What do people know about fertility? A systematic review on fertility awareness and its associated factors

Abstract

Introduction: Recent evidence indicates that reproductive-age people have inadequate fertility awareness (FA) concerning fertility, infertility risk factors, and consequences of delaying childbearing. However, no study has tried to summarize these studies and to clarify the variables associated with FA, namely the role of gender, age, education, and reproductive status on FA.

Methods: A literature search up to February 2017 was conducted using the EBSCO, Web of Science, Scielo, and Scopus electronic databases with combinations of keywords and MeSH terms (e.g. ‘awareness’ OR ‘health knowledge, attitudes, practice’ AND ‘fertility’; ‘fertile period’; ‘assisted reprod*’).

Results: Seventy-one articles met the eligibility criteria and were included. The main results showed that participants report low-to-moderate FA. Higher levels of FA were shown by women, highly educated individuals, people who reported difficulties with conceiving, and those who had planned their pregnancies. Having or desiring to have children was not related to FA level. An inconsistent association between study participant age and FA was observed, with some studies indicating that older participants had higher FA, but others found an opposite result or did not find any association.

Conclusion: The current findings suggest that interventions to increase FA are warranted, especially those targeting men, people with low education, and in family planning settings. Interventions and campaigns should be customized to meet individuals’ needs regarding FA. Because of the high heterogeneity regarding the assessment of FA, these conclusions must be interpreted with caution.

Keywords:

• Age-related fertility decline
• fertility awareness
• health-literacy
• infertility risk factors
• obesity
• sexual transmitted infections
• smoking
• systematic review

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the Portuguese Foundation for Science and Technology [grant SFRH/BD/103234/2014; SFRH/BPD/85789/2012; UID/PSI/04345/2013].

Notes on contributors

Juliana Pedro

Juliana Pedro, MS Psychology, is a PhD student at the Faculty of Psychology and Education Sciences of University of Porto (FPCEUP) and researcher at the Centre for Psychology at University of Porto (CPUP), Portugal. Her research within health psychology has been focused on fertility education and reproductive goals, promotion of reproductive health literacy and psychosocial consequences of infertility. She is also Deputy of the ESHRE Psychology and Counselling Special Interest Group.

Tânia Brandão

Tânia Brandão, MS Psychology, PhD, is Professor at Universidade Autónoma de Lisboa Luís de Camões (UAL), and researcher at the Center for Research in Psychology (CIP) and the Centre for Psychology at University of Porto (CPUP), Portugal. Her research within clinical and health psychology focuses on relational and emotional factors involved in the process of adaptation to chronic diseases.

Lone Schmidt

Lone Schmidt, DMSci, PhD, MD, is a Professor and researcher at the University of Copenhagen, Department of Public Health, Section of Social Medicine, Denmark. Her research interests within the field of public health are: infertility, assisted reproduction, prevention of infertility, and family formation. She contributes to put prevention of infertility on the public and health policy agenda and she is the principal investigator and responsible to established The Copenhagen Multi-centre Psychosocial Infertility (COMPI) Research Group.

Maria E. Costa

Maria E. Costa, PhD, is a Full Professor at Faculty of Psychology and Education Sciences of University of Porto (FPCEUP) and researcher at the Centre for Psychology at University of Porto (CPUP), Portugal. She is the Coordinator of the scientific committee in FPCEUP.

Mariana V. Martins

Mariana V. Martins, MS Psychology, PhD, is an Assistant Professor at the Faculty of Psychology and Education Sciences of University of Porto (FPCEUP), and researcher at the CPUP, Portugal. Her research within reproductive health has been focused on protective and risk factors that can influence the couple's relationship and decisions through fertility care, gestational loss and family formation. She is the coordinator of the ESHRE Psychology and Counselling Special Interest Group and a member of the ESHRE Fertility Awareness Working Group.