IMR Press / CEOG / Volume 46 / Issue 3 / DOI: 10.12891/ceog4685.2019
Open Access Original Research
Investigation of understanding the influence of age on fertility in Kаzakhstan: reality the physicians need to face in IVF clinic
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1 Department of Obstetrics and Gynecology, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan
2 Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan
3 Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA
Clin. Exp. Obstet. Gynecol. 2019 , 46(3), 461–465; https://doi.org/10.12891/ceog4685.2019
Published: 10 June 2019
Abstract

Introduction: Women’s intentions to delay attempting a family until later in life is well known all over the world, but their knowledge of this behavior’s influence on fertility rate, as well as all the accompanying disadvantages that might appear, has not been systematically investigated. Therefore, the aim of the study was to investigate women’s awareness of delayed childbearing age on fertility rate and IVF procedure success in Kazakhstan. Materials and Methods: The investigation was carried out at Department of Obstetrics and Gynecology, National Research Center of Mother and Child Health, University Medical Center, Astana, throughout a period of 24 months. The questionnaires consisting of 44 open-ended questions were given to 82 women aged over 40, who came for consultation to IVF unit due to infertility. Results: 31.7% of women in this cohort first attempted conception at an average age more than 35, while 61% stated that they had some awareness that fertility declined after age 40. Yet 90.2% of women expected their fertility to decline gradually until menopause at around 50 years and 30.5% reported that they expected to become pregnant without difficulty at age 40. Very few participants had considered the possibility that they would need IVF and 53.7% reported being ‘shocked’ and ‘alarmed’ to discover that their understandings of the rapidity of age-related reproductive decline were inaccurate. 97.6% of women advocated better fertility education earlier in life, so that men and women could acquire more information regarding childbearing decisions and 80.5% of women indicated that with more information regarding declining fertility, they might have attempted conception at an earlier age. Conclusion: Participants did not have a clear understanding of age influence on fertility decline. Moreover, over half of women were ‘shocked’ to discover that the chances of conception at their advanced ages were lower than they had previously anticipated. Although the failure to appreciate the true biological relationship between aging and fertility may reflect inaccessibility or misinterpretation of information, it was found not to be sufficient to explain the decades-long socio-demographic phenomenon of delayed childbearing.

Keywords
Age and fertility
Delayed childbearing
Fertility education
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