Online Japanese-Language Information on Lifestyle Factors Associated With Reduced Fertility: Content Analysis

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.

Japanese Magazine Articles on Lifestyle Factors Associated with Fertility: A Content Analysis

“…Although nutritional factors such as healthy dietary patterns are evidence-based lifestyle factors associated with fertility [13,39], they are covered in the articles to a greater extent than other factors. This is consistent with our findings from a previous study of online content [22]. A 2016 survey conducted in Japan reported that 59.7% of female respondents and 32.0% of male respondents reconsidered their dietary habits when pregnant or trying to conceive [15] consistent with the emphasis on nutrition we observed in the magazine articles.…”

“…Previous studies on infertility information analyzed online information on lifestyle factors associated with reduced fertility [22], newspaper articles on assisted reproductive technology [23], the readability, suitability, and quality of online information on infertility [24,25], and infertility-related videos [26]. Individuals diagnosed with infertility may obtain accurate information from healthcare providers.…”

Marriage, aging, and women’s pursuit of commercial sex in Japan

“…This compartmentalization of female sexuality based on age and maternal status provides a small window of time for young women to get married and involve themselves in reproductive sex. Married women without children are encouraged to engage in so-called kodukuri, literally trying to conceive a child, or more recently, ninkatsu, meaning active engagement in pregnancy (similarly to sh ukatsu, job hunting), within Japan's rapidly aging society (Yokota et al, 2020). In this social context, women in their 30s and 40s with children are in limbo.…”

Association Between Triglyceride Glucose Index and Infertility in Reproductive-Aged Women: A Cross-Sectional Study

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