STUDY QUESTION:How good is fertility knowledge and what are treatment beliefs in an international sample of men and women currently trying to conceive? SUMMARY ANSWER:The study population had a modest level of fertility knowledge and held positive and negative views of treatment. WHAT IS KNOWN ALREADY:Few studies have examined general fertility treatment attitudes but studies of specific interventions show that attitudes are related to characteristics of the patient, doctor and context. Further, research shows that fertility knowledge is poor. However, the majority of these studies have examined the prevalence of infertility, the optimal fertile period and/or age-related infertility in women, in university students and/or people from high-resource countries making it difficult to generalize findings. STUDY DESIGN, SIZE, DURATION:A cross-sectional sample completed the International Fertility Decision-making Study (IFDMS) over a 9-month period, online or via social research panels and in fertility clinics. PARTICIPANTS/MATERIALS, SETTING, METHODS:Participants were 10 045 people (8355 women, 1690 men) who were on average 31.8 years old, had been trying to conceive for 2.8 years with 53.9% university educated. From a total of 79 countries, sample size was >100 in 18 countries. All 79 countries were assigned to either a very high Human Development Index (VH HDI) or a not very high HDI (NVH HDI). The IFDMS was a 45-min, 64-item English survey translated into 12 languages. The inclusion criteria were the age between 18 and 50 years and currently trying to conceive for at least 6 months. Fertility knowledge was assessed using a 13-item correct/incorrect scale concerned with risk factors, misconceptions and basic fertility facts (range: 0-100% correct). Treatment beliefs were assessed with positive and negative statements about fertility treatment rated on a five-point agree/disagree response scale. MAIN RESULTS AND THE ROLE OF CHANCE:Average correct score for Fertility Knowledge was 56.9%, with greater knowledge significantly related to female gender, university education, paid employment, VH HDI and prior medical consultation for infertility (all P < 0.001). The mean agreement scores for treatment beliefs showed that agreement for positive items (safety, efficacy) was correlated with agreement for negative items (short/long-term physical/emotional effects) (P > 0.001). People who had given birth/fathered a child, been trying to conceive for less than 12 months, who had never consulted for a fertility problem and who lived in a country with an NVH HDI agreed less with negative beliefs. HDI, duration of trying to conceive and help-seeking were also correlates of higher positive beliefs, alongside younger age, living in an urban area and having stepchildren. Greater fertility knowledge was associated with stronger agreement on negative treatment beliefs items (P < 0.001) but was unrelated to positive treatment beliefs items. LIMITATIONS, REASONS FOR CAUTION:There was volunteer bias insofar as more women, people of higher education and people with fertility problems (i.e. met criteria for infertility, had consulted a medical doctor, had conceived with fertility treatment) participated and this was true in VH and NVH HDI countries. The bias may mean that people in this sample had better fertility knowledge and less favourable treatment beliefs than is the case in the general population. WIDER IMPLICATIONS OF THE FINDINGS:Educational interventions should be directed at improving knowledge of fertility health. Future prospective research should be aimed at investigating how fertility knowledge and treatment beliefs affect childbearing and help-seeking decision-making.

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研究问题:在目前试图受孕的国际男女样本中,生育知识的水平如何?对治疗的看法是什么?
总结答案:该研究人群对生育的知识水平不高,对治疗持正面和负面的看法。
已有的知识:很少有研究检查一般的生育治疗态度,但是对特定干预措施的研究表明,态度与患者,医生和环境的特征有关。此外,研究表明生育知识很差。但是,这些研究中的大多数都检查了大学生和/或资源丰富国家的人中女性的不育症患病率,最佳生育期和/或与年龄相关的不育症,因此难以一概而论。
研究设计,规模,期限:一个横断面样本在9个月的时间内通过在线或通过社会研究小组以及在生育诊所完成了国际生育力决策研究(IFDMS)。
参与者/材料,环境,方法:参与者为10045人(8355名女性,1690名男性),平均年龄31.8岁,尝试受孕2.8年,大学学历占53.9%。在总共79个国家中,有18个国家的样本量大于100。所有79个国家/地区都被分配为人类发展指数(VH HDI)很高或不是很高的HDI(NVH HDI)。 IFDMS是一项长达45分钟,包含64个项目的英语调查问卷,被翻译成12种语言。纳入标准为18至50岁之间的年龄,目前试图怀孕至少6个月。使用与危险因素,误解和基本生育率有关的13项正确/不正确的量表评估了生育知识(正确范围为0-100%)。用五点同意/不同意反应量表对有关生育力治疗的正面和负面陈述对治疗信念进行了评估。
主要结果和机会的作用:生育知识的平均正确分数为56.9%,其中更多知识与女性,大学教育,有偿就业,VH HDI和不育相关的医学咨询密切相关(所有P <0.001)。治疗信念的平均协议得分显示,阳性项目(安全性,有效性)的一致性与阴性项目(短期/长期的身体/情绪影响)的一致性相关(P> 0.001)。生育/生过孩子,试图怀孕少于12个月,从未就生育问题进行咨询并且生活在NVH HDI的国家的人不同意否定。人类发展指数(HDI),尝试受孕的时间和寻求帮助的时间也与较高的积极信念,较年轻的年龄,居住在市区和有继子女的信念相关。较高的生育知识与对消极治疗信念项目达成更强的共识有关(P <0.001),但与积极治疗信念项目无关。
局限性,注意事项的原因:自愿参加者的偏见涉及更多的妇女,受过高等教育的人和有生育问题的人(即达到不育标准,咨询医生,接受过生育治疗的人),这在VH中是正确的和NVH HDI国家。这种偏见可能意味着与一般人群相比,该样本中的人具有更好的生育知识和较差的治疗信念。
结论的教育意义:教育干预措施应旨在提高对生育健康的认识。未来的前瞻性研究应旨在调查生育知识和治疗观念如何影响生育和寻求帮助的决策。

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