Fertility Postponement Research Articles

Current trends and progress in clinical applications of oocyte cryopreservation.

To delineate the current trends in the clinical application of oocyte cryopreservation. Although the first live birth from oocyte cryopreservation was reported approximately three decades ago, significant improvement in the clinical application of oocyte cryopreservation took place only over the past decade. On the basis of the available evidence suggesting that success rates with donor oocyte vitrification are similar to that of IVF with fresh donor oocytes, the American Society of Reproductive Medicine has recently stated that oocyte cryopreservation should no longer be considered experimental for medical indications, outlying elective oocyte cryopreservation. Meanwhile, a few surveys on the attitudes toward oocyte cryopreservation revealed that elective use for the postponement of fertility is currently the most common indication for oocyte cryopreservation. Most recently, a randomized controlled trial revealed important evidence on the safety of nondonor oocyte cryopreservation, and confirmed that the clinical success of vitrification is comparable to that of IVF with fresh oocytes. The evidence suggesting similar IVF success rates with both donor and nondonor cryopreserved oocytes compared with fresh oocytes will increase the utilization of elective oocyte cryopreservation. Appropriate counseling of women for oocyte cryopreservation requires the establishment of age-based clinical success rates with cryopreserved oocytes for various indications.

Spatial continuities and discontinuities in two successive demographic transitions

This is a study of how the synergisms between cultural and structural factors, which played a major role during the historical fertility and nuptiality transition (first demographic transition or FDT), have continued to condition demographic innovations connected to the “second demographic transition” (SDT). The continuity or discontinuity from the “first” to the “second” demographic transition is studied for spatial aggregates over more than a century in two national contexts, i.e., Belgium and Spain. Special attention is paid to the role of successive secularization waves in shaping the geographical patterns of both transitions. The study also shows that the maps of the two aspects of the SDT, i.e., the “postponement” and the “non-conformism” transitions respectively, are shaped by different determinants. Explanations are offered using the “Ready, Willing, and Able” paradigm, which allows us to uncover the different conditioning and limiting factors involved. The “non-conformist” transitions (control of marital fertility during the FDT and rise of cohabitation and non-conventional family formation during the SDT) more closely mirror the history of secularization and the “Willingness” condition, whereas the fertility postponement aspect of the SDT mainly reflects female education and employment, or the “Readiness” condition. This generalization holds in both countries. However, in Belgium spatial continuity from FDT to SDT is connected to stable patterns of secularization, whereas in Spain it is linked to long standing differences with respect to female literacy and education

Postponement and Recuperation in Cohort Fertility:<br>Austria, Germany and Switzerland in a European Context<br>

Across developed countries, cohorts of women born after World War II have seen a shift of childbearing towards later ages and a concomitant decline in fertility level. We study this shift using the notions of fertility postponement (fertility decline at younger ages) and subsequent recuperation (a compensatory fertility increase at higher reproductive ages). We apply order-specific data and extend and elaborate on two broad approaches to this process: 1) a basic benchmark model extensively used by Tomas Frejka and his colleagues and 2) a relational model proposed by Ron Lesthaeghe (2001). Our work focuses especially on three predominantly German-speaking countries, Austria, Germany and Switzerland, and compares them with selected European countries and the United States. We illustrate the usefulness of these two approaches for constructing projection scenarios of completed cohort fertility among women of reproductive age. Using three key indicators of the postponement transition – initial fertility level, absolute fertility decline at younger ages, and the relative degree of fertility “recuperation” at older ages – we demonstrate that each of these components is salient for explaining contemporary cross-country differences in cohort fertility. Recuperation is especially important, but is also clearly patterned by birth order: whereas all the countries analysed have experienced a vigorous recovery of delayed first births, pronounced differentials are observed with regard to the recuperation of second and particularly of third and later births. In line with the differentials observed, projected values of completed fertility in five European countries vary widely for the cohorts born in the early 1980s, ranging from 1.3 in the lowest scenario for Spain to over 1.8 in the highest scenario for the Czech Republic.

Fertility postponement is largely due to rising educational enrolment

The rise in educational enrolment is often cited as a possible cause of the trend to later childbearing in developed societies but direct evidence of its contribution to the aggregate change in fertility tempo is scarce. We show that rising enrolment, resulting in later ages at the end of education, accounts for a substantial part of the upward shift in the mean age at first birth in the 1980s and 1990s in Britain and in France. The postponement of first birth over that period has two components: a longer average period of enrolment and a post-enrolment component that is also related to educational level. The relationship between rising educational participation and the move to later fertility timing is almost certainly causal. Our findings therefore suggest that fertility tempo change is rooted in macro-economic and structural forces rather than in the cultural domain.

Economic recession and first births in Europe: recession-induced postponement and recuperation of fertility in 14 European countries between 1970 and 2005

The economic crisis that emerged after 2008 caused speculation about further postponement of fertility and a recession-induced baby-bust in countries affected by the economic downturn. This paper aims to disentangle short-term and long-term effects of economic context on entry into parenthood and explores variation of postponement and recuperation by age, gender, educational level and welfare state context. Random-effects complementary log-log models including macro-level indicators are used to analyse longitudinal microdata on 12,121 first births to 20,736 individuals observed between 1970 and 2005. Adverse economic conditions and high unemployment significantly reduce first birth hazards among men and women below age 30, particularly among the higher educated. After age 30 economic context continues to affect first birth hazards of men, but not for women. Recuperation of fertility is further associated with access to labour markets and entry into cohabiting unions. The continuing postponement of first births has clear medical consequences and implications for health policies. Preventive policies should take access to labour markets for younger generations into account as an important factor driving postponement.

Fertility Forecasting in the German-speaking World:<br>Recent Experience and Opportunities for Improvement<br>

In this article, the official fertility projections of the statistical agencies in Germany, Austria, and Switzerland are examined. We refer to the literature on this topic and the history of fertility projections in all three countries. We conclude that the basis of fertility projections is the persistence of the present. We then investigate the most recent projections in more detail – with special regard for their consistency of timing and level changes of fertility. This shows that in the low fertility context, such as in the three countries under consideration, where fertility postponement is expected to stop sometime in upcoming decades, the medium assumptions of constancy contain an implicit decline in the forecasted level of fertility. Both tempo and cohort perspectives on projected fertility reveal this conclusion. Consequently, we suggest that agencies should deal explicitly with the prospect of postponement and their effect on fertility levels. The Bongaarts-Feeney framework or similar ones could be used. We also provide examples of three consistent variants (low, medium, and high) in the case of Germany, and show that such a forecast can in some cases outperform the usual constant level forecast in a low-fertility context.

A persistent misperception: assisted reproductive technology can reverse the “aged biological clock”

Delaying motherhood should be a free choice made in full knowledge of all the consequences, but modern women have alarming misconceptions about their own reproductive systems and the effectiveness of assisted reproductive technologies. Doctors and health professionals must begin to discuss fertility preservation with their patients and make sure that young women truly understand all their options. Preventing age-related infertility is the responsibility not only of doctors and medical practitioners but also of society at large. Social, economic, and personal pressures are causing women to decide to conceive later in life, yet those who choose to delay motherhood are stigmatized as being selfish and unconcerned about starting a family. This stigma must be banished, and age-related infertility should be faced as a medical problem.

A Demographic Explanation for the Recent Rise in European Fertility

Between 1998 and 2008 European countries experienced the first continent-wide increase in the period total fertility rate (TFR) since the 1960s. After discussing period and cohort influences on fertility trends, we examine the role of tempo distortions of period fertility and different methods for removing them. We highlight the usefulness of a new indicator: the tempo- and parity-adjusted total fertility rate (TFRp*). This variant of the adjusted total fertility rate proposed by Bongaarts and Feeney also controls for the parity composition of the female population and provides more stable values than the indicators proposed in the past. Finally, we estimate levels and trends in tempo and parity distribution distortions in selected countries in Europe. Our analysis of period and cohort fertility indicators in the Czech Republic, Netherlands, Spain, and Sweden shows that the new adjusted measure gives a remarkable fit with the completed fertility of women in prime childbearing years in a given period, which suggests that it provides an accurate adjustment for tempo and parity composition distortions. Using an expanded dataset for ten countries, we demonstrate that adjusted fertility as measured by TFRp* remained nearly stable since the late 1990s. This finding implies that the recent upturns in the period TFR in Europe are largely explained by a decline in the pace of fertility postponement. Other tempo-adjusted fertility indicators have not indicated such a large role for the diminishing tempo effect in these TFR upturns. As countries proceed through their postponement transitions, tempo effects will decline further and eventually disappear, thus putting continued upward pressure on period fertility. However, such an upward trend may be obscured for a few years by the effects of economic recession.

Has East Germany Overtaken West Germany? Recent Trends in Order‐Specific Fertility

Some 20 years after reunification, the contrast between East and West Germany offers a natural experiment for studying the degree of persistence of Communist-era family patterns, the effects of economic change, and fertility postponement. After reunification, period fertility rates plummeted in the former East Germany to record low levels. Since the mid-1990s, however, period fertility rates have been rising in East Germany, in contrast to the nearly constant rates seen in the West. By 2008, the TFR of East Germany had overtaken that of the West. We explore why fertility in East Germany is higher than in West Germany, despite unfavorable economic circumstances in the East. We address this and related questions by (a) presenting an account of the persisting East/West differences in attitudes toward and constraints on childbearing, (b) conducting an order-specific fertility analysis of recent fertility trends, and (c) projecting completed fertility for the recent East and west German cohorts. In addition to using the Human Fertility Database, perinatal statistics allow us to calculate a tempo-corrected TFR for East and West Germany.

Age‐related infertility: a tale of two technologies

The reproductive body has become the site of intensive medical intervention, yet, paradoxically, women have never been more at risk of suffering the distress of infertility. Drawing on in-depth interviews with 22 infertile women, this article explores their reproductive experience from fertility postponement to assisted conception. All had used both modern contraception and in vitro fertilisation, yet none achieved the fertility they desired, when they desired it. All had structured their use of these technologies around the social practice of postponement. Modern contraception, however, while removing the sexual costs of postponement, did not resolve its reproductive dilemmas. Rather it appeared to collapse the experience of this traditionally difficult process, sustaining an illusion of reproductive control in which fertility decisions were 'put on the back burner', undiscussed and sometimes unimagined. For these women this delay then revealed the hidden cost of postponement--infertility--which, in turn, led to their pursuit of assisted conception after the age of 35, at precisely the point when its already limited efficacy begins to fail sharply. In these accounts age-related infertility emerged as a tale of two technologies: two technologies linked to each woman, and each other, through the social practice of postponement.

The "second demographic transition": a conceptual map for the understanding of late modern demographic developments in fertility and family formation

Der zweite demo graphische Ubergang ': Ein Orientierungskon- zept zum Verstandnis spatmoderner demographischer Entwicklungen von Fer- tilitat und Familienbildung«. This article presents a narrative of the unfolding of the Second Demographic Transition (SDT) since the theory was first formu- lated in 1986. The first part recapitulates the foundations of the theory, and documents the spread of the SDT to the point that it now covers most European populations. Also for Europe, it focuses on the relationship between the SDT and the growing heterogeneity in period fertility levels. It is shown that the cur- rent positive relationship between SDT and TFR levels is not a violation of the SDT theory, but the outcome of a split correlation with different sub- narratives concerning the onset of fertility postponement and the degree of subsequent recuperation in two parts of Europe. The second part of the article addresses the issue of whether the SDT has spread or is currently spreading in industrialized Asian countries. Evidence gathered for Japan, South Korea, Hong Kong, Singapore, and Taiwan is presented. That evidence pertains to both the macro- level (national trends in postponement of marriage and parent- hood, rise of cohabitation) and the micro-level (connections between individual values orientations and postponement of parenthood). Strong similarities are

The Unfolding Story of the Second Demographic Transition

This article presents a narrative of the unfolding of the Second Demographic Transition (SDT) since the theory was first formulated in 1986. The first part recapitulates the foundations of the theory, and documents the spread of the SDT to the point that it now covers most European populations. Also for Europe, it focuses on the relationship between the SDT and the growing heterogeneity in period fertility levels. It is shown that the current positive relationship between SDT and TFR levels is not a violation of the SDT theory, but the outcome of a "split correlation" with different sub-narratives concerning the onset of fertility postponement and the degree of subsequent recuperation in two parts of Europe. The second part of the article addresses the issue of whether the SDT has spread or is currently spreading in industrialized Asian countries. Evidence gathered for Japan, South Korea, Hong Kong, Singapore, and Taiwan is presented. That evidence pertains to both the macro-level (national trends in postponement of marriage and parenthood, rise of cohabitation) and the micro-level (connections between individual values orientations and postponement of parenthood). Strong similarities are found with SDT patterns in Southern Europe, except for the fact that parenthood is still very rare among Asian cohabiting partners.

Postponement and recuperation of Belgian fertility: how are they related to rising female educational attainment?

Fertility trends in Europe after 1970 are routinely referred to in terms of the postponement of fertility. The shortening of the effective reproductive lifespan and its association with post-materialist values have raised questions as to whether fertility can or will be recuperated. Decomposition of cohort fertility in Belgium by level of education shows that the postponement of fertility after 1970 is closely related to the expansion of education: compared with cohorts born in 1946-1950, 40 to 50 per cent of the difference in cumulated fertility at age 25 in the 1951-1975 birth cohorts is attributable to rising educational levels. Educational differentials also prove relevant with regard to the recuperation of fertility at older ages as the tempo and quantum of order-specific fertility have responded differently to variations in the economic and policy context, depending on the educational level considered. Differential fertility trends by level of education have thus attenuated the relationship between female educational attainment and completed fertility in recent cohorts.

Deadline for Parenthood: Fertility Postponement and Age Norms in Poland

The postponement of childbearing is occurring across Europe, but the paths of this trend differ profoundly from country to country. In Poland, as in other Central and Eastern European countries, most women have their first child at a relatively young age. This article asks about the role of age norms in sustaining the pattern of early motherhood. We investigate young adults’ perceptions of age in relation to their fertility choices. We find that age is, indeed, a salient dimension that structures and regulates individual childbearing plans. The qualitative approach of our study allows for gaining insights into how age norms are explained, argued about and sanctioned. Finally, we reconstruct the mechanisms of the normative influence of age limits (deadlines) on fertility behaviour, improving our understanding of the timing of childbearing.

Postponement and preservation of fertility by oocyte freezing: preliminary experience

OBJECTIVE: While the techniques of oocyte cryopreservation are becoming increasingly refined, there is little data available on the subset of patients who have chosen to pursue this technology. Here, we analyze the epidemiology and demographic characteristics of our first 27 cycles of oocyte cryopreservation.

Preservation and Postponement of Female Fertility

In the last several decades, both the growing number of reproductive age cancer survivors, and the trend of women from western countries delaying child-bearing to a later age have been markedly increasing. The confluence of these two epidemiologic trends has led to the need for better and more widely available strategies for fertility preservation. In this paper, we will first review both the established and experimental methodologies which can be utilized for either the preservation or postponement of female fertility. These options currently include embryo and oocyte cryopreservation, cortical and whole ovary cryopreservation, ovarian transplantation, ovarian transposition, and gonadotropin releasing hormone agonist protection. As laboratory and surgical techniques for oocyte and ovary cryopreservation continue to improve, modalities now considered experimental will become part of routine practice for reproductive medicine specialists.

Religiosity and Fertility in the United States: The Role of Fertility Intentions.

Using data from the 2002 National Survey of Family Growth (NSFG), we show that women who report that religion is "very important" in their everyday life have both higher fertility and higher intended fertility than those saying religion is "somewhat important" or "not important." Factors such as unwanted fertility, age at childbearing, or degree of fertility postponement seem not to contribute to religiosity differentials in fertility. This answer prompts more fundamental questions: what is the nature of this greater "religiosity"? And why do the more religious want more children? We show that those saying religion is more important have more traditional gender and family attitudes and that these attitudinal differences account for a substantial part of the fertility differential. We speculate regarding other contributing causes.

Does Postponement Explain the Trend to Later Childbearing in France?

Fertility rates in most developed societies have been declining at younger ages and rising at older ages. This phenomenon is widely referred to as reflecting the postponement of fertility. But is this an accurate description? The present paper considers whether recent changes in the age-pattern of childbearing in France can be described as postponement. The statistical features of time series of rates are distinguished from the underlying behavioural process generating them. Criteria for the presence of postponement are proposed. In the absence of detailed, longitudinal information on intentions, the occurrence or otherwise of postponement is assessed by indirect means. Some evidence is found consistent with fertility postponement in recent decades. However, it cannot be interpreted causally, and so cannot be used either to explain recent trends or to anticipate future trends. Much more detailed evidence is required to establish the existence of postponement in the behavioural sense than is generally assumed.

Assessing the use of sample selection models in the estimation of fertility postponement effects

Several studies have shown that at the individual level there exists a negative relationship between age at first birth and completed fertility. Using twin data in order to control for unobserved heterogeneity as possible source of bias, Kohler et al. (2001) showed the significant presence of such "postponement effect" at the micro level. In this paper, we apply sample selection models, where selection is based on having or not having had a first birth at all, to estimate the impact of postponing first births on subsequent fertility for four European nations, three of which have now lowest-low fertility levels. We use data from a set of comparative surveys (Fertility and Family Surveys), and we apply sample selection models on the logarithm of total fertility and on the progression to the second birth. Our results show that postponement effects are only very slightly affected by sample selection biases, so that sample selection models do not improve significantly the results of standard regression techniques on selected samples. Our results confirm that the postponement effect is higher in countries with lowest-low fertility levels.

Child‐free and unmarried: Changes in the life planning of young east German women

Using evidence from demographic and survey data, this research examines how one decade of postsocialism has changed the life planning of young East German women. Aggregate data reflect marriage and fertility postponement and increased nonmarital birth rates and cohabitation. The analysis shows East German women's “stubbornness” (Dölling, 2003) in adhering to life perspectives in line with the German Democratic Republic (GDR) standard biography (high nonmarital childbearing, high work orientation, rejection of the homemaker status, desire to combine work and family). The most important findings are that (a) motherhood is postponed to increase child‐free time, (b) cohabitation is increasingly becoming an alternative to marriage, (c) marriage (but not partnership) is increasingly optional for childbearing, and (d) employment is prioritized over family formation.