Still childless at the age of 28 to 40 years: a cross-sectional study of Swedish women's and men's reproductive intentions.

Delayed childbearing is associated with adverse reproductive outcomes. Our aim was to investigate Swedish women's and men's childbearing intentions at the age of 28, 32, 36 and 40 years, in terms of: (1) time point for a first child, (2) number of children, and (3) reasons for not yet having children. Cross-sectional data from the Swedish Young Adult Panel Study, including 365 childless women and 356 childless men aged 28, 32, 36 and 40 years who responded to a questionnaire in 2009. Descriptive and multivariate logistic regression analyses were conducted. Most 28- and 32-year-olds intended to have children, but only 32% of women and 37% of men aged 36/40 years (merged), many of whom still postponed childbearing. Reasons for remaining childless differed by age. Most prominent in the 36/40-year-olds were: lack of a partner (women 60%, men 59%), no desire for children (women 44%, men 44%), not mature enough (women 29%, men 35%), and wanting to do other things before starting a family (women 26%, men 33%). The 36/40-year-olds had the highest odds for infertility problems (OR 3.8; CI 95% 1.8-7.9) and lacking a suitable partner (OR 1.8 CI 95% 1.1-3.0), and lower odds for reasons related to work and financial situation. Many childless 36- and 40-year-olds intended to have children but seemed to overestimate their fecundity. The most prominent reasons for being childless were: not having wanted children up to now, lack of a partner, infertility problems, and prioritising an independent life.

Schytt E ，Nilsen AB ，Bernhardt E 《-》

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

Daniluk JC ，Koert E 《-》

Agreement in Swedish childless couples' reproductive intentions in relation to age.

to investigate the agreement in Swedish childless couples' reproductive intentions, in terms of (1) expecting to have children or not, (2) time point for a first child, and (3) number of children, in relation to age. cross-sectional data from the Swedish Young Adult Panel Study in 2009. Sweden. 216 childless couples (216 women and 216 men) questionnaire data on reproductive intentions. Descriptive analyses including Cohen's kappa were conducted for all couples, both for younger and older couples, where the woman was below or above the mean age for having the first child in Sweden, namely ≤ 28 years (younger) and ≥ 29 years (older). agreement in the partners' expectations whether to have children or not was substantial but far from perfect (κ=0.69), and it was higher in older couples (κ=0.70) than in younger ones (κ=0.51). Compared with younger couples, a higher proportion of older couples agreed not to have children or were uncertain (32% versus 5%; p<0.001). Overall, there was moderate agreement concerning the intended time point for a first child (κ=0.60), also when younger couples (κ=0.54) and older couples (κ=0.57) were analysed separately. On the other hand, there was only a slight agreement between the partners' responses concerning the desired number of children (κ=0.00), and in general the woman wanted more children. Swedish couples are in substantial agreement on if and when to have children, especially the older couples. However, the female partner is more likely than her male partner to be the one wanting the most children. partners' individual and mutual desires should be taken into account in reproductive counselling.

Schytt E 《-》

The other side of the fertility coin: a comparison of childless men's and women's knowledge of fertility and assisted reproductive technology.

To determine childless men's knowledge about fertility and assisted reproductive technology (ART) treatments and family building options, compared to knowledge of a sample of childless women. Self-report questionnaire comprising 2 self-ratings and 20 knowledge questions related to later childbearing and ART. Online survey. A total of 599 presumed fertile, childless men between the ages of 20 and 50 years. None. Knowledge of fertility and ART as measured by the male version of the Fertility Awareness Survey. The majority of participants rated themselves as having some knowledge or being fairly knowledgeable about fertility and ART. However, on the 20 knowledge questions, overall knowledge was limited, with more than 50% of the sample answering correctly only 4 of 20 knowledge questions. The men demonstrated even less knowledge of fertility and ART than childless women. Given that the childless men in our study had no coherent body of knowledge regarding age-related fertility and ART treatment and family-building options, men may be contributing to the trend to delay childbearing. If they are to be effective in supporting informed fertility and childbearing decisions, education programs must target both women and men.

Daniluk JC ，Koert E 《-》

Family intentions and personal considerations on postponing childbearing in childless cohabiting and single women aged 35-43 seeking fertility assessment and counselling.

What characterizes childless women aged 35 years and above seeking fertility assessment and counselling in relation to their reproduction and are there significant differences between single and cohabiting women? Despite the women's advanced age and knowledge of the age-related decline in fecundity, 70% of the single women sought fertility assessment and counselling to gain knowledge regarding the possibility of postponing pregnancy. Recent studies have indicated an increasing demand for ovarian reserve testing in women without any known fertility problem to obtain knowledge on their reproductive lifespan and pro-fertility advice. Women postpone their first pregnancy, and maternal age at first birth has increased in western societies over the past two to four decades. Postponed childbearing implies a higher rate of involuntary childlessness, smaller families than desired and declining fertility rates. Baseline data from a cross-sectional cohort study of 340 women aged 35-43 years examined at the Fertility Assessment and Counselling (FAC) Clinic at Copenhagen University Hospital from 2011 to 2014. The FAC Clinic was initiated to provide individual fertility assessment and counselling. Eligible women were childless and at least 35 years of age. All completed a web-based questionnaire before and after the consultation including socio-demographic, reproductive, medical, lifestyle and behavioural factors. Consultation by a fertility specialist included transvaginal ultrasound, full reproductive history and AMH measurement. The study comprised 140 cohabiting and 200 single women. The majority (82%) were well-educated and in employment. Their mean age was 37.4 years. Nonetheless, the main reasons for attending were to obtain knowledge regarding the possibility of postponing pregnancy (63%) and a concern about their fecundity (52%). The majority in both groups (60%) wished for two or more children. The women listed their ideal age at birth of first child and last child as 33 (±4.7) years and 39 (±3.5) years, respectively. Of the single women, 70% would accept use of sperm donation compared with 25% of the cohabiting women (P < 0.001). In general, 45% considered oocyte vitrification for social reasons, yet only 15% were positive towards oocyte donation. The two groups were comparable regarding lifestyle factors, number of previous sexual partners, pregnancies, and ovarian reserve parameters. The women in the present study were conscious of the risk of infertility with increasing age and attended the FAC Clinic due to a concern about their remaining reproductive lifespan, which in combination with their high educational level could impair the generalizability to the background population. The results indicate that in general women overestimate their own reproductive capacity and underestimate the risk of future childlessness with the continuous postponement of pregnancies.

Birch Petersen K ，Hvidman HW ，Sylvest R ，Pinborg A ，Larsen EC ，Macklon KT ，Andersen AN ，Schmidt L ... -  《-》