Delbaere, I., Verbiest, S., & Tydén, T. (2020). Knowledge about the impact of age on fertility: a brief review. Upsala journal of medical sciences, 125(2), 167-174. https://doi.org/10.1080/03009734.2019.1707913
Delbaere I, Verbiest S, Tydén T. Knowledge about the impact of age on fertility: a brief review. Ups J Med Sci. 2020;125(2):167-174. doi:10.1080/03009734.2019.1707913
Delbaere, Ilse, et al. "Knowledge about the impact of age on fertility: a brief review." Upsala journal of medical sciences, vol. 125, no. 2, 2020, pp. 167-174.
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RRM Academy Synopsis
Knowledge of age and fertility is low, even among medical students
A 2020 brief review of surveys finds that students and OB/GYN residents misjudge how age affects fertility and overestimate IVF success. Nearly half of US OB/GYN residents were misinformed. Some studies found knowledge rose after counseling.
Key Findings
Chances of conceiving within 1 year are 85% for women younger than 30, 75% at age 30, 66% at age 35 and 44% at age 40.
Nearly half of US OB/GYN residents held wrong ideas about how fertility declines with age. Three out of four overestimated how well IVF treatment works.
One-fourth of the doctoral students in Swedish surveys overestimated how likely women aged 35 to 40 were to conceive. About half of them were overly optimistic about IVF.
A Copenhagen fertility assessment clinic followed up 570 women by questionnaire after 2 years. Of them, 68% had tried to conceive, and three-quarters of those had achieved a pregnancy.
Interpretation
The paper is a brief review of earlier work. The age-by-age pregnancy chances come from studies the review cites. The knowledge findings come from surveys of students and trainees in several countries, so they describe those groups. Counseling studies reported no effect on effective contraception use. Their gains were in fertility knowledge and awareness. The Copenhagen follow-up reports outcomes for women who attended the clinic and describes no comparison group. The authors list the clinic's cost-effectiveness as a question for future studies.
RRM Context
The review cites a simulation that found assisted reproduction could not make up for the effect of age on fertility. Overestimating IVF success can lead people to plan around a technology that cannot make up for age-related decline. Restorative reproductive medicine teaches fertility awareness and cycle charting. The review also calls for counseling that reaches men. Fertility belongs to the couple.
Our editorial summary of this paper, not the article's abstract.
Abstract
Delayed childbearing is currently a major challenge in reproductive medicine as increased age has an important impact on successful conception, both in natural and in assisted reproduction. There is a lack of knowledge about the impact of age on fertility, even in highly educated populations. A number of initiatives have been taken to increase fertility awareness. Health care providers have been encouraged to talk with patients about their reproductive life plan (RLP) for almost a decade based on recommendations from the Centres for Disease Control and Prevention. This concept has been explored successfully in Swedish contraception counselling. A growing number of online interventions aim to raise fertility awareness. These websites or interactive tools provide relevant information for individuals and couples as they consider whether they want children, when they should have them, and how many they may wish to have. These interventions are important, because research depicts that knowledge helps people in their decision-making process. With new fertility preservations such as egg freezing now available, additional education is needed to be sure that women and couples are well informed about the cost and low success rates of this intervention.
Conceição C et al., 2017·Eur J Contracept Reprod Health Care
Recent evidence has shown that young adults have poor knowledge about reproductive health and fertility, and that interventions are needed to increase fertility awareness. The aim of this study was to assess the effectiveness of a brief video in increasing knowledge about fertility and infertility in young adults. We carried out a two-arm, parallel-group, randomised controlled trial with a pre-test/post-test design (NCT02607761, ClinicalTrials.gov). The sample was composed of 173 undergraduates who completed a self-report questionnaire. Participants were randomly assigned to exposure or no exposure to an educational video about reproductive health and infertility (intervention group, n = 89; control group, n = 84). At baseline, participants revealed poor knowledge of infertility risk factors and fertility issues, and average knowledge of the definition of infertility. Interaction effects between group and time were found for all variables targeted in the video. Participants in the intervention group significantly increased their knowledge of fertility issues, infertility risk factors and the definition of infertility. No significant differences in post-test knowledge were observed in the control group, except for the age at which there is a marked decrease in female fertility. A short video intervention is effective in increasing short-term knowledge about reproductive health and infertility. If future research using longer intervals corroborates our findings, video intervention could be a useful tool in public health prevention campaigns.
Patient Education · Fertility Knowledge and Misconceptions
Wainwright E et al., 2025·Reprod Health·Free full text on PubMed Central
Fertility rates in the UK are at an all-time low, with infertility affecting approximately 1 in 7 couples. Despite the rising demand for fertility services, fertility awareness, specifically knowledge of ovulation and the fertile window, remains low among women of reproductive age. Most existing studies offer a broad perspective, lacking focus on women actively trying to conceive (TTC). This study aims to assess the level of understanding surrounding the fertile window among women TTC, identifying factors associated with knowledge gaps. A retrospective, cross-sectional analysis of 97,414 women actively TTC who answered an online health assessment was conducted. Participants provided information on menstrual cycle characteristics, previous pregnancies, and fertility knowledge, including the timing of the fertile window. Frequencies, percentages were calculated and chi-squared tests performed to assess differences in categorical data. Logistic regression models were used to calculate odds ratios (ORs) to better understand factors significantly associated with not knowing the fertile window. Out of the total respondents (97,414), over a third (33,756, 41%) could not accurately identify the fertile window, with substantial misconceptions observed across all age groups and ethnicities. Women with previous pregnancies were more likely to correctly identify the fertile window (OR = 1.45, 97.5% CI: 1.20-1.75, p < 0.001). However, knowledge was significantly lower among those with irregular cycles, non-White ethnicities, younger age groups and longer time TTC. Additionally, misconceptions about cycle regularity were apparent, of 60,322 women describing their cycles as regular 10% did not know their cycle length (66,95) and a further 2.9% fell outside of the clinically regular 21-35 day range. These misconceptions followed a similar trend with younger age groups, non-white ethnicities and longer time TTC having significantly increased rates of misidentifying regular cycles. This further increased the odds of not knowing their fertile window (OR = 2.99, 97.5% CI: 2.83-3.17, p < 0.001). The findings reveal gaps in fertility awareness among women actively TTC. Addressing these knowledge gaps through targeted educational interventions could potentially reduce time-to-pregnancy and the reliance on assisted reproductive technologies. Improved fertility education focusing on cycle tracking and ovulation timing is essential to assist women with accurate information during their TTC journey.
To synthesize the literature on fertility knowledge and fertility-awareness among women seeking pregnancy. Data Sources: The search terms "fertility-awareness OR fertility knowledge AND women AND subfertile OR infertile OR seeking pregnancy OR trying to conceive OR pre-conception OR conception NOT contraception NOT birth control" were used via CINAHL, PubMed, and Web of Science. Primary research studies were considered in the search parameters. Searches yielded 116 studies published between 1978 and 2020. After screening, 43 full-text studies were assessed for eligibility, 35 of which were omitted as not relevant. Nine quantitative studies using cross-sectional designs met this review's inclusion criteria. Data Extraction: Studies were reviewed for information on the relationship between fertility knowledge/fertility-awareness and pregnancy intention. Studies examining the results of fertility-awareness based method (FABM) efficacy, FABMs for contraception, and provider knowledge regarding FABMs were omitted. Analysis showed low knowledge regarding the identification of the fertile window in the menstrual cycle to optimize pregnancy. There was moderate general knowledge on fertility (e.g., infertility definition, age of fertility decline, etc.). Use of an FABM and education regarding FABMs were infrequent, yet participants recognized that it would be beneficial to use and learn when trying to conceive. Women seeking pregnancy have low to moderate fertility knowledge. More research is necessary on the relationship between fertility knowledge/fertility-awareness and unexplained infertility. Nurses, nurse practitioners, and nurse-midwives should provide education on FABMs to women when they first report difficulty achieving pregnancy. Clinicians' approaches toward FABM education for women and how to implement FABM education into the preconception visit are important areas for future research.
Mu Q et al., 2019·Journal of obstetric, gynecologic, and neonatal nursing : JOGNN
To explore the relationships among young women's demographic characteristics, their self-perceived and actual knowledge about fertility, and their fertility health risk factors. A quantitative, cross-sectional study. Online survey. Young women between the ages of 18 and 24 years (N = 342). We used an online survey to collect data from young women regarding their demographic characteristics, their self-perceived and actual knowledge about fertility, and their fertility health risk factors. We used multiple linear regression to explore the relationships among these factors. Participants were mainly White, had some form of college education, and used a variety of contraception methods. Regression modeling indicated that participants' self-perceived knowledge and actual knowledge about fertility and their methods of contraception were significantly associated with their fertility health risks (R2 = .13, p < .001). Participants who had higher actual scores of knowledge about fertility and who used fertility awareness methods had fewer self-reported fertility health risk factors. A greater level of self-perceived knowledge about fertility was associated with more fertility health risk factors. Age, education level, and pregnancy history were not significantly associated with fertility health risks. Our findings provide evidence that knowledge about fertility is important to enhance fertility self-care for young women. The significant relationship between young women's knowledge about fertility and their fertility health risks highlights the need to assess their knowledge and teach them about fertility as important components of preconception care. Such education may help them avoid fertility health risks and protect young women's current and future fertility.
Longevity and Reproductive Aging › Age and Fertility › Female Age and Fecundability · Body Literacy › Patient Education › Fertility Knowledge and Misconceptions · Ethics and Policy › Advocacy and Public Understanding › Public Awareness
Ilse Delbaere, Tanja Tydén, Sarah Verbiest
I Delbaere, T Tydén, S Verbiest
PMID 31964217 31964217 DOI 10.1080/03009734.2019.1707913 10.1080/03009734.2019.1707913 Delbaere et al. 2020, Delbaere 2020
Cite this article
Delbaere, I., Verbiest, S., & Tydén, T. (2020). Knowledge about the impact of age on fertility: a brief review. Upsala journal of medical sciences, 125(2), 167-174. https://doi.org/10.1080/03009734.2019.1707913
Delbaere I, Verbiest S, Tydén T. Knowledge about the impact of age on fertility: a brief review. Ups J Med Sci. 2020;125(2):167-174. doi:10.1080/03009734.2019.1707913
Delbaere, Ilse, et al. "Knowledge about the impact of age on fertility: a brief review." Upsala journal of medical sciences, vol. 125, no. 2, 2020, pp. 167-174.
