Fertility

About: Fertility is a research topic. Over the lifetime, 29988 publications have been published within this topic receiving 681106 citations.

Reproductive health of war-affected populations: what do we know?

Abstract: In this article available data are reviewed to determine if and how reproductive health status is affected by refugee or displaced status in war-affected populations. Refugees in stable camp settings are the population most often studied. Also evidence on fertility and family planning safe motherhood sexually transmitted diseases and HIV and sexual and gender-based violence is examined. Social and demographic factors such as age socioeconomic status education and urban/rural residence as well as access to services rather than refugee or displaced status in itself appear to influence fertility desires and health behavior with respect to reproductive health concerns. Moreover it is noted that emergency contraception is an important family planning service for refugees including those whose access to regular contraceptive supplies has been disrupted and where women have been raped. Overall all the studies conducted as well as other fertility reviews suggest that no common fertility pattern emerges among refugees.

A Demographic Explanation for the Recent Rise in European Fertility

Abstract: Between 1998 and 2008 European countries experienced the first continent-wide increase in the period total fertility rate (TFR) since the 1960s. After discussing period and cohort influences on fertility trends, we examine the role of tempo distortions of period fertility and different methods for removing them. We highlight the usefulness of a new indicator: the tempo- and parity-adjusted total fertility rate (TFRp*). This variant of the adjusted total fertility rate proposed by Bongaarts and Feeney also controls for the parity composition of the female population and provides more stable values than the indicators proposed in the past. Finally, we estimate levels and trends in tempo and parity distribution distortions in selected countries in Europe. Our analysis of period and cohort fertility indicators in the Czech Republic, Netherlands, Spain, and Sweden shows that the new adjusted measure gives a remarkable fit with the completed fertility of women in prime childbearing years in a given period, which suggests that it provides an accurate adjustment for tempo and parity composition distortions. Using an expanded dataset for ten countries, we demonstrate that adjusted fertility as measured by TFRp* remained nearly stable since the late 1990s. This finding implies that the recent upturns in the period TFR in Europe are largely explained by a decline in the pace of fertility postponement. Other tempo-adjusted fertility indicators have not indicated such a large role for the diminishing tempo effect in these TFR upturns. As countries proceed through their postponement transitions, tempo effects will decline further and eventually disappear, thus putting continued upward pressure on period fertility. However, such an upward trend may be obscured for a few years by the effects of economic recession.

Nutrition, fertility and maternal investment in primates

Abstract: While the energetics of reproduction have been intensively investigated among women, studies of mother-offspring relationships among non-human primates have tended to neglect the effect of nutrition of the mother on lactational performance and on growth and survival of offspring. Typically fertility has been compared between populations under different nutritional regimes. In this paper, the relations between suckling frequencies, the time of weaning, the survivorship of offspring, the contraceptive effects of lactation and the quality of maternal diets are outlined. Energy transfer from mother to offspring in the form of milk is proposed as a measurable component of maternal investment, and the behavioural causes and consequences of lactational anoestrus are explored using data from free-ranging vervet monkeys. It is suggested that nutrition of the mother is most important during the early phase of rapid infant growth, because at that time the energetic requirements of lactation are high; and that a mother's ability to assess her infant's demands and needs for nutrition for growth leads to alterations in suckling frequencies which result in variation in female fertility.

Fertility knowledge and beliefs about fertility treatment: findings from the International Fertility Decision-making Study

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).