Showing papers on "Fertility published in 2007"

Births: final data for 2005.

Abstract: Objectives—This report presents 2005 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother’s state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant charac­ teristics are described and interpreted. Methods—Descriptive tabulations of data reported on the birth certificates of the 4.1 million births that occurred in 2005 are presented. Denominators for population-based rates are postcensal estimates derived from the U.S. 2000 census. Results—In 2005, 4,138,349 births were registered in the United States, 1 percent more than in 2004. The 2005 crude birth rate was 14.0, unchanged from the previous year; the general fertility rate increased slightly to 66.7. Teenage childbearing continued to decline, dropping to the lowest levels recorded. Rates for women aged 20–29 were fairly stable, whereas childbearing among women 30 years of age and older increased. All measures of unmarried childbearing rose substantially in 2005. Smoking during pregnancy continued to decline. No improvement was seen in the timely initiation of prenatal care. The cesarean delivery rate climbed to more than 30 percent of all births, another all-time high. Preterm and low birthweight rates also continued to rise; the twin birth rate was unchanged and the rate of triplet and higher order multiple births declined for the 7th consecutive year.

Psychological impact of infertility.

Abstract: The inability to conceive children is experienced as a stressful situation by individuals and couples all around the world. The consequences of infertility are manifold and can include societal repercussions and personal suffering. Advances in assisted reproductive technologies, such as IVF, can offer hope to many couples where treatment is available, although barriers exist in terms of medical coverage and affordability. The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood. Evidence is emerging of an association between stress of fertility treatment and patient drop-out and pregnancy rates. Fortunately, psychological interventions, especially those emphasizing stress management and coping-skills training, have been shown to have beneficial effects for infertility patients. Further research is needed to understand the association between distress and fertility outcome, as well as effective psychosocial interventions.

The impact of family policies on fertility in industrialized countries: a review of the literature

Abstract: This paper examines the theoretical propositions and empirical evidence linking policies and fertility. More specifically, the analysis presented in this paper draws attention to the complex mechanisms that theoretically link policies and demographic outcomes: mechanisms that involve imperfect information and decisions that are rationally bound by very specific circumstances. As to the empirical evidence, studies provide mixed conclusions as to the effect of policies on fertility. While a small positive effect of policies on fertility is found in numerous studies, no statistically significant effect is found in others. Moreover, some studies suggest that the effect of policies tends to be on the timing of births rather than on completed fertility.

Fertility, Female Labor Force Participation, and the Demographic Dividend

Abstract: We estimate the effect of fertility on female labor force participation in a cross-country panel data set using abortion legislation as an instrument for fertility. We find a large negative effect of the fertility rate on female labor force participation. The direct effect is concentrated among those aged 20-39, but we find that cohort participation is persistent over time giving an effect among older women. We present a simulation model of the effect of fertility reduction on income per capita, taking into account these changes in female labor force participation as well as population numbers and age structure.

Effects of nurse home visiting on maternal and child functioning: age-9 follow-up of a randomized trial

Abstract: OBJECTIVE. Our goal was to test the effect of prenatal and infancy home visits by nurses on mothers9 fertility and children9s functioning 7 years after the program ended at child age 2. METHODS. We conducted a randomized, controlled trial in a public system of obstetric and pediatric care. A total of 743 primarily black women RESULTS. Nurse-visited women had longer intervals between births of first and second children, fewer cumulative subsequent births per year, and longer relationships with current partners. From birth through child age 9, nurse-visited women used welfare and food stamps for fewer months. Nurse-visited children born to mothers with low psychological resources, compared with control-group counterparts, had better grade-point averages and achievement test scores in math and reading in grades 1 through 3. Nurse-visited children, as a trend, were less likely to die from birth through age 9, an effect accounted for by deaths that were attributable to potentially preventable causes. CONCLUSIONS. By child age 9, the program reduced women9s rates of subsequent births, increased the intervals between the births of first and second children, increased the stability of their relationships with partners, facilitated children9s academic adjustment to elementary school, and seems to have reduced childhood mortality from preventable causes.

Obesity and infertility

Abstract: Purpose of reviewTo summarize major factors affecting fertility in obesity.Recent findingsFertility can be negatively affected by obesity. In women, early onset of obesity favours the development of menses irregularities, chronic oligo-anovulation and infertility in the adult age. Obesity in women c

China's Local and National Fertility Policies at the End of the Twentieth Century

Abstract: In this article we survey variations in Chinas fertility policy as of the late 1990s in an attempt to describe local policy and the implications of the aggregation of local policies for national policy. Following a brief discussion of the politics of population policymaking in contemporary China we summarize fertility policy regulations within Chinas provinces. Our survey illustrates the intricacies and complexities of the population control process in China and serves as a background for our detailed analysis of the policy-stipulated fertility level in China based on local fertility policies. Using data collected on fertility policy for 420 prefecture-level units in China the administrative level below the province we estimate fertility levels that would obtain locally if all married couples had births at the levels permitted by local policy. Chinese birth control officials term this fertility level as "policy fertility" (zhengce shengyulu). We compute the average provincial and national policy fertility levels implied by policy fertility at the prefecture level and map the geographic and demographic distributions of policy fertility in China. This policy fertility level is a quantitative summary of Chinas current fertility policy informing what is pursued in terms of population control nationally on the basis of diverse local policies. Policy fertility serves as a reference for evaluating Chinas fertility policy implementation and as a starting point in evaluating the necessity and feasibility of continuing Chinas current fertility policy. (excerpt)

Changing relationships between education and fertility – a study of women and men born 1940-64

Abstract: Surprisingly, relatively little is known about the relationship between education and completed fertility in low fertility countries and especially the trend in this relationship over time. An inverse relationship is expected, but the topic has been left largely unexplored for at least a generation, and for men the topic is almost completely unexplored empirically. In this paper, we use data from the population registers covering all Norwegians born 1940-64. Among women, the relationship between completed fertility and the educational level attained at age 39 has become substantially less negative. In all the cohorts, better educated women have more often remained childless than the less educated, and they have had later first births, which also contributes to lower subsequent fertility. However, the negative effect of education on higher-order birth rates net of this impact of later motherhood has disappeared in the younger cohorts. Family-friendly policies and ideologies, leading, for example, to better access to high-quality day care, are likely the main engine behind this shift. Among men, a positive relationship has emerged. The better educated become fathers later than others, but fewer remain childless, and there has been an increasingly stimulating effect of education on second- and third-birth rates. We discuss these sex differences in the light of the persistent differences between mother and father roles.

Delayed Marriage and Very Low Fertility in Pacific Asia

Abstract: The general decline in fertility levels in Pacific Asia has in its vanguard countries where fertility rates are among the lowest in the world. A related trend is toward delayed marriage and nonmarriage. When prevalence of cohabitation in European countries is allowed for, levels of “effective singlehood” in many countries of Pacific Asia have run ahead of those in northern and western Europe. This raises questions about the extent to which delayed marriage has been implicated in fertility declines, and whether the same factors are leading both to delayed marriage and to lowered fertility within marriage. The article argues that involuntary nonmarriage is likely to be more common in Pacific Asia than in Western countries, and that resultant involuntary childlessness plays a substantial role in the low fertility rates currently observed.

Men's body mass index and infertility

Abstract: Background In men, excess weight may be linked with altered testosterone, estradiol levels, poor semen quality and infertility. We investigated whether higher BMI among men is associated with infertility and if so, to what extent that effect might be mediated by altered sexual function. Methods A retrospective cohort study of pregnancies from 1999 through 2005 based within the Norwegian Mother and Child Cohort Study (MoBa). Questionnaires assessed mother's and father's height and weight and time to pregnancy. Our sample comprises 26 303 planned pregnancies. Couples were considered infertile if they took >or=12 months to achieve pregnancy or received infertility treatment. Results After adjusting for the woman's BMI, coital frequency and the ages and smoking habits of both partners, the odds ratio for infertility was 1.20 for overweight men [BMI 25-29.9; 95% confidence interval (CI) = 1.04-1.38] and 1.36 for obese men (BMI 30-34.9; 95% CI = 1.13-1.63) relative to men with low-normal BMI (20.0-22.4). When BMI was divided into eight categories, there was a trend of increased infertility with increased male BMI. The effect of men's BMI was nearly identical when coital frequency was not included indicating that the effect is not mediated by sexual dysfunction in heavier men. Conclusions This study adds further support that men with excess body weight are at increased risk of infertility. Values may be underestimated because the most severe cases, couples who do not conceive, are not included in this birth cohort. Research is needed to see if weight loss improves fertility for these men.

Queering Reproduction: Achieving Pregnancy in the Age of Technoscience

Abstract: Originally developed to help heterosexual couples, fertility treatments such as in vitro fertilization and sperm donation have provided lesbians with new methods for achieving pregnancy during the past two decades. Queering Reproduction is an important sociological analysis of lesbians’ use of these medical fertility treatments. Drawing on in-depth interviews with lesbians who have been or are seeking to become pregnant, Laura Mamo describes how reproduction has become an intensely medicalized process for lesbians, who are transformed into fertility patients not (or not only) because of their physical conditions but because of their sexual identities. Mamo argues that this medicalization of reproduction has begun to shape queer subjectivities in both productive and troubling ways, destabilizing the assumed link between heterosexuality and parenthood while also reinforcing traditional, heteronormative ideals about motherhood and the imperative to reproduce. Mamo provides an overview of a shift within some lesbian communities from low-tech methods of self-insemination to a reliance on outside medical intervention and fertility treatments. Reflecting on the issues facing lesbians who become parents through assisted reproductive technologies, Mamo explores questions about the legal rights of co-parents, concerns about the genetic risks of choosing an anonymous sperm donor, and the ways decisions to become parents affect sexual and political identities. In doing so, she investigates how lesbians navigate the medical system with its requisite range of fertility treatments, diagnostic categories, and treatment trajectories. Combining moving narratives and insightful analysis, Queering Reproduction reveals how medical technology reconfigures social formations, individual subjectivity, and notions of kinship.

Discussion of fertility preservation with newly diagnosed patients: oncologists’ views

Abstract: Introduction Although physician discussion with patients regarding fertility preservation (FP) options prior to cancer treatment can provide important information for survivors concerning their future fertility, little is known about the extent to which physicians discuss FP with patients. This qualitative study sought to identify current physician FP communication practices and determine factors that may impact communication efforts regarding FP.

The effects of male age on sperm DNA damage in healthy non-smokers

Abstract: The trend for men to have children at older ages raises concerns that advancing age may increase the production of genetically defective sperm, increasing the risks of transmitting germ-line mutations. We investigated the associations between male age and sperm DNA damage and the influence of several lifestyle factors in a healthy non-clinical group of 80 non-smokers (age: 22-80) with no known fertility problems using the sperm Comet analyses. The average percent of DNA that migrated out of the sperm nucleus under alkaline electrophoresis increased with age (0.18% per year, p=0.006); but there was no age association for damage measured under neutral conditions (p=0.7). Men who consumed >3 cups coffee per day had {approx}20% higher % tail DNA under neutral but not alkaline conditions compared to men who consumed no caffeine (p=0.005). Our findings indicate that (a) older men have increased sperm DNA damage associated with alkali-labile sites or single-strand DNA breaks, and (b) independent of age, men with substantial daily caffeine consumption have increased sperm DNA damage associated with double-strand DNA breaks. DNA damage in sperm can be converted to chromosomal aberrations and gene mutations after fertilization increasing the risks for developmental defects and genetic diseases among offspring.

Prevalence and determinants of fertility intentions of HIV-infected women and men receiving antiretroviral therapy in South Africa.

Abstract: Despite the increased emphasis on antiretroviral therapy (ART) and other health care services for HIV-infected individuals in sub-Saharan Africa, issues of fertility and childbearing have received relatively little attention. In particular, little is known about the prevalence and determinants of fertility intentions among HIV-infected women and men who are receiving ART. We conducted a cross-sectional study from August to November 2005 investigating these issues among patients attending a public sector ART service who had been receiving ART for at least one month. Overall, 311 individuals were interviewed (median age, 33 years) and 29% (n = 89) stated that they wanted to have children in the future. This proportion was slightly higher among males than females (36% versus 26%, p = 0.09). In a multivariate model predicting fertility desire among all participants, fertility desire was associated with male gender (odds ratio (OR):2.58; 95% confidence interval [CI]:1.29–5.08), younger age (OR: 0.92; 95% CI: 0...

Population Policies, Fertility, Women's Human Capital, and Child Quality

Abstract: Population policies are defined here as voluntary programs which help people control their fertility and expect to improve their lives. There are few studies of the long-run effects of policy-induced changes in fertility on the welfare of women, such as policies that subsidize the diffusion and use of best practice birth control technologies. Evaluation of the consequences of such family planning programs almost never assess their long-run consequences, such as on labor supply, savings, or investment in the human capital of children, although they occasionally estimate the short-run association with the adoption of contraception or age-specific fertility. The dearth of long-run family planning experiments has led economists to consider instrumental variables as a substitute for policy interventions which not only determine variation in fertility but are arguably independent of the reproductive preferences of parents or unobserved constraints that might influence family life cycle behaviors. Using these instrumental variables to estimate the effect of this exogenous variation in fertility on family outcomes, economists discover these "cross effects" of fertility on family welfare outcomes tend to be substantially smaller in absolute magnitude than the OLS estimates of partial correlations referred to in the literature as evidence of the beneficial social externalities associated with the policies that reduce fertility. The paper summarizes critically the empirical literature on fertility and development and proposes an agenda for research on the topic.

Safety and efficacy of sperm washing in HIV-1-serodiscordant couples where the male is infected: results from the European CREAThE network.

Abstract: Objective: To examine the safety and effectiveness of assisted reproduction using sperm washing for HIV-1-serodiscordant couples wishing to procreate where the male partner is infected. Design and methods: A retrospective multicentre study at eight centres adhering on the European network CREAThE and involving 1036 serodiscordant couples wishing to procreate. Sperm washing was used to obtain motile spermatozoa for 3390 assisted reproduction cycles (2840 intrauterine inseminations, 107 in-vitro fertilizations, 394 intra-cytoplasmic sperm injections and 49 frozen embryo transfers). An HIV test was performed in female partners at least 6 months after assisted reproduction attempt. The outcome measures recorded were number of assisted reproduction cycles, pregnancy outcome and HIV test on women post-treatment. Results: A total of 580 pregnancies were obtained from 3315 cycles. Pregnancy outcome was unknown in 47 cases. The 533 pregnancies resulted in 410 deliveries and 463 live births. The result of female HIV testing after assisted reproduction was known in 967 out of 1036 woman (7.1% lost to follow-up). All tests recorded were negative. The calculated probability of contamination was equal to zero (95% confidence interval, 0‐0.09%). Conclusion: This first multicentre retrospective study of assisted reproduction following sperm washing demonstrates the method to be effective and to significantly reduce HIV1 transmission risk to the uninfected female partner. These results support the view that assisted reproduction with sperm washing could not be denied to serodiscordant couples in developed countries and, where possible, could perhaps be integrated into a global public health initiative against HIV in developing countries.

Infertility, assisted reproduction technologies and imprinting disturbances: a Dutch study

Abstract: BACKGROUND: Evaluation of relationships between assisted reproduction technologies (ART), fertility problems and disorders caused by disturbed genetic imprinting such as Angelman syndrome (AS) and Beckwith-Wiedemann syndrome (BWS). METHODS: A nation-wide questionnaire survey was performed regarding ART in families with a child with AS, BWS or Prader-Willi syndrome (PWS) including questions on fertility. Molecular data on the genetic disorder in affected children were gathered. RESULTS: Of the 220 affected children in this study, 14 (6.4%) were born following any form of ART compared with 83 818 (2.1%) in the Dutch population. Of AS, PWS or BWS children 15 (6.8%) were born after a fertility problem (Time To Pregnancy > 12 months, no forms of ART) compared to 141,340 (3.5%) in the Dutch population. Maternal age in the individual syndromes was higher than in the Dutch population. Families with affected children were three times more likely to experience fertility problems than the general population. All three syndromes were also individually associated with increased fertility problems in the families. CONCLUSIONS: After correction for the increased fertility problems of the parents, there is no increased incidence of ART related birth of AS, PWS or BWS children. ART does not seem to have a direct effect on the increase of imprinted diseases.

Evaluation of the effect of using mobile phones on male fertility

Abstract: The problem of the lack of offspring is a phenomenon concerning approxi- mately 15% of married couples in Poland. Infertility is defi ned as inability to conceive after a year of sexual intercourses without the use of contraceptives. In half of the cases the causative factor is the male. Males are exposed to the effect of various environmental factors, which may decrease their reproductive capabilities. A decrease in male fertility is a phenomenon which occurs within years, which may suggest that one of the reasons for the decrease in semen parameters is the effect of the development of techniques in the surrounding environment. A hazardous effect on male fertility may be manifested by a decrease in the amount of sperm cells, disorders in their mobility, as well as structure. The causative agents may be chemical substances, ionizing radiation, stress, as well as elec- tromagnetic waves. The objective of the study was the determination of the effect of the usage of cellular phones on the fertility of males subjected to marital infertility therapy. The following groups were selected from among 304 males covered by the study: Group A: 99 patients who did not use mobile phones, Group B: 157 males who have used GSM equipment sporadically for the period of 1-2 years, and Group C: 48 people who have been regularly using mobile phone for more than 2 years. In the analysis of the effect of GSM equipment on the semen it was noted that an increase in the percentage of sperm cells of abnormal morphology is associated with the duration of exposure to the waves emitted by the GSM phone. It was also confi rmed that a decrease in the percentage of sperm cells in vital progressing motility in the semen is correlated with the frequency of using mobile phones.

The hypothesis of reproductive compensation and its assumptions about mate preferences and offspring viability

Abstract: The Compensation Hypothesis says that parents and prospective parents attempt to make up for lowered offspring viability by increasing reproductive effort to produce healthy, competitive offspring and by increasing investment in less viable, but still-living progeny (parental effects). The hypothesis assumes that offspring viability is lower when individuals are constrained (often through sexual conflict) to breed with individuals they do not prefer. We review results of experimental tests of the offspring-viability assumption in Tanzanian cockroaches, fruit flies, pipefish, wild mallards, and feral house mice. Experimental constraints on mating preferences lowered offspring viability in each of the studies. Females breeding under constraints laid more eggs or gave birth to more young than females breeding without or with fewer constraints on their mating preferences, and males mating under constraints on their mate preferences ejaculated more sperm than males mating without constraints. The number of eggs laid or offspring born was higher when female choosers were experimentally constrained to reproduce with males they did not prefer. Constrained females may increase fecundity to enhance the probability that they produce adult offspring with rarer phenotypes with survival benefits against offspring generation pathogens. Similarly, ejaculation of more sperm when males are paired with females they do not prefer may be a mechanism that provides more variable sperm haplotypes for prospective mothers or that may provide nutritional benefits to mothers and zygotes.

Mood disorders and fertility in women: a critical review of the literature and implications for future research

Abstract: A medline literature review of fertility and mood disorder articles published since 1980 was performed in order to critically review the literature regarding a relationship between mood disorders, fertility and infertility treatment. Previous studies suggests that mood disorders, both in the bipolar and unipolar spectrum, may be associated with decreased fertility rates. Most studies report that women seeking treatment for infertility have an increased rate of depressive symptoms and possibly major depression (none showed evaluated mood elevations). Many, but not all, studies found that depressive symptoms may decrease the success rate of fertility treatment. Treatments for infertility may independently influence mood through their effects on estrogen and progesterone, which have been shown to influence mood through their actions on serotonin. Studies are limited in scope and confounding variables are many, limiting the strength of the results. In conclusion, a range of existing studies suggests that fertility and mood disorders are related in a complex way. Future studies should use clinical interviews and standardized and validated measures to confirm the diagnosis of mood disorders and control for the variables of medication treatment, desire for children, frequency of sexual intercourse, age, FSH levels, menstrual cycle regularity in assessing an interrelationship between mood disorders and fertility.

The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple's sexual behaviour during the fertile time: a prospective longitudinal study

Abstract: BACKGROUND: The efficacy of fertility awareness based (FAB) methods of family planning is critically reviewed. The objective was to investigate the efficacy and the acceptability of the symptothermal method (STM), an FAB method that uses two indicators of fertility, temperature and cervical secretions observation. This paper will recommend a more suitable approach to measure the efficacy. METHODS: Since 1985, an ongoing prospective observational longitudinal cohort study has been conducted in Germany. Women are asked to submit their menstrual cycle charts that record daily basal body temperature, cervical secretion observations and sexual behaviour. A cohort of 900 women contributed 17 638 cycles that met the inclusion criteria for the effectiveness study. The overall rates of unintended pregnancies and dropout rates have been estimated with survival curves according to the Kaplan–Meier method. In order to estimate the true method effectiveness, the pregnancy rates have been calculated in relation to sexual behaviour using the ‘perfect/imperfect-use’ model of Trussell and Grummer-Strawn. RESULTS: After 13 cycles, 1.8 per 100 women of the cohort experienced an unintended pregnancy; 9.2 per 100 women dropped out because of dissatisfaction with the method; the pregnancy rate was 0.6 per 100 women and per 13 cycles when there was no unprotected intercourse in the fertile time. CONCLUSIONS: The STM is a highly effective family planning method, provided the appropriate guidelines are consistently adhered to.

Does Female Schooling Reduce Fertility? Evidence from Nigeria

Abstract: The literature generally points to a negative relationship between female education and fertility. Citing this pattern, policymakers have advocated educating girls and young women as a means to reduce population growth and foster sustained economic and social welfare in developing countries. This paper tests whether the relationship between fertility and education is indeed causal by investigating the introduction of universal primary education in Nigeria. Exploiting differences by region and age, the paper uses differences-in-differences and instrumental variables to estimate the role of education in fertility. The analysis suggests that increasing education by one year reduces fertility by 0.26 births.

Impact of Obesity on female reproductive health: British Fertility Society, Policy and Practice Guidelines

Abstract: Obesity has a significant adverse impact on reproductive outcome. It influences not only the chance of conception but also the response to fertility treatment, and increases the risk of miscarriage, congenital anomalies and pregnancy complications in addition to potential adverse effects on long term health of both mother and infant. Women should aim for a normal BMI before starting any form of fertility treatment. Treatment should be deferred until the BMI is less than 35 kg/m2, although in those with more time (e.g., less than 37 years; normal serum FSH concentration) a weight reduction to a BMI of less than 30 kg/m2 is preferable. Clinicians should consider deferring treatment to women outside these guidelines. Women should be provided with assistance to lose weight, including psychological support, dietary advice, exercise classes and where appropriate, weight reducing agents or bariatric surgery. Even a moderate weight loss of 5-10% of body weight can be sufficient to restore fertility and improve metabolic markers.

Family planning as an investment in development: Evaluation of a program's consequences in Matlab, Bangladesh

Abstract: The paper analyzes 141 villages in Matlab, Bangladesh from 1974 to 1996, in which half the villages received from 1977 to 1996 a door-to-door outreach family planning and maternal-child health program Village and individual data confirm a decline in fertility of about 15 percent in the program villages compared with the control villages by 1982, as others have noted, which persists until 1996 The consequences of the program on a series of long run family welfare outcomes are then estimated in addition to fertility: women's health, earnings and household assets, use of preventive health inputs, and finally the inter-generational effects on the health and schooling of the woman's children Within two decades many of these indicators of the welfare of women and their children improve significantly in conjunction with the program-induced decline in fertility and child mortality This suggests social returns to this reproductive health program in rural South Asia have many facets beyond fertility reduction, which do not appear to dissipate over two decades

Reproductive History and Mortality in Late Middle Age among Norwegian Men and Women

Abstract: There is growing recognition that reproductive patterns may have long-term health implications, although most evidence is restricted to women. The authors used register data to derive fertility histories for all Norwegian men and women born in 1935-1958. Discrete-time hazard modeling was used to analyze later-life mortality by aspects of reproductive history. A total of 63,312 deaths were observed during 14.5 million person-years of follow-up in 1980-2003, when subjects were aged 45-68 years. Models included detailed information on educational qualifications and marital status. Odds of death relative to those for subjects with two children were highest for the childless (women: odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.43, 1.57; men: OR = 1.35, 95% CI: 1.30, 1.40) and next highest for those with only one child (women: OR = 1.31, 95% CI: 1.26, 1.37; men: OR = 1.20, 95% CI: 1.16, 1.24). Results for the parous showed a positive association between earlier parenthood and later mortality, a reverse association with late age at last birth, and an overall negative association between higher parity and mortality. The similarity of results for women and men suggests biosocial pathways underlying associations between reproductive history and health. The lack of any high-parity disadvantage suggests that in the "family friendly" Norwegian environment, the health benefits of having several children may outweigh the costs.