Factors Affecting Decision Making Process for Fertility Preservation among Adult Asian American Women
Creators: name: Lee, Sangeun
Publisher: name: University of Illinois at Chicago
Year: 2024

description: Fertility preservation (FP) is a novel practice enabling women to have biological children in the future. Presently, Asian American women have one of the lowest fertility rates in the United States. However, little is known about the factors affecting FP decision-making in this population. To achieve a more comprehensive understanding of factors influencing decision-making for fertility preservation among Asian American women, the aims of this dissertation study were as follows: the first study (Chapter I) was performed to investigate factors affecting fertility preservation decision-making among healthy women and the second study (Chapter II) was conducted to examine fertility knowledge, intention, concern, anxiety, and traumatic stress and childbearing beliefs and to identify factors significantly influencing fertility preservation decision-making in healthy Asian American adult women. 

Chapter I presents an integrative review focusing on factors affecting fertility preservation for non-medical reasons in women. Previous study findings regarding influencing factors were categorized based on Hershberger et al.’s (2013) decision-making process model. The five categories of factors were cognitive, moral judgment, emotional, decision partner, and contextual factors. Among the cognitive factors, fertility intention was observed to be a strong indicator of engaging in fertility preservation. Also, fertility knowledge was found to have a positive association with fertility preservation intention. As for moral judgment factors, the percentages of study participants selecting fertility preservation varied depending on the study setting, the countries and cultures involved, and participants’ individual circumstances. The emotional factors included participants’ negative feelings about fertility, including anxiety and depression, and their paradoxical emotional reactions during the fertility preservation process. With respect to decision partner factors, some women’s choices regarding fertility and fertility preservation differed depending on whether they currently had a partner. Finally, regarding contextual factors, the most frequently observed factors associated with fertility preservation were level of education and career. Notably, women were found to change their minds about engaging in fertility preservation depending on their insurance coverage.

Chapter II presents a primary research study exploring factors affecting decision-making for fertility preservation in adult Asian American women. The study was guided by Hershberger et al.’s (2013) decision-making process model and had a cross-sectional correlational online survey design. Data analysis was performed using the t-test, Chi-square, and binomial logistic regression. Among the 139 respondents, most participants reported that they had never been pregnant (87.8%) and had no children (91.4%). Among individuals having no children, 29.9% indicated that did not want to have a child. Among all participants, 43.9% reported that they would choose FP. We observed significant differences between FP and non-FP decision-making groups regarding decision-partner; considering postponing having a child; and the number of future children desired. Factors significantly associated with FP decision-making were fertility intention, traumatic stress, immigration generational status, and considering postponing having a child. Based on the findings, effective programs need to be developed to reduce traumatic stress of Asian American women and to enhance maternity and parenting support for this population.