P-564 factors influencing men’s attitudes and behaviours regarding family building decisions: a systematic review and global perspective
Authors: Emin E , Grace B , Hall J 
Published: June 2023

Abstract

Study question
What factors influence men’s attitudes and behaviours regarding family building decisions?

Summary answer
The attitudes and behaviours of men regarding family building decisions are influenced by a combination of social and personal factors.

What is known already
Men have an important role to play in the decision-making process regarding family building. However, research on this topic has historically focused on women. Furthermore, existing research focuses primarily on data from high-income countries with limited perspectives from men from low- and middle-income countries. This study aimed to explore the factors influencing men's attitudes and behaviours regarding family building decisions across low-, middle-, and high-income countries.

Study design, size, duration
A systematic review was conducted via a search on PubMed, Psych Info and Web of Science databases using the following keyword combinations; fertility AND intention OR desire OR pregnancy AND childbearing OR family building OR reproductive decision making AND attitudes OR motivations OR desires OR behaviours AND parenthood OR fatherhood OR men. Study designs were either qualitative, quantitative or mixed-methods.

Participants/materials, setting, methods
Studies were included if they examined men’s attitudes and behaviours regarding family building decisions, involved only male participants or male and female participants if the results for male participants were reported separately. Male participants undergoing fertility treatment, participants with or without children, or homosexual participants were included. Studies from any country, published between years 2010-2022, and in English language only were included.

Main results and the role of chance
A comprehensive search yielded 1745 articles, with studies being excluded if they involved female participants only, results were aggregated for studies including male and female participants and studies involving participants undergoing surrogacy or adoption. As a result, 22 studies were included in this review. From the 22 included studies, 2 main themes were derived; personal and social factors. The personal theme consisted of factors at the individual level related to finance, education, health, age, sexuality, masculinity, knowledge and other personal factors. The social theme related to wider issues, including social pressure, social support and marital status. Across included studies, the most common personal factor influencing men’s attitudes and behaviours regarding family building decisions was financial issues, that is, being financially stable/secure. The most common social factor across included studies was discovered to be support, that is, receiving support from family, society and workplace. Half of the included studies reported the stability of men’s relationship with their partner as a factor that influences their intention for fatherhood. Interestingly, masculinity was a recurring theme, with men reporting fatherhood as being an expression of masculinity and a way to fulfil their masculine roles and identity within their family, society and community.

Limitations, reasons for caution
Of the 22 studies included in this review, 8 of the studies involved young participants of ages ≤25 years, thus results obtained from these studies were not representative of the attitudes and behaviours of all adult men regarding family building decisions.

Wider implications of the findings
This is the first review to include studies of men from a combination of low-, middle- and high-income countries. Understanding men’s attitudes and behaviours regarding family building decisions can help raise and promote fertility awareness among men, thereby helping men achieve their desired reproductive intentions.

Trial registration number
not applicable