NVH HDI countries. The bias may mean that people in this sample had better Fertility knowledge and less favourable treatment beliefs than is the case in the general population. WIDER IMPLICATIONS OF THE FINDINGS Educational interventions should be directed at improving knowledge of Fertility health. Future prospective research should be aimed at investigating how Fertility knowledge and treatment beliefs affect childbearing and help-seeking Decision-making. STUDY FUNDING/COMPETING INTEREST(S) Merck-Serono S. A. Geneva-Switzerland (an affiliate of Merck KGaA Darmstadt, Germany) and the Economic and Social Research Council (ESRC, UK) funded this project (RES-355-25-0038, ‘Fertility Pathways Network’). L.B. is funded by a postdoctoral fellowship from the Medical Research Council (MRC) and the ESRC (PTA-037-27-0192). I.T. is an employee of Merck-Serono S. A. Geneva-Switzerland (an affiliate of Merck KGaA Darmstadt, Germany).

Teresa K Woodruff - One of the best experts on this subject based on the ideXlab platform.

Laura Elizabeth Bunting - One of the best experts on this subject based on the ideXlab platform.

  • the role of knowledge and perceived susceptibility in intentions to optimize Fertility findings from the international Fertility Decision making study ifdms
    2013
    Co-Authors: Bethan Fulford, I Tsibulsky, Laura Elizabeth Bunting, Jacky Boivin
    Abstract:

    STUDY QUESTION What is the role of knowledge, perceived vulnerability and level of risk of inFertility in women's intentions to take action to improve their chance of becoming pregnant (i.e. by seeking medical and/or non-medical help and making lifestyle changes)? SUMMARY ANSWER Women younger than age 35 were more likely to intend to take measures to improve their chance of conceiving when they were knowledgeable about Fertility and felt susceptible to inFertility; however, there was no such association in older women. WHAT IS KNOWN ALREADY The majority of young adults wish to become parents but many are jeopardizing their chances by engaging in behaviours that decrease Fertility (e.g. smoking, not seeking timely medical advice when faced with problems conceiving). Research is needed to establish what motivates people to take steps to optimize their chances of pregnancy. The Health Belief Model (HBM) postulates that knowledge and beliefs about susceptibility to inFertility are critical in whether people will engage in Fertility-optimizing behaviours. STUDY DESIGN, SIZE AND DURATION This cross-sectional survey included 1345 childless women (trying to conceive and having never engaged in Fertility medical treatment) from the International Fertility Decision-Making Study (IFDMS). PARTICIPANTS/MATERIALS, SETTING, METHODS InFertility risk factors were determined using the FertiSTAT. The Cardiff Fertility Knowledge Scale (CFKS) assessed Fertility knowledge. Perceived susceptibility was defined as whether a Fertility problem was suspected. The outcome measure was intentions to optimize one's Fertility by making lifestyle changes and/or seeking help. MAIN RESULTS AND THE ROLE OF CHANCE In this study, 75.5% of women had an inFertility risk factor and 60.3% suspected a Fertility problem. The average correct score on the CFKS was 51.9%. Intentions to optimize Fertility were lower among women who were heavy smokers (P < 0.05) and who had been trying to conceive for a year or over (P < 0.01), while intentions to optimize Fertility were greater among those with a higher body mass index or greater knowledge and those who suspected a Fertility problem (all P < 0.001). These overall effects were qualified in some subgroups. Heavy smokers were more likely to intend to seek medical help when they had greater knowledge (P < 0.001) and women having difficulty conceiving were more likely to intend to seek medical help if they felt susceptible to inFertility (P < 0.001). Heavy smokers who were knowledgeable intended to change their lifestyle only when they felt they had a Fertility problem (P < 0.01). Intentions to change were not dependent on knowledge and perceived susceptibility in older women. LIMITATIONS, REASONS FOR CAUTION The data were cross-sectional and thus we cannot infer causality. The results may have been affected by the sample profile, which was biased towards high levels of perceived susceptibility and low levels of knowledge. WIDER IMPLICATIONS OF THE FINDINGS To maximize impact, educational campaigns should take into account the presence and type of inFertility risk factors in the target audience.

  • Fertility knowledge and beliefs about Fertility treatment findings from the international Fertility Decision making study
    2013
    Co-Authors: Laura Elizabeth Bunting, I Tsibulsky, Jacky Boivin
    Abstract:

    STUDY QUESTION How good is Fertility knowledge and what are treatment beliefs in an international sample of men and women currently trying to conceive? SUMMARY ANSWER The study population had a modest level of Fertility knowledge and held positive and negative views of treatment. WHAT IS KNOWN ALREADY Few studies have examined general Fertility treatment attitudes but studies of specific interventions show that attitudes are related to characteristics of the patient, doctor and context. Further, research shows that Fertility knowledge is poor. However, the majority of these studies have examined the prevalence of inFertility, the optimal fertile period and/or age-related inFertility in women, in university students and/or people from high-resource countries making it difficult to generalize findings. STUDY DESIGN, SIZE, DURATION A cross-sectional sample completed the International Fertility Decision-making Study (IFDMS) over a 9-month period, online or via social research panels and in Fertility clinics. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were 10 045 people (8355 women, 1690 men) who were on average 31.8 years old, had been trying to conceive for 2.8 years with 53.9% university educated. From a total of 79 countries, sample size was >100 in 18 countries. All 79 countries were assigned to either a very high Human Development Index (VH HDI) or a not very high HDI (NVH HDI). The IFDMS was a 45-min, 64-item English survey translated into 12 languages. The inclusion criteria were the age between 18 and 50 years and currently trying to conceive for at least 6 months. Fertility knowledge was assessed using a 13-item correct/incorrect scale concerned with risk factors, misconceptions and basic Fertility facts (range: 0–100% correct). Treatment beliefs were assessed with positive and negative statements about Fertility treatment rated on a five-point agree/disagree response scale. MAIN RESULTS AND THE ROLE OF CHANCE Average correct score for Fertility Knowledge was 56.9%, with greater knowledge significantly related to female gender, university education, paid employment, VH HDI and prior medical consultation for inFertility (all P 0.001). People who had given birth/fathered a child, been trying to conceive for less than 12 months, who had never consulted for a Fertility problem and who lived in a country with an NVH HDI agreed less with negative beliefs. HDI, duration of trying to conceive and help-seeking were also correlates of higher positive beliefs, alongside younger age, living in an urban area and having stepchildren. Greater Fertility knowledge was associated with stronger agreement on negative treatment beliefs items (P < 0.001) but was unrelated to positive treatment beliefs items. LIMITATIONS, REASONS FOR CAUTION There was volunteer bias insofar as more women, people of higher education and people with Fertility problems (i.e. met criteria for inFertility, had consulted a medical doctor, had conceived with Fertility treatment) participated and this was true in VH and NVH HDI countries. The bias may mean that people in this sample had better Fertility knowledge and less favourable treatment beliefs than is the case in the general population. WIDER IMPLICATIONS OF THE FINDINGS Educational interventions should be directed at improving knowledge of Fertility health. Future prospective research should be aimed at investigating how Fertility knowledge and treatment beliefs affect childbearing and help-seeking Decision-making. STUDY FUNDING/COMPETING INTEREST(S) Merck-Serono S. A. Geneva-Switzerland (an affiliate of Merck KGaA Darmstadt, Germany) and the Economic and Social Research Council (ESRC, UK) funded this project (RES-355-25-0038, ‘Fertility Pathways Network’). L.B. is funded by a postdoctoral fellowship from the Medical Research Council (MRC) and the ESRC (PTA-037-27-0192). I.T. is an employee of Merck-Serono S. A. Geneva-Switzerland (an affiliate of Merck KGaA Darmstadt, Germany).

I Tsibulsky - One of the best experts on this subject based on the ideXlab platform.

  • the role of knowledge and perceived susceptibility in intentions to optimize Fertility findings from the international Fertility Decision making study ifdms
    2013
    Co-Authors: Bethan Fulford, I Tsibulsky, Laura Elizabeth Bunting, Jacky Boivin
    Abstract:

    STUDY QUESTION What is the role of knowledge, perceived vulnerability and level of risk of inFertility in women's intentions to take action to improve their chance of becoming pregnant (i.e. by seeking medical and/or non-medical help and making lifestyle changes)? SUMMARY ANSWER Women younger than age 35 were more likely to intend to take measures to improve their chance of conceiving when they were knowledgeable about Fertility and felt susceptible to inFertility; however, there was no such association in older women. WHAT IS KNOWN ALREADY The majority of young adults wish to become parents but many are jeopardizing their chances by engaging in behaviours that decrease Fertility (e.g. smoking, not seeking timely medical advice when faced with problems conceiving). Research is needed to establish what motivates people to take steps to optimize their chances of pregnancy. The Health Belief Model (HBM) postulates that knowledge and beliefs about susceptibility to inFertility are critical in whether people will engage in Fertility-optimizing behaviours. STUDY DESIGN, SIZE AND DURATION This cross-sectional survey included 1345 childless women (trying to conceive and having never engaged in Fertility medical treatment) from the International Fertility Decision-Making Study (IFDMS). PARTICIPANTS/MATERIALS, SETTING, METHODS InFertility risk factors were determined using the FertiSTAT. The Cardiff Fertility Knowledge Scale (CFKS) assessed Fertility knowledge. Perceived susceptibility was defined as whether a Fertility problem was suspected. The outcome measure was intentions to optimize one's Fertility by making lifestyle changes and/or seeking help. MAIN RESULTS AND THE ROLE OF CHANCE In this study, 75.5% of women had an inFertility risk factor and 60.3% suspected a Fertility problem. The average correct score on the CFKS was 51.9%. Intentions to optimize Fertility were lower among women who were heavy smokers (P < 0.05) and who had been trying to conceive for a year or over (P < 0.01), while intentions to optimize Fertility were greater among those with a higher body mass index or greater knowledge and those who suspected a Fertility problem (all P < 0.001). These overall effects were qualified in some subgroups. Heavy smokers were more likely to intend to seek medical help when they had greater knowledge (P < 0.001) and women having difficulty conceiving were more likely to intend to seek medical help if they felt susceptible to inFertility (P < 0.001). Heavy smokers who were knowledgeable intended to change their lifestyle only when they felt they had a Fertility problem (P < 0.01). Intentions to change were not dependent on knowledge and perceived susceptibility in older women. LIMITATIONS, REASONS FOR CAUTION The data were cross-sectional and thus we cannot infer causality. The results may have been affected by the sample profile, which was biased towards high levels of perceived susceptibility and low levels of knowledge. WIDER IMPLICATIONS OF THE FINDINGS To maximize impact, educational campaigns should take into account the presence and type of inFertility risk factors in the target audience.

  • Fertility knowledge and beliefs about Fertility treatment findings from the international Fertility Decision making study
    2013
    Co-Authors: Laura Elizabeth Bunting, I Tsibulsky, Jacky Boivin
    Abstract:

    STUDY QUESTION How good is Fertility knowledge and what are treatment beliefs in an international sample of men and women currently trying to conceive? SUMMARY ANSWER The study population had a modest level of Fertility knowledge and held positive and negative views of treatment. WHAT IS KNOWN ALREADY Few studies have examined general Fertility treatment attitudes but studies of specific interventions show that attitudes are related to characteristics of the patient, doctor and context. Further, research shows that Fertility knowledge is poor. However, the majority of these studies have examined the prevalence of inFertility, the optimal fertile period and/or age-related inFertility in women, in university students and/or people from high-resource countries making it difficult to generalize findings. STUDY DESIGN, SIZE, DURATION A cross-sectional sample completed the International Fertility Decision-making Study (IFDMS) over a 9-month period, online or via social research panels and in Fertility clinics. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were 10 045 people (8355 women, 1690 men) who were on average 31.8 years old, had been trying to conceive for 2.8 years with 53.9% university educated. From a total of 79 countries, sample size was >100 in 18 countries. All 79 countries were assigned to either a very high Human Development Index (VH HDI) or a not very high HDI (NVH HDI). The IFDMS was a 45-min, 64-item English survey translated into 12 languages. The inclusion criteria were the age between 18 and 50 years and currently trying to conceive for at least 6 months. Fertility knowledge was assessed using a 13-item correct/incorrect scale concerned with risk factors, misconceptions and basic Fertility facts (range: 0–100% correct). Treatment beliefs were assessed with positive and negative statements about Fertility treatment rated on a five-point agree/disagree response scale. MAIN RESULTS AND THE ROLE OF CHANCE Average correct score for Fertility Knowledge was 56.9%, with greater knowledge significantly related to female gender, university education, paid employment, VH HDI and prior medical consultation for inFertility (all P 0.001). People who had given birth/fathered a child, been trying to conceive for less than 12 months, who had never consulted for a Fertility problem and who lived in a country with an NVH HDI agreed less with negative beliefs. HDI, duration of trying to conceive and help-seeking were also correlates of higher positive beliefs, alongside younger age, living in an urban area and having stepchildren. Greater Fertility knowledge was associated with stronger agreement on negative treatment beliefs items (P < 0.001) but was unrelated to positive treatment beliefs items. LIMITATIONS, REASONS FOR CAUTION There was volunteer bias insofar as more women, people of higher education and people with Fertility problems (i.e. met criteria for inFertility, had consulted a medical doctor, had conceived with Fertility treatment) participated and this was true in VH and NVH HDI countries. The bias may mean that people in this sample had better Fertility knowledge and less favourable treatment beliefs than is the case in the general population. WIDER IMPLICATIONS OF THE FINDINGS Educational interventions should be directed at improving knowledge of Fertility health. Future prospective research should be aimed at investigating how Fertility knowledge and treatment beliefs affect childbearing and help-seeking Decision-making. STUDY FUNDING/COMPETING INTEREST(S) Merck-Serono S. A. Geneva-Switzerland (an affiliate of Merck KGaA Darmstadt, Germany) and the Economic and Social Research Council (ESRC, UK) funded this project (RES-355-25-0038, ‘Fertility Pathways Network’). L.B. is funded by a postdoctoral fellowship from the Medical Research Council (MRC) and the ESRC (PTA-037-27-0192). I.T. is an employee of Merck-Serono S. A. Geneva-Switzerland (an affiliate of Merck KGaA Darmstadt, Germany).

Martha Hickey - One of the best experts on this subject based on the ideXlab platform.

  • it s now or never Fertility related knowledge Decision making preferences and treatment intentions in young women with breast cancer an australian Fertility Decision aid collaborative group study
    2011
    Co-Authors: Michelle Peate, Bettina Meiser, Michael Friedlander, Helen Zorbas, Susan Rovelli, Ursula M Sansomdaly, Jennifer Sangster, Dusan Hadzipavlovic, Martha Hickey
    Abstract:

    Purpose For many young women with early breast cancer, Fertility is a priority. Interventions to retain Fertility options generally need to be accessed before chemotherapy, but many women do not receive information regarding these options in a timely fashion. Knowledge about Fertility and Decisional conflict has not previously been measured in young patients with breast cancer considering future pregnancies. Methods One hundred eleven young women with early breast cancer who had not yet completed their families were recruited around the time of diagnosis. Knowledge regarding Fertility-related information, Decisional conflict, and preferences regarding Fertility information and Decision making was measured. Results From a potential Fertility-related knowledge score of 10, the mean was 5.2 (standard deviation 2.3; range, 0 to 10). Decreased knowledge was associated with increased Decisional conflict about pursuing Fertility preserving interventions (odds ratio [OR] 0.57; 95% CI, 0.44 to 0.73; P .001). Thirty-one percent of women reported that they would consider undertaking in vitro fertilization (IVF) as a method to conserve their Fertility, whereas 38% were uncertain. Consideration of IVF was not related to whether subjects were in a committed relationship (OR 1.20; P .716) or a definite desire for more children (OR 1.54; P .513). Conclusion Around diagnosis, many young patients with breast cancer have low levels of knowledge about Fertility issues. Further, low knowledge is associated with increased Decisional conflict, which is likely to undermine the quality of Decision making. These findings suggest that targeted and timely Fertility information may reduce Decisional conflict and increase informed choice. Neither relationship status nor firm plans regarding future children reliably predict desire to pursue Fertility preservation.