The Effect of Fertility Health Awareness Strategies on Fertility Knowledge and Childbearing in Young Married Couples

Study Overview
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Brief Summary
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Singapore, like many developed countries, is experiencing low birth rates, which is coupled with increasing age at first marriage and birth. In addition, demand for assisted reproduction technology treatments has increased over the years. Fertility awareness surveys have consistently shown that public awareness of age-related fertility decline and the limitations of fertility treatments is generally low, and this may lead to couples not optimising their fertility potential to achieve their family aspirations. This trial aims to study the effect of fertility health screening and fertility awareness tools on knowledge, attitudes and practice around childbearing among young Singaporean married couples.

Official Title
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The Effect of Fertility Health Awareness Strategies on Fertility Knowledge and Childbearing in Young Married Couples (FertStart)

Conditions
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Fertility Awareness, Childbearing Intentions

Intervention / Treatment
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* Diagnostic Test: Fertility Health Screening
* Behavioral: Fertility Awareness Tools


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Married couple Both partners should be Singapore Citizens or Permanent Residents Female partner is 25 - 34 years old at time of recruitment Both partners agreeable and able to complete study procedures Exclusion Criteria: Already have children, including from previous marriages Pregnant Currently undergoing or had previously went for intra-uterine insemination (IUI) and/or IVF Self-reported history of previous ectopic pregnancy in the female partner At least 1 partner unable to complete a self-administered questionnaire in English

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 34 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Fertility Health Screening<br>Clinic-based fertility health screening and counselling | Diagnostic Test: Fertility Health Screening<br>* Basic fertility health screening comprising an anti-Mullerian hormone (AMH) test and semen analysis, a doctor's consultation to explain the results, and standardised reproductive counselling by a trained nurse comprising a discussion of reproductive plans (including addressing barriers the couple face), education on age-related fertility decline and limitations of artificial reproductive technologies, advice on the optimal reproductive timing and when to seek further help. An educational brochure will be handed to the couple during the counselling session.<br>|
| Active Comparator: Fertility Awareness Tools<br>Online intervention to provide fertility education and behavioural nudge for optimal reproductive timing. | Behavioral: Fertility Awareness Tools<br>* Online intervention consisting of 1) video targeting fertility education and specific attitudes, social norms and perceived control for having children, 2) a fertility awareness tool (FERTISTAT) and 3) an educational brochure on fertility. This intervention can be self-administered and is therefore easily scalable.<br>|
| No Intervention: Control<br>No intervention but exposed to usual information from the media on fertility and family benefits (no different from general population). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in parenthood intentions | The difference in the female partner's intended age at first birth at 6 months post-randomization compared to baseline, elicited by a direct question in pre and post-questionnaires. | Baseline (before intervention) and 6 months later | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in fertility awareness | The difference in fertility awareness as measured by the Cardiff Fertility Knowledge Scale (CFKS) at 6 months post-randomization compared to baseline. The CFKS is a 13-item scale where each correct answer is assigned 1 point. Points are summed and converted to the % correct fertility knowledge score with a range of 0 - 100%. | Baseline (before intervention) and 6 months later | 
| Conception efforts | Proportion of couples who are (a) attempting to conceive, (b) pregnant, (c) who pursued more comprehensive fertility screening and/or (d) who pursued fertility treatment. | 6 moths post-randomization | 
| Birth number | Number of births | 2 and 3 years post-randomization | 
| Birth timing | Time to first birth | 2 and 3 years post-randomization | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Fertility awareness, Attitudes, Intentions, Fertility screening, Couples