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Nihon Eiseigaku Zasshi. Japanese... 2018The factors contributing to the declining birthrate in Japan include the declining marriage rate, an increase in the average age of those getting married, economic... (Review)
Review
The factors contributing to the declining birthrate in Japan include the declining marriage rate, an increase in the average age of those getting married, economic burden, childcare burden, later child-bearing, and infertility. There is a gender difference in role division, with 70% of unmarried people live with their parents and continue to work while leaving the household chores to their mothers. The loss of these housekeeping services and the increase in the number of irregular workers are factors contributing to the declining marriage rate and the increase in the average age of those getting married. The expansion of the family support policy in Japan from the male breadwinner model to the earner-career model may have been delayed, but it is expected to provide economic benefits as well as actual childcare service benefits in order to reduce the economic and physical burden of childcare for married couples. It is also necessary to provide education in reproductive health to both men and women in schools and workplaces regarding late child-bearing and infertility. Furthermore, it is necessary to evaluate the cost-effectiveness analysis of improvements in fertility and disclose the relevant information in addition to sharing information on medical technology related to pregnancy/childbirth and treatment of diseases. It is urgent to prepare society for natural and healthy pregnancies/childbirths during optimal child-bearing years.
Topics: Adult; Age Factors; Birth Rate; Child; Child Care; Female; Gender Identity; Health Education; Humans; Income; Infertility; Japan; Male; Marriage; Middle Aged; Population Dynamics; Reproductive Health; Social Support; Socioeconomic Factors; Young Adult
PubMed: 30270298
DOI: 10.1265/jjh.73.305 -
The Journal of Adolescent Health :... Feb 2015To examine pregnancy rates and outcomes (births and abortions) among 15- to 19-year olds and 10- to 14-year olds in all countries for which recent information could be...
PURPOSE
To examine pregnancy rates and outcomes (births and abortions) among 15- to 19-year olds and 10- to 14-year olds in all countries for which recent information could be obtained and to examine trends since the mid-1990s.
METHODS
Information was obtained from countries' vital statistics reports and the United Nations Statistics Division for most countries in this study. Alternate sources of information were used if needed and available. We present estimates primarily for 2011 and compare them to estimates published for the mid-1990s.
RESULTS
Among the 21 countries with complete statistics, the pregnancy rate among 15- to 19-year olds was the highest in the United States (57 pregnancies per 1,000 females) and the lowest rate was in Switzerland (8). Rates were higher in some former Soviet countries with incomplete statistics; they were the highest in Mexico and Sub-Saharan African countries with available information. Among countries with reliable evidence, the highest rate among 10- to 14-year olds was in Hungary. The proportion of teen pregnancies that ended in abortion ranged from 17% in Slovakia to 69% in Sweden. The proportion of pregnancies that ended in live births tended to be higher in countries with high teen pregnancy rates (p = .02). The pregnancy rate has declined since the mid-1990s in the majority of the 16 countries where trends could be assessed.
CONCLUSIONS
Despite recent declines, teen pregnancy rates remain high in many countries. Research on the planning status of these pregnancies and on factors that determine how teens resolve their pregnancies could further inform programs and policies.
Topics: Abortion, Induced; Adolescent; Birth Rate; Child; Female; Humans; Pregnancy; Pregnancy Outcome; Pregnancy in Adolescence; Young Adult
PubMed: 25620306
DOI: 10.1016/j.jadohealth.2014.09.007 -
National Vital Statistics Reports :... Jan 2023Objectives-This report presents 2021 data on U.S. births according to a variety of characteristics. Trends in fertility patterns and maternal and infant characteristics...
Objectives-This report presents 2021 data on U.S. births according to a variety of characteristics. Trends in fertility patterns and maternal and infant characteristics are described and interpreted.
Topics: Pregnancy; Female; Adolescent; Humans; United States; Maternal Age; Pregnancy in Adolescence; Birth Rate; Birth Certificates; Parturition
PubMed: 36723449
DOI: No ID Found -
Proceedings of the National Academy of... Feb 2022Women in the United States are much more likely to become mothers as teens than those in other rich countries. Teen births are particularly likely to be reported as...
Women in the United States are much more likely to become mothers as teens than those in other rich countries. Teen births are particularly likely to be reported as unintended, leading to debate over whether better information on sex and contraception might lead to reductions in teen births. We contribute to this debate by providing causal evidence at the population level. Our causal identification strategy exploits county-level variation in the timing and receipt of federal funding for more comprehensive sex education and data on age-specific teen birth rates at the county level constructed from birth certificate natality data covering all births in the United States. Our results show that federal funding for more comprehensive sex education reduced county-level teen birth rates by more than 3%. Our findings thus complement the mixed evidence to date from randomized control trials on teen pregnancies and births by providing population-level causal evidence that federal funding for more comprehensive sex education led to reductions in teen births.
Topics: Adolescent; Birth Rate; Contraception; Female; Humans; Models, Theoretical; Pregnancy; Pregnancy in Adolescence; Sex Education; Sexual Behavior; United States; Young Adult
PubMed: 35165192
DOI: 10.1073/pnas.2113144119 -
Fertility and Sterility Sep 2018To evaluate the association between the number of oocytes retrieved and cumulative live birth rates.
Cumulative live birth rates according to the number of oocytes retrieved after the first ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection: a multicenter multinational analysis including ∼15,000 women.
OBJECTIVE
To evaluate the association between the number of oocytes retrieved and cumulative live birth rates.
DESIGN
Retrospective multicenter analysis using individual patient data.
SETTING
Tertiary referral hospitals.
PATIENT(S)
In total, 14,469 patients were analyzed. The study included the first cycle of patients stimulated for IVF/intracytoplasmic sperm injection (ICSI) from 2009 to 2014. All patients included in the analysis had either delivered a baby or had used all their embryos after their first stimulated cycle. All patients had vitrification as cryopreservation method. All women were followed up for at least 2 years.
INTERVENTION(S)
Ovarian stimulation with GnRH antagonist protocol for IVF/ICSI.
MAIN OUTCOME MEASURE(S)
The primary outcome was the cumulative live birth rate defined as the delivery of at least one live-born infant (>24 weeks of gestation) in the fresh or in the subsequent frozen-thawed cycles in relation to the number of oocytes retrieved. Only the first delivery was considered in the analysis. The secondary outcome was live birth after the fresh IVF/ICSI cycle only.
RESULT(S)
Cumulative live birth rates steadily increased with the number of oocytes, reaching 70% when ≥25 oocytes were retrieved. Interestingly, no plateau in cumulative live birth rates was observed, but a moderate increase of 5.1% on average was detected beyond 27 oocytes. Regarding the fresh cycle outcome, live birth probability increased up to seven oocytes retrieved and remained relatively unchanged (increase or decrease of ≤5%) between seven and 20 oocytes retrieved. However, a drop in fresh live birth rates was identified thereafter, which could be attributed to the progressive increase in "freeze-all" cycle rate with the number of oocytes retrieved, exceeding 20% in patients with >20 oocytes retrieved.
CONCLUSION(S)
This is the largest multicenter study evaluating for the first time the impact of ovarian response on cumulative live birth rate. The significant progressive increase of cumulative live birth rate with the number of oocytes in our study suggests that ovarian stimulation may not have a detrimental effect on oocyte/embryo quality in good-prognosis women less than 40 year old. Nevertheless, although very high ovarian response may further increase cumulative live birth rates, ovarian stimulation should be rational and avoid extreme response in terms of oocytes retrieved to preserve patients' convenience and safety and avoid ovarian hyperstimulation syndrome or other iatrogenic complications.
Topics: Adult; Birth Rate; Cohort Studies; Female; Fertilization in Vitro; Humans; Internationality; Live Birth; Male; Oocytes; Ovulation Induction; Retrospective Studies; Sperm Injections, Intracytoplasmic; Tertiary Care Centers
PubMed: 30196963
DOI: 10.1016/j.fertnstert.2018.04.039 -
Fertility and Sterility Apr 2022Mild stimulation (MS) consists in prescribing gonadotropin at the minimum amount alone or in combination with other compounds. This strategy has gained popularity in... (Review)
Review
Mild stimulation (MS) consists in prescribing gonadotropin at the minimum amount alone or in combination with other compounds. This strategy has gained popularity in assisted reproduction for the reduced costs, better patient compliance, and reduced risk of hyperstimulation syndrome. Some investigators proposed MS even in women with low prognosis. The Poseidon group proposed new criteria to identify these patients categorizing them into 4 different groups, each one characterized by a specific segment of prognosis. The use of MS in women with low prognosis involves risks that cannot be overlooked. The most crucial concerns are the increased rate of cycle cancellation and the reduced number of eggs collected. Notably, the number of eggs collected still represents the most accurate predictor of live birth and cumulative live birth rate. Despite promising preliminary data, recent evidence has confirmed that MS does not improve gamete quality. Hence, considering that no robust strategy was identified so far to improve oocyte quality, the only reasonable strategy to improve the chance of live birth in women with low prognosis is to collect the necessary number of oocytes to maximize the probability to obtain at least 1 good-quality embryo. In this sense, conventional protocols offer better results when compared with the mild approach. Given the difficulty in collecting enough oocytes in a single round of stimulation, accumulation strategy could represent a valuable approach especially in women with advanced reproductive age and reduced ovarian reserve.
Topics: Birth Rate; Female; Fertilization in Vitro; Gonadotropins; Humans; Live Birth; Ovulation Induction; Pregnancy
PubMed: 35367011
DOI: 10.1016/j.fertnstert.2022.02.022 -
Fertility and Sterility Dec 2022This month's Views and Reviews examines the current evidence regarding the association between a man's age and his reproductive health. Wood and Goriely review the link... (Review)
Review
This month's Views and Reviews examines the current evidence regarding the association between a man's age and his reproductive health. Wood and Goriely review the link between paternal age and de novo mutations. Zweifel and Woodward expand on the implications to the offspring of older fathers by exploring the neurodevelopmental syndromes that become more prevalent in children of older fathers. Finally, Jimbo et al. examines the association between paternal age and several measures of male fertility including semen quality, birth rates, and assisted reproductive technology success rates.
Topics: Child; Male; Humans; Semen Analysis; Paternal Age; Reproductive Techniques, Assisted; Birth Rate; Reproductive Health; Fathers
PubMed: 36307289
DOI: 10.1016/j.fertnstert.2022.09.021 -
NCHS Data Brief Jul 2019This report presents selected highlights from 2018 final birth data on key demographic, health care utilization, and infant health indicators. General fertility rates... (Review)
Review
This report presents selected highlights from 2018 final birth data on key demographic, health care utilization, and infant health indicators. General fertility rates (the number of births per 1,000 women aged 15-44) and teen birth rates are presented. Also shown are the distribution of births with a previous cesarean delivery (vaginal births after previous cesarean [VBAC] and repeat cesarean delivery) and the distribution of births by gestational age. All indicators are compared between 2017 and 2018 and are presented for the three largest race and Hispanic-origin groups: non-Hispanic white, non-Hispanic black, and Hispanic.
Topics: Adolescent; Adult; Birth Rate; Ethnicity; Female; Humans; Infant, Newborn; Pregnancy; Premature Birth; United States; Vaginal Birth after Cesarean; Young Adult
PubMed: 31442195
DOI: No ID Found -
Lancet (London, England) Oct 2020Understanding potential patterns in future population levels is crucial for anticipating and planning for changing age structures, resource and health-care needs, and...
Fertility, mortality, migration, and population scenarios for 195 countries and territories from 2017 to 2100: a forecasting analysis for the Global Burden of Disease Study.
BACKGROUND
Understanding potential patterns in future population levels is crucial for anticipating and planning for changing age structures, resource and health-care needs, and environmental and economic landscapes. Future fertility patterns are a key input to estimation of future population size, but they are surrounded by substantial uncertainty and diverging methodologies of estimation and forecasting, leading to important differences in global population projections. Changing population size and age structure might have profound economic, social, and geopolitical impacts in many countries. In this study, we developed novel methods for forecasting mortality, fertility, migration, and population. We also assessed potential economic and geopolitical effects of future demographic shifts.
METHODS
We modelled future population in reference and alternative scenarios as a function of fertility, migration, and mortality rates. We developed statistical models for completed cohort fertility at age 50 years (CCF50). Completed cohort fertility is much more stable over time than the period measure of the total fertility rate (TFR). We modelled CCF50 as a time-series random walk function of educational attainment and contraceptive met need. Age-specific fertility rates were modelled as a function of CCF50 and covariates. We modelled age-specific mortality to 2100 using underlying mortality, a risk factor scalar, and an autoregressive integrated moving average (ARIMA) model. Net migration was modelled as a function of the Socio-demographic Index, crude population growth rate, and deaths from war and natural disasters; and use of an ARIMA model. The model framework was used to develop a reference scenario and alternative scenarios based on the pace of change in educational attainment and contraceptive met need. We estimated the size of gross domestic product for each country and territory in the reference scenario. Forecast uncertainty intervals (UIs) incorporated uncertainty propagated from past data inputs, model estimation, and forecast data distributions.
FINDINGS
The global TFR in the reference scenario was forecasted to be 1·66 (95% UI 1·33-2·08) in 2100. In the reference scenario, the global population was projected to peak in 2064 at 9·73 billion (8·84-10·9) people and decline to 8·79 billion (6·83-11·8) in 2100. The reference projections for the five largest countries in 2100 were India (1·09 billion [0·72-1·71], Nigeria (791 million [594-1056]), China (732 million [456-1499]), the USA (336 million [248-456]), and Pakistan (248 million [151-427]). Findings also suggest a shifting age structure in many parts of the world, with 2·37 billion (1·91-2·87) individuals older than 65 years and 1·70 billion (1·11-2·81) individuals younger than 20 years, forecasted globally in 2100. By 2050, 151 countries were forecasted to have a TFR lower than the replacement level (TFR <2·1), and 183 were forecasted to have a TFR lower than replacement by 2100. 23 countries in the reference scenario, including Japan, Thailand, and Spain, were forecasted to have population declines greater than 50% from 2017 to 2100; China's population was forecasted to decline by 48·0% (-6·1 to 68·4). China was forecasted to become the largest economy by 2035 but in the reference scenario, the USA was forecasted to once again become the largest economy in 2098. Our alternative scenarios suggest that meeting the Sustainable Development Goals targets for education and contraceptive met need would result in a global population of 6·29 billion (4·82-8·73) in 2100 and a population of 6·88 billion (5·27-9·51) when assuming 99th percentile rates of change in these drivers.
INTERPRETATION
Our findings suggest that continued trends in female educational attainment and access to contraception will hasten declines in fertility and slow population growth. A sustained TFR lower than the replacement level in many countries, including China and India, would have economic, social, environmental, and geopolitical consequences. Policy options to adapt to continued low fertility, while sustaining and enhancing female reproductive health, will be crucial in the years to come.
FUNDING
Bill & Melinda Gates Foundation.
Topics: Birth Rate; Female; Forecasting; Global Burden of Disease; Human Migration; Humans; Male; Mortality; Population Growth
PubMed: 32679112
DOI: 10.1016/S0140-6736(20)30677-2 -
Ugeskrift For Laeger Nov 2021The number of treatments with donated oocytes has risen markedly in Denmark during the latest decade due to changes in legislation and because female age is increasingly... (Review)
Review
The number of treatments with donated oocytes has risen markedly in Denmark during the latest decade due to changes in legislation and because female age is increasingly advanced when fertility treatment is warranted. Today, oocyte donation is a standard procedure offering the otherwise untreatable a high chance of achieving a pregnancy. Live birth rates as high as 35% per treatment are being reported. It is, however, important to be aware of increased risks of hypertensive disorders and bleeding complications in these pregnancies. As pointed out in this review, continuous research in the field is therefore highly needed.
Topics: Birth Rate; Female; Fertility; Humans; Oocyte Donation; Oocytes; Pregnancy; Retrospective Studies
PubMed: 34852907
DOI: No ID Found