P-570 Which fertility education interventions have been delivered to adolescents and are effective in increasing fertility knowledge? A systematic review
Authors: Martins M , Martins R , Nunes F , Costa M E 
Published: June 2023

Abstract

Study question
Which fertility education interventions have been delivered to adolescents and are effective in increasing fertility knowledge? A systematic review

Summary answer
Adolescents’ fertility knowledge is low, particularly when it comes to individual factors. Educational interventions are perceived as useful and can increase fertility knowledge.

What is known already
The importance of fertility education is now well-recognized, but most research has focused on young and emergent adults. Targeting these populations has often resulted in negative public opinion feedback including pressure to have children, with studies showing that increasing young women’s knowledge leads to higher anxiety levels. Despite recent calls for including fertility education within the reproductive health education framework at an age where prevention could be more effective, there are no systematic reviews on the effects of these interventions in adolescents.

Study design, size, duration
We are conducting a living systematic review based on a registered protocol (PROSPERO CRD42022345551, registered 26 September 2022). A literature search from 01.01.2010 to 29.09.2022 and an update has been planned. Databases included ISI Web of Science, PubMed, PsychArticles and PsychInfo. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed.

Participants/materials, setting, methods
A search was conducted using combinations of MeSH terms and keywords, (e.g. “adolescents”; “fertility knowledge”). Studies in English, Spanish, French and Portuguese, with both qualitative and quantitative methods, were eligible. Two reviewers independently selected studies and extracted data. A third researcher solved conflicts. A narrative synthesis approach was used.

Main results and the role of chance
Our search identified 5127 records after removal of duplicates, and 427 met eligibility criteria for full text analysis. However, &lt;30 were included in the review (update planned). Studies included adolescents from all continents, with most participants from USA. Results revealed that adolescents have a low understanding of fertility risk factors, particularly individual ones when compared to environmental factors. The majority of adolescents agree that fertility knowledge should be included in sex education curricula and perceive this awareness as relevant for future decisions regarding family formation and existent options. The preferred source of information is online digital media, but adolescents acknowledge that information has to be delivered via several sources and that literacy is built through repeated and progressive exposure.

Limitations, reasons for caution
Included studies were limited to those published in peer review journals. The analyzed studies over-represent interventions in Western countries. There was no sufficient data to perform meta-analysis. Although these limitations suggest a cautious approach to data interpretation, the studies found constitute the best available evidence.

Wider implications of the findings
Our findings indicate that fertility education is not included in most reproductive health programs or interventions, and that evidence of effective interventions is scarce. Further prospective multicountry studies including fertility knowledge as main outcome are warranted to allow meta-analysis and compare results concerning preferred learning method and treatment options.

Trial registration number
not applicable