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Effectiveness of fertility health awareness strategies on fertility knowledge and childbearing: a randomized
Sze Ling Chan1, Julian Thumboo2, Jacky Boivin3
1Health Services Research Centre, SingHealth, Singapore; Health Services Research and Population Health, Duke-NUS Medical School, Singapore.
Reproductive Biomedicine Online
|May 20, 2026
Summary
Fertility health screening (FHS) and fertility awareness tools (FAT) did not significantly alter parenthood intentions, measured by intended age at first birth, in couples. While both interventions improved fertility knowledge, they did not impact decisions about starting a family.
Area of Science:
- Reproductive Health
- Fertility Awareness
- Parenthood Intentions
Background:
- Parenthood intentions are influenced by various factors, including fertility awareness and health screening.
- Understanding the impact of fertility health screening (FHS) and fertility awareness tools (FAT) is crucial for reproductive health planning.
Purpose of the Study:
- To evaluate the effect of FHS and FAT on parenthood intentions, specifically the wife's intended age at first birth.
- To compare the outcomes of FHS and FAT interventions against a control group receiving no intervention.
Main Methods:
- A multicentre, three-arm, parallel-group, open-label randomized controlled trial.
- Married Singaporean couples (wives aged 25-34) were randomized to FHS, FAT, or a control group.
- Primary outcome: change in wife's intended age at first birth; Secondary outcomes: fertility knowledge, conception attempts, pregnancy, and further fertility service uptake at 6 months.
Main Results:
- No significant difference in the change of wife's intended age at first birth was observed between FHS/FAT groups and the control group.
- Both FHS and FAT significantly increased fertility awareness scores in both wives and husbands.
- No significant differences were found in other secondary outcomes, including attempts to conceive or pregnancy rates.
Conclusions:
- Fertility health screening and fertility awareness tools did not significantly modify parenthood intentions at 6 months post-randomization.
- While effective in increasing fertility knowledge, these interventions did not alter the timing of intended parenthood.
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