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

STUDY QUESTION

What are the childbearing intentions of currently childless men and women? What is their attitude towards, and willingness to use, assisted human reproduction (AHR) treatments and family-building options should they be faced with fertility challenges in the future?

SUMMARY ANSWER

Men and women expect to become parents significantly later in life than they believe is ideal. If faced with future fertility challenges, respondents were open to using IVF, but were not positively predisposed to third-party family-building options.

WHAT IS KNOWN ALREADY

Delayed childbearing is an increasing worldwide phenomenon that has considerable health and fertility-related implications. Research to date has focused primarily on women, and indicates a lack of knowledge about the fertility life span and the limitations of AHR in fully compensating for age-related fertility declines.

STUDY DESIGN, SIZE, DURATION: Cross-sectional study of 2000 childless women and 599 childless men, conducted between April 2010 and May 2011.

PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 2599 childless, presumed fertile individuals between the ages of 20 and 50 years. An online questionnaire assessed fertility beliefs and intentions and willingness to use AHR.

MAIN RESULTS AND THE ROLE OF CHANCE

The findings indicate that men and women expect to become parents significantly later in life than they believe is ideal. If faced with fertility challenges in the future, both men and women were open to using IVF. Men were significantly more willing to consider using donated eggs and embryos, gestational surrogacy and fertility preservation. Women were significantly more willing to consider using home fertility testing, IVF, ICSI and donor sperm. Overall, the childless respondents were not positively predisposed to third party-family-building options.

LIMITATIONS

The geographic specificity of the sample, the online format and recruitment methods may limit the generalizability of these findings.

WIDER IMPLICATIONS OF THE FINDINGS

Given the worldwide trend towards delayed childbearing, and the widespread availability of AHR, it is likely that these findings could extend to the wider North American, European and Australasia populations of English- and French-speaking childless men and women. However, it should be noted that international differences exist, especially concerning regulations governing the funding of AHR and payment for gametes and surrogacy. It is significant that women and men in this study indicated a lack of willingness to consider the use of third third-party treatments--the very options they may need to use in building their families, if the increasing trend towards delayed childbearing continues.

STUDY FUNDING/COMPETING INTERESTS: This research was funded by a grant from the Canadian Institutes of Health Research and Assisted Human Reproduction Canada #PAH-103594, 2009/10. No competing interests.