Childless Canadian men's and women's childbearing intentions, attitudes towards and willingness to use assisted human reproduction

Daniluk, Judith C.; Koert, Emily

doi:10.1093/humrep/des190

Cited by 62 publications

(53 citation statements)

References 27 publications

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“…Our intervention influenced women to plan for their last child earlier in life. This is very promising, as previous studies have indicated a need for education about age and fertility (Bretherick et al ., 2010; Rovei et al ., 2010; Virtala et al ., 2011; Hashiloni-Dolev et al ., 2011; Daniluk and Koert, 2012; Peterson et al , 2012). The midwives explicitly told the women in the IG to take folic acid pills when they discontinued hormonal contraceptive pills.…”

Section: Discussionmentioning

confidence: 99%

Introducing reproductive life plan-based information in contraceptive counselling: an RCT

et al. 2013

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STUDY QUESTIONCan reproductive life plan (RLP)-based information in contraceptive counselling before pregnancy increase women's knowledge of reproduction, and of the importance of folic acid intake in particular?SUMMARY ANSWERThe RLP-based information increased women's knowledge of reproduction including knowledge of folic acid intake.WHAT IS KNOWN ALREADYMany women have insufficient knowledge of reproduction, including a health-promoting lifestyle prior to conception, and highly educated women in particular postpone childbearing until an age when their fertile capacity has started to decrease.STUDY DESIGN, SIZE, DURATIONThe study was an randomized controlled trial with one intervention group (IG) and two control groups (CG1, CG2). A sample size calculation indicated that 82 women per group would be adequate. Recruitment took place during 3 months in 2012 and 299 women were included. The women were randomized in blocks of three. All groups received standard care (contraceptive counselling, Chlamydia testing, cervical screening). In addition, women in the IG were given oral and written RLP-based information about reproduction.PARTICIPANTS/MATERIALS, SETTING, METHODSA total of 299 out of 338 (88%) Swedish-speaking women visiting a Student Health Centre were included (mean age 23 years); response rate was 88%. Before the counselling, women in the IG and the CG1 completed a baseline questionnaire, including questions about lifestyle changes in connection to pregnancy planning, family planning intentions and knowledge of reproduction (e.g. the fecundity of an ovum). At follow-up 2 months after inclusion, a structured telephone interview was performed in all groups (n = 262, 88% participation rate).MAIN RESULTS AND THE ROLE OF CHANCEThere was no difference between the groups regarding the mean knowledge score at baseline. The IG scored higher at follow-up than at baseline (P < 0.001); the mean increased from 6.4 to 9.0 out of a maximum 20 points. The women in the CG1 scored no differently at follow-up than at baseline. The difference in the knowledge score between the IG and the two CGs was significant (P < 0.001), whereas no difference was shown between the two CGs. There was no difference between the groups at baseline regarding how many women could mention folic acid intake among the things to do when planning to get pregnant. At follow-up, 22% in the IG, 3% in CG1 and 1% in CG2 mentioned folic acid intake (P < 0.001). At follow-up, more women in the IG also wished to have their last child earlier in life (P < 0.001) than at baseline, while there was no difference in the CG1.LIMITATIONS, REASONS FOR CAUTIONAs the study sample consisted of university students, it is possible that the effect of the intervention was connected to a high level of education and conclusions for all women of reproductive age should be drawn with caution.WIDER IMPLICATIONS OF THE FINDINGSThe provision of RLP-based information seems to be a feasible tool for promoting reproductive health.STUDY FUNDING/COMPETING INTEREST(S)Study funding was re...

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Section: Discussionmentioning

confidence: 99%

Introducing reproductive life plan-based information in contraceptive counselling: an RCT

et al. 2013

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“…A study of childless Canadian adults reported both men and women were open to using IVF but were less willing to consider third-party options (i.e. donor eggs/embryos, surrogacy) [61]. ART uptake has increased over the past decade in Canada [59] and the US [60], supporting the need for health promotion regarding fertility preservation and the risks and benefits of ART.…”

Section: Discussionmentioning

confidence: 99%

A qualitative study of Ottawa university students’ awareness, knowledge and perceptions of infertility, infertility risk factors and assisted reproductive technologies (ART)

et al. 2013

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BackgroundAwareness of infertility risk factors is an essential first step to safeguard future fertility. Whereas several studies have examined university students’ awareness of female fertility and related risk factors, the topic of male infertility has not been well examined. The objective of this study was to assess young men and women’s awareness, knowledge and perceptions of infertility, male and female infertility risk factors and assisted reproductive technologies (ART).MethodsSemi-structured interviews were conducted in 2008 with a multi-ethnic sample of sixteen male and twenty-three female Ottawa university students, followed by qualitative data analysis to identify major themes. Interview topics included awareness of male and female infertility risk factors, infertility diagnosis/treatments and personal options in the event of future infertility.ResultsParticipants were generally familiar with infertility as a biomedical health problem, could identify sex-specific risk factors but overestimated fertility of women in their thirties and ART success rates. Reproductive health knowledge gaps and confusion of the physiological life-stage of menopause with infertility were apparent. Most participants would pursue in vitro fertilization or international adoption in the event of personal infertility. Some participants wished to use a ‘natural’ approach and were concerned with potential side effects of ART-related medications.ConclusionsThe general awareness of infertility in young adults is promising and supports the potential uptake for health promotion of fertility preservation. This study underscores the continued need for comprehensive sexual and reproductive health education and promotion for adolescents and young adults.

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“…A 2012 survey reveals that surrogacy is neither a taboo topic nor an unrealistic reproductive option for many Canadians; onequarter of childless adult women and 40% of childless adult men would consider using a surrogate should they or their partner not be able to carry and give birth to their biological child. 7 Personal testimonials featured in popular magazines, [8][9][10] newspaper articles reporting on out-of-province and outof-country surrogate births, [11][12][13] and exposés of media celebrities including Joël Legendre and his husband, who forced the Quebec government to pay their surrogacy costs, 14 lead one to conclude that surrogacy as practiced in Canada is an acknowledged, albeit controversial, twenty-first century familymaking activity.…”

Section: Introductionmentioning

confidence: 99%

Hidden from view: Canadian gestational surrogacy practices and outcomes, 2001-2012

White

2016

Reproductive Health Matters

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This paper raises some troubling questions about the fertility treatments provided to Canadian gestational surrogates, women not genetically related to the child that they carry. Using information published between 2003 and 2012 by Canada's Assisted Reproduction Registry, the paper traces the growing incidence of births to gestational surrogates. The transfer of more than one embryo increases the chance of pregnancy and the incidence of multiple births, and while the incidence of multiple births has declined overall since 2010, gestational surrogates consistently experience a higher proportion of multiple births and experienced higher levels of multiple embryo transfers. In 2012, just 26% of gestational surrogates received a single embryo transfer compared to 47% of other in vitro fertilisation (IVF) patients. The paper suggests that renewed attention needs to be paid to the counselling provided to gestational surrogates and treatment consenting mechanisms used by IVF clinics and that review of the 2007 Canadian Medical Association surrogate treatment guidelines is warranted. Finally, the paper describes the difficulties in obtaining accurate data about Canadian assisted reproductive medicine. Without good data, it becomes far more difficult to identify the possibility of potentially harmful practices.

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Childless Canadian men's and women's childbearing intentions, attitudes towards and willingness to use assisted human reproduction

Abstract: This research was funded by a grant from the Canadian Institutes of Health Research and Assisted Human Reproduction Canada #PAH-103594, 2009/10. No competing interests.

Cited by 62 publications

References 27 publications

Introducing reproductive life plan-based information in contraceptive counselling: an RCT

Introducing reproductive life plan-based information in contraceptive counselling: an RCT

A qualitative study of Ottawa university students’ awareness, knowledge and perceptions of infertility, infertility risk factors and assisted reproductive technologies (ART)

Hidden from view: Canadian gestational surrogacy practices and outcomes, 2001-2012

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