Men's knowledge, attitudes and behaviours relating to fertility.

The increasingly common practice in high-income countries to delay childbearing to the fourth and fifth decades of life increases the risk of involuntary childlessness or having fewer children than desired. Older age also increases the risk of age-related infertility, the need for ART to conceive, and obstetric and neonatal complications. Existing research relating to childbearing focusses almost exclusively on women, and in public discourse declining fertility rates are often assumed to be the result of women delaying childbearing to pursue other life goals such as a career and travel. However, evidence suggests that the lack of a partner or a partner willing to commit to parenthood is the main reason for later childbearing. To better understand men's contributions to childbearing decisions and outcomes, the literature pertaining to men's fertility-related knowledge, attitudes and behaviours was reviewed. The electronic databases of Medline, Embase and PsycINFO were searched to identify investigations of men's knowledge, attitudes and behaviours relating to fertility, infertility, reproductive health or childbearing using relevant fertility keyword search terms. Studies were included if they had investigated factors associated with men's fertility-related knowledge, attitudes and behaviours, had been conducted in a high-income country and were published in an English language peer-reviewed journal between January 2005 and August 2016. The search yielded 1349 citations. Of these, 47 papers representing 43 unique studies were included in the review. Where response rate was reported, it ranged between 13 and 94%. Studies varied in terms of research design; inclusion and exclusion criteria; recruitment strategies; adequacy of sample size; recruitment and retention rates and data collection tools. However, findings were consistent and indicate that men almost universally value parenthood, want and expect to become fathers, and aspire to have at least two children. Yet most men have inadequate knowledge about the limitations of female and male fertility and overestimate the chance of spontaneous and assisted conception. Perceptions of ideal circumstances in which to have children included being in a stable and loving relationship, having completed studies, secured a permanent job and a dependable income, having achieved personal maturity, and having a partner who desires children and is 'suitable' as a potential co-parent. Although all studies were conducted in high-income countries, between-country social and cultural differences may have influenced the findings relating to attitudes. Men aspire to parenthood as much as women do but have limited knowledge about the factors that influence fertility. The gap between ideal biological and ideal social age for having children appears to be widening, narrowing the time frame in which parenthood can be achieved. This may lead to unfulfilled parenthood aspirations. The findings can inform government policies and public education strategies aimed to support childbearing during the most fertile years, reduce the personal and societal cost of infertility and ART use, and allow people to fulfil their parenthood goals.

Hammarberg K ，Collins V ，Holden C ，Young K ，McLachlan R ... -  《-》

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 《-》

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

Daniluk JC ，Koert E 《-》

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

Bunting L ，Tsibulsky I ，Boivin J 《-》

Fertility awareness online: the efficacy of a fertility education website in increasing knowledge and changing fertility beliefs.

How effective is online education in increasing knowledge of fertility and assisted reproductive technologies (ART), and changing beliefs about the timing of parenthood? Exposure to an online educational intervention resulted in immediate changes in participants' beliefs about the ideal timing of parenthood, and a significant increase in their knowledge of fertility and ART treatments and options; most of these changes were not sustained over time, particularly for men. Research has identified significant gaps in men's and women's knowledge of fertility and ART, contributing to the trend to delay childbearing. Effective educational programs need to be developed, to support informed fertility and child-timing decisions. Pre-post intervention study of 199 currently childless men and women, and a 6-month follow-up of 110 of these participants. One hundred and ninety-nine childless participants between the ages of 18 and 35 were asked to complete 4 beliefs and 22 knowledge questions prior to, and immediately after, reading 10 online posts related to: fertility testing and preservation, fertility history and lifespan, the effects of health and fitness on fertility, and assisted reproduction. Six months later, 110 of the original sample repeated the 26-item survey. Participants' fertility and ART knowledge scores increased significantly immediately after the intervention, as did their confidence in their fertility and ART knowledge. Participants' beliefs about the ideal and latest age a woman or man should consider producing a child decreased. However, 6 months later, participants' beliefs and knowledge levels largely returned to their pre-intervention levels, particularly for the men in the study. The sample size and the recruitment methods may limit the generalizability of these findings. Previous studies have demonstrated the short-term efficacy of online educational approaches to increase fertility knowledge and support informed family planning decisions. Web-based approaches have the benefit of being easily and conveniently accessed by individuals worldwide. However, the findings of the current study call into question the long-term efficacy of online fertility education, and suggest that variables such as gender and relevance need to be considered in assessing the efficacy of online fertility education strategies.

Daniluk JC ，Koert E 《-》