Fertility Desires Research Articles

(335) Motivation for Vasectomy Reversal Among U.S. Military Population

Abstract Introduction Vasectomy is a relatively common procedure performed for the purposes of sterilization; however, an estimated up to 6% of men that undergo vasectomy wish for reversal at some point. Few studies have examined the motivation behind vasectomy reversal, and very limited research within special populations, such as U.S. military members. Objective The aim of this study was to explore the motivations of U.S. military servicemen who opted for vasectomy reversal (VR) surgery, considering their unique access to this surgical care. Methods We conducted a retrospective review of patient records of microsurgical vasectomy reversal performed by a single surgeon (DJH) between 2020 and 2023. We evaluated the age at which vasectomy was performed, age at vasectomy reversal, reasons for seeking VR surgical care, number of children fathered before the vasectomy, and the age of the current partner. Results During the specified period, 106 patients underwent vasectomy reversal, and 102 of them had their medical records available for evaluation. The average age at the time of vasectomy was 31.3 years, while the average age at vasectomy reversal was 40.2 years. The average age of the partners they were with at the time of seeking care was 34.8 years. Before undergoing vasectomy, the subjects had fathered an average of 2.7 children. Among the patients, 73% (76) cited having a new partner after divorce as the primary motivation for seeking vasectomy reversal. Within this group, 57 mentioned remarriage, 3 were newly engaged, and 15 were in a new relationship. One individual mentioned seeking VR after their spouse's passing to explore the possibility of fertility with a potential future partner. Additionally, 20.6% (21) of the subjects sought vasectomy reversal to have more children with the same spouse as before vasectomy. Among them, 2 men mentioned an improvement in their financial status, and 2 cited an improvement in their wife's health condition as reasons for seeking VR. Two patients opted for vasectomy reversal due to non-fertility reasons, such as scrotal pain that affected their quality of life, and one patient cited religious beliefs as their motivation. Conclusions The primary driver for seeking VR surgical care among these men was the desire for fertility with a new partner, often after divorce. However, approximately 20% of the men cited the wish to have more children with the same partner as their motivation. Non-fertility reasons, such as religious beliefs and scrotal pain after vasectomy, were also observed as motivations for seeking VR, albeit less frequently. Disclosure No.

Quality of life following a maternal near-miss event during the COVID-19 pandemic at a tertiary care center in South India.

To assess the quality of life (QoL) in women following a maternal near-miss event and to assess the women's attitude towards future fertility and their contraceptive choices. A cross-sectional observational study was conducted in Government Medical College, Kozhikode, India among women who had experienced a near-miss event (n = 50) between January 1, 2020 and May 31, 2021 during the peak of the COVID-19 pandemic. The QoL was assessed using the WHO Quality of Life, BREF Version, questionnaire, which was administered to the consenting participants over phone. Information regarding desire for future fertility, contraceptive choices, and urogenital symptoms was also collected. A comparison between the short-term and long-term effects on the QoL was also done. A maternal near-miss event was not found to adversely affect the overall quality of life in the present study. The scores in all the four domains-physical, psychological, social relationships, and environmental-suggested good QoL, although greater variability in values were observed in the physical and psychological domains. The influence in these two domains was more pronounced following a perinatal loss and following prolonged physical morbidities. There was no difference in short- and long-term QoL following a maternal near miss (MNM). The MNM did not influence the contraceptive choices and there was no subsequent pelvic floor dysfunction in most women. MNM was not found to adversely affect the overall subsequent QoL in the present study. There was no difference in short- and long-term QoL following a MNM. Studies carried out over a longer period of time with a control group would yield more information.

Chinese Women's Concept of Childbirth Based on the Social Media Topic "What Does Childbirth Mean to a Woman": Content and Thematic Analysis.

In recent years, women's fertility desire has attracted increasing attention in China. This study aims to detect attitudes toward giving birth among young female users on Douban, a very popular Chinese social media platform. A total of 2634 valid posts from 2489 users discussing the topic "What does childbirth mean to a woman" on Douban were crawled and retained for analysis. We utilized content and thematic analysis methods to capture users' concepts of childbirth. The findings reveal that a significant majority of users conveyed generally neutral (1060/2634, 40.24%) or negative (1051/2634, 39.90%) attitudes toward childbirth, while only about one-fifth of users expressed positive (523/2634, 19.86%) sentiments. Notably, posts with negative attitudes garnered more replies and likes, and the proportion of posts expressing negativity exhibited fluctuations over time. Health risk (339/2634, 12.87%) emerged as the most frequently cited aspect of childbirth cost, with subjective happiness and the fulfillment of mental needs identified as primary benefits. Surprisingly, only a minimal number of posts (10/2634, 0.38%) touched upon the traditional objective benefits of raising children for old-age care. Thematic analysis results suggest that discussions about fertility on social media platforms might contribute to an exaggerated perception of health risks among women. Additionally, a lack of knowledge about childbirth was observed, partially attributable to longstanding neglect and avoidance of communication on these matters, likely influenced by traditional cultural biases. Moreover, there is a prevailing assumption that women should naturally sacrifice themselves for childbirth and childcare, influenced by the idealization of the female figure. Consequently, women may harbor hesitations about having a baby, fearing the potential loss of their own identity in the process. The results indicate a shift in the perception of childbirth among modern Chinese women over time, influenced by their increasing social status and the pursuit of self-realization. Implementing strategies such as public education on the health risks associated with pregnancy and delivery, safeguarding women's rights, and creating a supportive environment for mothers may enhance women's willingness to undergo childbirth. RR2-10.2196/preprints.50468.

Religious Affiliation and Fertility in Vietnam: Exploring Desire for Additional Children and Actual Fertility

The authors investigate the relationship between reported religious affiliation and fertility among reproductive-age women in Vietnam using the nationally representative 2014 Multiple Indicator Cluster Survey. Fertility includes (1) desire for additional children and (2) the hazard of having the next birth on the basis of actual fertility. The results of probit regression and survival analysis show that Christian women have a higher desire for additional children and actual fertility compared with those with no religious affiliation. In contrast, Buddhist affiliation is not significantly associated with both fertility behaviors. In addition to demonstrating the connection between religion and fertility decisions, this study shows that son preference is still prevalent in Vietnam and that both religion and son preference are significant determinants of fertility. The findings have implications for family planning policies.

Fertility Desire and Protection Practices Among Turkish Young Breast Cancer Patients Treated with Chemotherapy

Fertility Desire and Protection Practices Among Turkish Young Breast Cancer Patients Treated with Chemotherapy

Reproductive health among women living with HIV attending Melbourne Sexual Health Centre for HIV care from February 2019 to February 2020.

Women living with HIV are a minority population with unique care needs. Rates of unintended pregnancy are higher among women living with HIV versus HIV negative women. However, uptake of contraception among women living with HIV including long-acting-reversible contraceptives (LARCs) remains low. This quality improvement project aimed to identify gaps in reproductive healthcare for women living with HIV attending Melbourne Sexual Health Centre (MSHC). We performed a retrospective review of women living with HIV attending MSHC for HIV care February 2019-February 2020. Women aged over 45years were excluded. Primary outcomes included proportion using contraception, methods used and whether a sexual or reproductive health history had been taken in the past year. A total of 100 women were included, predominantly born overseas (Asia, 38%; sub-Saharan Africa, 34%). Of these, 5% were pregnant, 16% were trying to conceive and 1% were undergoing elective oocyte preservation. Of the remaining 74 women, 48.6% were using any form of contraception, including 17.6% women using less-effective methods (withdrawal and condoms), 6.8% using the combined oral contraceptive pill, 18.9% using LARCs and 5.4% using permanent methods. Sexual activity status was documented for 61% women, 1% declined to answer and not documented for 38% women. Rate of contraceptive use in this study was lower than previously reported among women living with HIV in Australia; however, our findings suggest contraceptive methods may be changing in light of undetectable equals untransmittable and increased fertility desires. Discussions regarding sexual activity and reproductive health were limited. Mechanisms to increase clinician-patient discourse regarding these important issues should be explored.

The Collision of Global Scripts with Local Constraints: Education as a Risk Factor for Unintended Pregnancy

Extensive sociological research concludes that education informs people’s desires for their lives and plays an instrumental role in facilitating the fulfillment of those desires. In this article, we ask if societal barriers can leave the most educated to desire outcomes that are unattainable and thus paradoxically place them at highest risk of unwanted outcomes. We answer this question by analyzing societal variation in the potential for education to facilitate women achieving their lower fertility desires: Are there fertility contexts wherein educated women’s lower fertility desires are distinctly unattainable? Multilevel models analyzing Demographic and Health Survey Program data on women from 50 low- and middle-income countries emphasize the collision of global scripts with local constraints: In low contraceptive contexts, education is associated with higher risk of unintended pregnancy. The results clarify that the potential for education to facilitate the achievement of desires is fraught with contingencies.

Chinese Female Individual Independence and Fertility Desire ----from the Perspective of Feminism

In response to the aging population, the Chinese government has changed the birth policy to change the population structure. However, encouraging fertility policy faces the challenge of women's independence consciousness and the reality of striving for gender equality. The core of women's independence consciousness is to change their weak position in the labor market and pursue a more equal division of labor within the family. Under this pursuit, women's attitude towards fertility has also changed, and the value of fertility to women has been measured. This study aimed to explore the effect of female independence awareness on female reproductive choice. The study focuses on the dual pressure and role contradiction of women in the family and workplace under the sense of independence, and gives appropriate policy advice. The results show that under the influence of women's independent consciousness, women's control of their reproductive rights will make women more independent to their reproductive choices. In addition, the discrimination in the workplace and the pressure of family affairs that they may face after giving birth will make the reality of life different from the vision of pursuing career and independence, and this difference will also make women more cautious about their reproductive choices.

Research on Bovine Endometritis: Current Insights and Future Directions – A Review

The post-partum reproductive performance of cows is identified as a pivotal factor influencing the success or failure of the dairy industry. Achieving timely uterine involution, complete endometrial regeneration, and the resumption of ovarian cyclic activity are crucial for conception within the desired timeframe. However, uterine contamination with pathogens during parturition remains an unavoidable challenge, leading to suboptimal productivity and fertility. Metritis and clinical endometritis are recognized post-partum conditions, while sub-clinical endometritis has emerged as a significant threat to achieving desired fertility in dairy cows. This review summarizes a comprehensive assessment of factors contributing to delayed clearance and persistence of uterine infections in dairy cows, particularly sub-clinical endometritis (SCE). Diagnostic techniques, including bacterial culture, the Whiteside test, endometrial cytology, and trans-rectal ultrasonography (TRUS), are discussed, each with advantages and limitations.The paper explores the association between SCE and various risk factors, such as negative energy balance (NEB), metabolic indicators, and hormonal changes during the post-partum period. The significance of parameters like body condition score (BCS), backfat thickness (BFT), and metabolic indicators (leptin, NEFA, BHBA) in assessing energy status and predicting reproductive efficiency is highlighted.In addition, the underexplored area of fungal infections in dairy cows’ uteri, emphasizing fungi’s opportunistic nature and their potential to cause reproductive failure has also been reviewed. The immune system’s role in uterine defense against fungal infections and the diagnostic challenges, including mycological cultures and cytological examinations, the therapeutic challenges, and the poor prognosis associated with fungal endometritis have also been discussed.

Public perceptions of air pollution and its impacts on fertility desire: a nationwide study in China.

Over the past few years, there has been a significant focus on air pollution due to its various detrimental effects on human health. However, its influence on people's tendency to have children remains uncertain, as only a few studies have examined the correlation between public perception of air pollution and the desire to start a family. This article introduces a theoretical framework utilizing a two-stage interval iteration model to explore the connection between children's relative utility and the perception of air pollution. Data for this study were gathered from the "Chinese General Social Survey" (CGSS 2013). The CGSS 2013 project employed a four-stage stratified random sampling technique and conducted household interviews using questionnaires. The sample covered 28 provincial-level cities across China. The hypothesis was tested using a Probit regression model. The findings indicate that individuals considering air pollution a significant issue are 8.62% less likely to have more than one child. The variation in fertility desire sensitivity to air pollution points to heterogeneity among residents, such as registered residents and those living in various residential areas, as well as individuals with different characteristics like education levels. The study concludes that air quality significantly influences human fertility desire, highlighting the urgent necessity to raise awareness of environmental protection issues among both the public and authorities. In particular, there are two key steps to address this issue. Firstly, the government should establish clear air pollution control objectives and refine policies to enhance governance efficiency. Secondly, there is a need to encourage environmentally friendly behaviours among the public, promote more significant involvement in public environmental matters, and ensure effective oversight of the government's responsibilities in managing air pollution.

Do Resources Blunt the Impact of COVID-19 on Fertility Desires in the United States?

Do Resources Blunt the Impact of COVID-19 on Fertility Desires in the United States?

Fertility preservation choices and decisional regret after gender-affirming surgery in transgender men or gender nonbinary persons

To investigate the prevalence of decisional regret regarding preoperative fertility preservation choices after gender-affirming surgery or removal of reproductive organs. Cross-sectional. University-based pratice. A total of 57 survey respondents identifying as transgender men or gender nonbinary with a history of gender-affirming surgery or removal of reproductive organs between 2014 and 2023 with the University of North Carolina Minimally Invasive Gynecology division. Survey or questionnaire. The prevalence and severity of decisional regret regarding preoperative fertility preservation choices were measured with the use of the validated decisional regret scale (DRS) (scored 0-100). Secondary outcomes included patient-reported barriers to pursuing reproductive endocrinology and infertility consultation and fertility preservation treatment. The survey response rate was 50.9% (57/112). "Mild" to "severe" decisional regret was reported by 38.6% (n = 22) of survey respondents, with DRS scores among all respondents ranging from 0-85. Higher median DRS scores were associated with patient-reported inadequacy of preoperative fertility counseling regarding implications of surgery on future fertility or family-building (0vs. 50) and fertility preservation options (0 vs. 12.5). No desire for future fertility at the time of fertility counseling was the most frequent reason (68.4%) for declining a referral to reproductive endocrinology and infertility for additional fertility preservation discussion. Decisional regret regarding preoperative fertility preservation choices is experienced among transgender men or gender nonbinary persons after gender-affirming surgery or the removal of reproductive organs. Preoperative, patient-centered fertility counseling and fertility preservation treatments should be provided to reduce the risk of future regret.

Fertility Desires of HIV-positive Women Attending Care and Treatment Clinics (CTC) in Urban Areas in Tanzania

Introduction: Reproductive concerns by People Living with HIV (PLHIV) are matters that are important for both individual and general public health. We described fertility desire among HIV-positive women attending Care and Treatment Clinics (CTC) and determined factors for having such a desire to get children in urban areas of Dar es Salaam and Dodoma in Tanzania. Material and Methods: Cross-sectional study for which primary data were collected in a random sample of women of reproductive age (15-49 years) after accessing HIV care and treatment services. A survey was conducted among HIV-positive women receiving anti-retroviral treatment to document service needs, service quality, and fertility preferences. A Univariate model was used to examine the relationship between the dependent and the independent variables, and all associations were taken into account in the final model. Results: Among 691 participants, 282 (40.8%) women living with HIV have fertility desire. Women aged above 25 experienced a reduction in the odds of fertility desire by 56% (P value =0.003) compared to the reference group of women aged 25 years or less. Fertility desire was predicted to have two times as much growth with 1 to < 3 years (p- value=0.02) and 5 or 5+ years (P value =0.01) time lapse since the debut of ART, compared to the group of women who were on ART for 3 years but less than five years. Conclusion: Our data has not only reconfirmed the importance of ART and PMTCT services to PLHIV but also contributed to evidence on their value addition in terms of the creation of resilience to normal fertility family life after debut HIV diagnosis.

The better future projections the more childbirth: the association between subjective social status and fertility desire of the Chinese population

The better future projections the more childbirth: the association between subjective social status and fertility desire of the Chinese population

Childcare burden and changes in fertility desires of mothers during the COVID-19 pandemic.

Previous studies have documented a decline in fertility desires and intentions following the COVID-19 outbreak, but the reasons for this decline are not well understood. This study examined whether childcare burden on mothers during the lockdown and quarantines, COVID-related stress, and COVID exposure were associated with a change in the desired number of children. The survey was conducted online, in Poland from April to July 2021 on a sample of 622 non-pregnant mothers without diagnosed infertility. Associations were observed between childcare responsibilities during the quarantine and fertility desires: mothers who solely or mainly took care of their children during the quarantine(s) were more likely to decrease their desired number of children ([adjusted] aOR = 1.91, 95% CI = 1.16-3.15). Mothers with higher levels of COVID-related stress (aOR = 1.81, 95% CI = 1.48-2.22) and a greater COVID exposure index (aOR = 1.39, 95% CI = 1.12-1.72) were more likely to decrease their fertility desires. Higher childcare burden during quarantines was related to a lower desired number of children among mothers. Both greater COVID-related stress and COVID exposure were associated with fertility desires, regardless of childcare responsibilities during the pandemic.

Educational experiences and American young adults' childbearing goals: A research note.

This research note describes the relationship between young adults' educational experiences and childbearing goals in the U.S. In the U.S., education is associated with later childbearing and fewer children, but the relationship between education and fertility desires and intentions is less well-understood. This article contributes to the research literature by illustrating variation in prospective fertility goals by education, focusing on the early life course in order to understand young adults' goals before they have been shaped by parenting and extensive workforce experiences. This analysis uses data from the National Surveys of Family Growth (1995-2019), a nationally representative survey, to study fertility desires and intentions among childless U.S. men and women ages 19-24. Predicted probabilities demonstrating differences in fertility goals by educational experiences, from three sets of multivariable analyses (logistic regression predicting fertility desires and intentions, separately, and negative binomial regression predicting intended parity), are shown. Men and women with a bachelor's degree and those enrolled in college do not have lower fertility goals than those without a degree and not enrolled; if anything, more educated individuals are slightly more likely to desire (for men only) and intend children and to have slightly larger intended family size. Education gaps in fertility in the United States are not attributable to differences in early-life fertility goals.

Fertility desire and associated factors among women of reproductive age living with HIV/AIDS attending antiretroviral therapy clinic in Arba Minch General Hospital, South Ethiopia, 2021.

The fertility desire of women living with HIV to have children can have significant implications for public health. Despite the increase in the number of HIV-positive women, the issues of their fertility desire have not been well-studied. This study aims to assess fertility desire and associated factors among women living with HIV/AIDS. A facility-based cross-sectional study was conducted from 1 May to 30 July 2021. The researchers employed a systematic sampling technique. The data were gathered and entered into EpiData 3.1 software, and subsequently exported to the statistical package for social science version 25 for analysis. Binary logistic regression analyses were used to identify the factors involved, and a p-value of <0.05 at a 95% confidence level was deemed to be statistically significant. The findings of this study indicate that 47.8% of women expressed a desire to conceive. Various factors such as parents' pressure [adjusted odds ratio (AOR) = 4.41, 95% confidence interval (CI): 2.15-9.05], community pressure (AOR = 2.62, 95% CI: 1.30-5.26), being married (AOR = 0.25, 95% CI: 0.09-0.73), having only female offspring (AOR = 2.57, 95% CI: 1.12-5.90), and having HIV seropositive children (AOR = 2.45, 95% CI: 1.23-4.85) had statistically significant association with fertility desire. The study area exhibited a high level of fertility desire. Various factors can influence fertility desire, including parents' pressure, community pressure, being married, having only female offspring, and having children who are HIV seropositive. When developing interventions on sexual and reproductive health issues, it is imperative for policymakers and healthcare providers who are working in antiretroviral therapy clinics to take into account the effects of these factors on women living with HIV. When designing and implementing prevention of mother-to-child transmission services, it is important to consider the fertility desires of mothers who are living with HIV.

Psychometric Properties of Patients' Health Questionnaire Assessed on Obstetric Fistula Patients in Northwestern, Nigeria

Nigeria is among the highest contributor to global prevalence of obstetrics fistula (OF) and weak health care policies and services have left the victims reeling in untold psycho-social and physical morbidities. This study was aimed at assessing the psychometric properties of a globally used Patients’ Health Questionnaire (PHQ-9) among these patients. A descriptive cross-sectional study design was employed to study the fertility desires, mental health and patients’ quality of life among women with obstetric fistula in three selected OF centers in Northwestern region of Nigeria. Using two-stage sampling technique four hundred twenty (420) OF patients were recruited into the study. Maximum likelihood (ML) factor analysis was deployed to produce latent factors from the responses to the PHQ-9 scale, internal reliability and construct validity were determined by Cronbach alpha values while comparative mean analysis was used to validate standardized scores of the derived PHQ-9 scale factors against socio-demographic and obstetric characteristics. Mean age and standard deviation of respondents were 26.4±8.4 years as 60% aged between 20-25 years. The married, divorced and those in polygamous were 45%, 47.1% and 73.6% respectively. More than half (55.5%) were traders while majority (89.8%) earned NGN4500 or less monthly. Three factors of somatic (r= 0.72-0.82; α=0.86), non-somatic (r= 0.64-0.76; α=0.77) and affective (r= 0.64-0.96; α=0.74) constructs emerged from the ML factor analysis. Patients of ages 20-25 years, divorced/single and widows, the formally educated and farmers significantly differed with high scores of the affective construct of the PHQ-9 scale. Those who had more than four pregnancies and greater than a single stillbirth significantly differed with affective symptoms (0.29±0.90; 0.69±0.9 The 15–17-year-olds at first birth and those who waited more than ten years for OF surgical repairs differed with non-somatic symptoms’ construct of the PHQ-9 scale (0.21±1.04; 0.31±0.87) significantly differed with affective factors. The PHQ-9 instrument exhibited possibility of being used to assess the quality of OF patients’ mental health. Future studies could expand the sample size to accommodate advanced inferential psychometric methods.

Influence of sex composition of surviving children on childbearing intention among high fertility married women in stable union in Northwestern, Nigeria.

Achievement of Sustainable Development Goals (SDGs), especially goals one (end all forms of poverty), three (ensure healthy lives and promote well-being for all at all ages), four (ensure inclusive and equitable quality education and promote life-long learning opportunities for all) and five (achieve gender equality and empower all women and girls) might be a mirage without conscious efforts on the part of many developing countries to reduce population growth. Rapid population growth due to a high fertility rate and fertility desire may engender strife, poverty, unemployment, competition for scarce resources.The study explored the influence of sex composition of living children on childbearing intention among high fertility married women in stable union. This was a cross-sectional descriptive study and the study population were married women with high fertility in stable union. Results showed that sex composition of surviving children were significantly associated with respondents' fertility intentions. The following were the predictors of fertility intentions; sex composition of surviving children, type of family, contraceptive use, child parity, women empowerment status and others. Sex composition of surviving children was significantly associated with the fert ility intentions of the high fertility married women in stable union.

High-intensity Focused Ultrasound is a Better Choice for Women with Fertility Desire: A Systematic Review and Meta-analysis of the Comparison between High-intensity Focused Ultrasound and Laparoscopic Treatment of Uterine Fibroids.

High-intensity focused ultrasound (HIFU) is commonly used to treat uterine fibroids and adenomyosis, but there is no evidence using metadata to compare fertility outcomes between conventional laparoscopic procedures and HIFU. The purpose of this study analysis is that evidence-based fertility outcomes may provide better treatment options for clinicians and patients considering fertility. The literature on fertility data for HIFU surgery versus laparoscopic myomectomy was searched in seven English language databases from January 1, 2010, to November 23, 2022. A total of 1375 articles were received in the literature, 14 of which were selected. We found that women who underwent HIFU surgery had higher rates of spontaneous pregnancy, higher rates of spontaneous delivery, and higher rates of full-term delivery but may have higher rates of miscarriage or postpartum complications than women who underwent laparoscopic myomectomy. Looking forward to future studies, it is hoped that the literature will examine endometrial differences in women who undergo HIFU and laparoscopic myomectomy to demonstrate the ability of endometrial repair. The location of fibroids in the sample should also be counted to allow for attribution statistics on the cause of miscarriage.