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Fertility

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


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Journal ArticleDOI
01 Oct 2003-JAMA
TL;DR: Intracytoplasmic sperm injection (ICSI), first reported as an IVF laboratory technique in 1992, has similarly changed the management of male infertility, leading to better awareness of potential fertility defects before and after fertilization, as well as possible errors in embryonic development.
Abstract: INFERTILITY, DEFINED AS 1 YEAR OF attempted conception without success, is one of the most prevalent chronic health disorders involving young adults Affecting 6 million or more US couples, infertility is clinically distinct from recurrent spontaneous pregnancy loss Since 1978, the management of female infertility has been transformed by in vitro fertilization (IVF) Intracytoplasmic sperm injection (ICSI), first reported as an IVF laboratory technique in 1992, has similarly changed the management of male infertility In vitro fertilization and ICSI have increased knowledge of the mechanisms of fertilization and implantation, leading to better awareness of potential fertility defects before and after fertilization, as well as possible errors in embryonic development The use of IVF and ICSI remains low, however, because of the cost and complexity of the treatment

211 citations

Journal ArticleDOI
TL;DR: Evidence suggests that the Family Health Program is a highly cost-effective tool for improving health in poor areas and Municipalities in the poorest regions of the country benefit particularly from the program.
Abstract: This paper analyzes the direct and indirect impacts of Brazil's Family Health Program, using municipality level mortality data from the Brazilian Ministry of Health, and individual level data from the Brazilian household survey. We estimate the effects of the program on mortality and on household behavior related to child labor and schooling, employment of adults, and fertility. We find consistent effects of the program on reductions in mortality throughout the age distribution, but mainly at earlier ages. Municipalities in the poorest regions of the country benefit particularly from the program. For these regions, implementation of the program is also robustly associated with increased labor supply of adults, reduced fertility, and increased school enrollment. Evidence suggests that the Family Health Program is a highly cost-effective tool for improving health in poor areas.

211 citations

Journal ArticleDOI
TL;DR: The importance of fertility ideals and intentions for understanding observed fertility levels is discussed, a model that can account for variable attitude-behavior consistency is proposed, and a framework is used to examine trends in American women's fertility ideals, intentions, and actual fertility.
Abstract: How do contemporary fertility ideals, desires, and intentions relate to contemporary low fertility? At the empirical level the answer is straightforward: observed fertility is well below the levels of ideal family size and also usually well below respondents' desires and intentions. In fact, below-replacement fertility in many countries would disappear if respondents' fertility intentions were realized (Bongaarts 2001, 2002; Goldstein, Lutz, and Testa 2003). At the conceptual level, all behavioral models of contemporary low fertility feature choice: individuals choose to have children (Thomson and Brandreth 1995). Thus fertility intentions, if not ideals, hold the promise that actual fertility could mirror intentions over the long run, thus bringing observed fertility closer to replacement. Consistent with this view, Bongaarts (2002) argues that a substantial part of the discrepancy between aggregate fertility intentions and contemporary fertility levels can be accounted for by timing shifts, specifically the postponement of childbearing to later ages. Once this postponement abates, as it eventually must,1 intentions and current behavior will be more similar. In addition, frustrated demand for children could encourage institutional adjustments that would allow childbearing to correspond to levels desired by women and couples, again raising fertility to levels that approximate intentions. Expressing an alternative view, Goldstein, Lutz, and Testa (2003) report that German-speaking areas of Europe now show levels of ideal and expected family size well below replacement levels (i.e., less than two children per woman), a pattern they suggest portends a permanent shift to sub-replacement fertility. They argue that the previous disjuncture between intentions and behavior in German-speaking counties, now evident in many other countries as well, represents “cultural lag.” Specifically, women and couples act in accordance with contemporary antinatalist constraints and have few children, but continue for a period (a time lag) to express the prevailing cultural imperatives to be parents and to have at least two children. Younger cohorts, once they have lived much of their lives in a low-fertility setting, adopt the status quo as an expectation and thus express intentions (and ideals) that more closely correspond to contemporary behavior. Goldstein et al. (2003) hypothesize that fertility intentions and ideals in Italy, Spain, and elsewhere will soon decline further, creating greater symmetry between subreplacement fertility and subreplacement ideals and expectations. The suggestion that aggregate shifts in intentions can follow rather than precede behavioral shifts is not new (see Lee 1980; Westoff and Ryder 1977; Morgan 1981, 1982). Finally, Demeny (2003) argues that a wide gap between expressed preferences and behavior can persist indefinitely. Even if such preferences for a particular number of children are genuine, these preferences compete with others, and the result need not be reconciled by having children. Demeny characterizes the deficit of actual-to-preferred number of births as those that occur only “in the minds of their would-be parents.” Current social and economic conditions, he argues, encourage a persistent shortfall of the actual number of births compared to what women say they would wish to have. Hence, this shortfall provides little evidence against long-term subreplacement fertility even when expressed fertility preferences are at replacement level. Thus while we juxtapose these positions as starkly as possible and acknowledge that they need not be mutually exclusive, reasonable arguments can be made that: i) fertility will rise soon to more closely approximate intentions, ii) intentions will fall soon to approximate subreplacement levels of fertility, or iii) a shortfall of births relative to fertility preferences will persist. Given such a range of expectations, do we conclude, as Demeny's argument suggests, that data on preferences are irrelevant to debates about “how low will fertility go”? We argue no. First, we note the inconsistency in taking seriously the disjuncture between intended and realized fertility when the observed outcomes are greater than the former (e.g., unwanted fertility) but not the reverse (when fertility falls short of intentions or expectations). In both cases, the intention–behavior disjuncture puts the interest of the individual and the collective in agreement, that is, realizing individuals' stated intention or preference increases the likelihood of a desired aggregate outcome (i.e., replacement-level fertility). Such an aligning of individual and collective goals is opportune for policy interventions. Second, a large theoretical and empirical literature focuses on the predictive validity of reproductive intentions. Morgan's (2001) review of this literature concludes that intended parity is not a consistently accurate predictor of completed fertility for individuals or of aggregate fertility for cohorts. However, a model proposed by Bongaarts (2002) that we use below provides a framework for explaining intention–behavior inconsistency. Further, examining cross-national variation in the extent to which intentions match behavior allows us to assess societal features that promote correspondence between intention and behavior. Figure 1 provides data that are consistent with key claims above and that situate and motivate our research. Data from European countries (for countries of the EU-15, with data for Germany shown separately for West and East) come from the 2001 Eurobarometer Study (see Goldstein, Lutz, and Testa 2003). The US data come from sources examined in detail in this article and described fully below. Note that US average ideal family size is among the highest, but it is not unique. As in many other countries, mean ideal family size in the United States is clearly above 2.0. What is striking and unique about the US estimates is the coupling of the mean levels of intended fertility with correspondingly high levels of period fertility (TFR). The contrasting and dominant pattern is for fertility intentions to substantially exceed levels of contemporary fertility. FIGURE 1 Average ideal and expected family sizes and total fertility rates for countries of the EU-15 and the United States In this article, we 1) discuss the import of fertility ideals and intentions for understanding fertility levels, 2) propose a model that can account for variable inconsistency between attitude and behavior, and 3) use this model as a framework to examine trends in American women's fertility ideals, intentions, and actual fertility.

210 citations

Journal ArticleDOI
TL;DR: Results to date are encouraging and suggest that the planned program of work will lead to a fertility index that, when used by breeding companies, will leading to improvements in national dairy cow fertility.

210 citations

Journal ArticleDOI
TL;DR: This technical report reviews the topic of fertility preservation in pediatric and adolescent patients with cancer, including ethical considerations.
Abstract: Many cancers that present in children and adolescents are curable with surgery, chemotherapy, and/or radiation therapy. Potential adverse consequences of treatment include sterility, infertility, or subfertility as a result of either gonad removal or damage to germ cells from adjuvant therapy. In recent years, treatment of solid tumors and hematologic malignancies has been modified in an attempt to reduce damage to the gonads. Simultaneously, advances in assisted reproductive techniques have led to new possibilities for the prevention and treatment of infertility. This technical report reviews the topic of fertility preservation in pediatric and adolescent patients with cancer, including ethical considerations.

210 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
20241
20232,042
20223,958
20211,098
20201,105
20191,047