Household extension and reproductive behaviour in Taiwan

The inflence of household type on reproductive behavior is examined for a national probability sample of Taiwanese women. Data were derived from a 1980 national household survey of the labor force in Taiwan, focusing on 10,624 couples. Reproductive variables include measures of current and prospective fertility as well as cumulative fertility. In spite of remarkable social and economic development over the past 3 decades, extended families are still widely found in Taiwan. Women in extended households have only slightly higher fertility preferences and current fertility than women in nuclear families once marital duration is controlled. Although women in extended households marry earlier and receive more family help with child care than women in nuclear families, such factors are no longer considered sufficient to produce major differentials in reproductive behavior. Residence and husband's class of work are the strongest correlates of whether a household is currently extended or nuclear. In general, the husband's characteristics are more strongly related to family type than the wife's. Findings suggest that preferences for smaller families and low fertility need not await a transformation to a nuclear family structue.     

What do men want? Re-examining whether men benefit from higher fertility than is optimal for women

Several empirical observations suggest that when women have more autonomy over their reproductive decisions, fertility is lower. Some evolutionary theorists have interpreted this as evidence for sexual conflicts of interest, arguing that higher fertility is more adaptive for men than women. We suggest the assumptions underlying these arguments are problematic: assuming that women suffer higher costs of reproduction than men neglects the (different) costs of reproduction for men; the assumption that men can repartner is often false. We use simple models to illustrate that (i) men or women can prefer longer interbirth intervals (IBIs), (ii) if men can only partner with wives sequentially they may favour shorter IBIs than women, but such a strategy would only be optimal for a few men who can repartner. This suggests that an evolved universal male preference for higher fertility than women prefer is implausible and is unlikely to fully account for the empirical data. This further implies that if women have more reproductive autonomy, populations should grow, not decline. More precise theoretical explanations with clearly stated assumptions, and data that better address both ultimate fitness consequences and proximate psychological motivations, are needed to understand under which conditions sexual conflict over reproductive timing should arise.     

Preservation of fertility in females treated for cancer

Advancements of diagnosis and treatment have substantially improved cancer survival rates in the last few decades. The increasing number of survivors focuses attention on long-term effects caused by cancer treatment and its impact on quality of life. Ovarian failure is one of the major sequelae of cytotoxic chemotherapy and/or radiotherapy in female children and reproductive-age women. Oncologists should address the patients about fertility preservation options before therapy. Embryo cryopreservation is the only well-established method for females in preserving fertility; however other strategies including ovarian suppression, ovarian transposition and cryopreservation of oocytes and ovarian tissue are still experimental. Patients need advice and to know which are the most practical options for them. This article reviews the available fertility preservation methods in women, and the related issues including normal physiology of the ovary, effect of anticancer therapy on fertility, role of the oncologist and ethics. We performed a MEDLINE search from 1971 to 2011 in a similar way as Jensen et al. 2011, using the following MeSH terms: antineoplastic agents; ovarian failure; premature; infertility, female; fertility preservation; child and cancer; reproductive technologies, assisted.     

The theoretical and political framing of the population factor in development

The silence about population growth in recent decades has hindered the ability of those concerned with ecological change, resource scarcity, health and educational systems, national security, and other global challenges to look with maximum objectivity at the problems they confront. Two central questions about population—(i) is population growth a problem? and (2) what causes fertility decline?—are often intertwined; if people think the second question implies possible coercion, or fear of upsetting cultures, they can be reluctant to talk about the first. The classic and economic theories explaining the demographic transition assume that couples want many children and they make decisions to have a smaller family when some socio-economic change occurs. However, there are numerous anomalies to this explanation. This paper suggests that the societal changes are neither necessary nor sufficient for family size to fall. Many barriers of non-evidence-based restrictive medical rules, cost, misinformation and social traditions exist between women and the fertility regulation methods and correct information they need to manage their family size. When these barriers are reduced, birth rates tend to decline. Many of the barriers reflect a patriarchal desire to control women, which can be largely explained by evolutionary biology. The theoretical explanations of fertility should (i) attach more weight to the many barriers to voluntary fertility regulation, (ii) recognize that a latent desire to control fertility may be far more prevalent among women than previously understood, and (iii) appreciate that women implicitly and rationally make benefit–cost analyses based on the information they have, wanting modern family planning only after they understand it is a safe option. Once it is understood that fertility can be lowered by purely voluntary means, comfort with talking about the population factor in development will rise.     

Global uptake of fertility preservation by women undergoing cancer treatment: An unmet need in low to high-income countries

Although the incidence of cancers is on the rise globally, mortality has continued to decrease due to advances in early detection and treatment. Cancer treatments such as chemotherapy and radiotherapy can impact the reproductive capacity of survivors by inducing premature ovarian failure and subsequent infertility causing significant psychological distress with decreased quality of life. Despite the increasing need for fertility preservation services for the rising number of cancer survivors and the recent advances in assisted reproductive technology, many women with cancers in low, middle, and to a lesser extent, high-income countries have no access to these services. This article, therefore, presents an overview of the effect of cancer treatment on fertility, options of fertility preservation, and factors influencing fertility preservation utilization by women who had a cancer diagnosis. In addition, we discuss the availability, practices, and outcomes of fertility preservation services in low, middle, and high-income countries and highlight pragmatic steps to improving access to oncofertility care for women with cancers globally.     

Desire for sons and subsequent fertility in rural India. A 20-year longitudinal study

This paper compares the desired fertility of rural Indian women in 1987 with their actual fertility in 2007. Seventy-one respondents who stated definite fertility intentions and had fewer children than desired in 1987 were re-interviewed 20 years later, as part of a larger study. The results indicated that these women had fewer children than intended and stopped childbearing once they reached, or approximated, their desired number of sons. The majority had been sterilized, indicating broad acceptance of lower fertility among rural women and the success of India's family planning efforts, although the practice of sex determination seems also to have played a role. These findings echo those of an earlier longitudinal study of reproductive intentions and outcomes in the same community, demonstrating the persistence of son preference in determining reproductive behaviour, even in the context of low overall fertility. The paper concludes with a discussion of the policy and programme implications of the study's findings.     

Selection intensities in menopausal and permanent contraceptor women of a rural population in India

Changing fertility and mortality patterns due to socioeconomic forces have a profound effect on natural selection in human populations. The opportunity for selection was estimated in the rural population of Visakhapatnam District, Andra Pradesh, India, in 1979. A total of 1570 women were interviewed, 1544 among them had ever been pregnant. Data were analyzed to compute fertility and mortality components of the population. The index of total selection was found to be low. Selection in relation to birth control reveals that opportunity for selection is lower among women who completed their fertility by family planning methods than in women who completed their fertility by attaining menopause. Further, the results showed that differential fertility and mortality make equal contributions to the total measure of selection in both groups, whereas in developed countries like the US the mortality component contributes only a small fraction to the total index, due to improved health conditions.     

Community-level education accelerates the cultural evolution of fertility decline

Explaining why fertility declines as populations modernize is a profound theoretical challenge. It remains unclear whether the fundamental drivers are economic or cultural in nature. Cultural evolutionary theory suggests that community-level characteristics, for example average education, can alter how low-fertility preferences are transmitted and adopted. These assumptions have not been empirically tested. Here, we show that community-level education accelerates fertility decline in a way that is neither predicted by individual characteristics, nor by the level of economic modernization in a population. In 22 high-fertility communities in Poland, fertility converged on a smaller family size as average education in the community increased—indeed community-level education had a larger impact on fertility decline than did individual education. This convergence was not driven by educational levels being more homogeneous, but by less educated women having fewer children than expected, and more highly educated social networks, when living among more highly educated neighbours. The average level of education in a community may influence the social partners women interact with, both within and beyond their immediate social environments, altering the reproductive norms they are exposed to. Given a critical mass of highly educated women, less educated neighbours may adopt their reproductive behaviour, accelerating the pace of demographic transition. Individual characteristics alone cannot capture these dynamics and studies relying solely on them may systematically underestimate the importance of cultural transmission in driving fertility declines. Our results are inconsistent with a purely individualistic, rational-actor model of fertility decline and suggest that optimization of reproduction is partly driven by cultural dynamics beyond the individual.     

Selection intensities in menopausal and permanent contraceptor women of a rural population in India

Abstract

The opportunity for selection was estimated in the rural population of Visakhapat‐nam District, Andhra Pradesh, India. The index of total selection was found to be low. Selection in relation to birth control reveals that opportunity for selection is lower among the women who completed their fertility by family planning methods than in women who completed their fertility by attaining menopause. Further, the results showed that differential fertility and mortality make equal contributions to the total measure of selection in both groups.     

CXCL12/CXCR4/CXCR7轴在子宫内膜异位症中的研究进展

子宫内膜异位症(endometriosis, EMT)是常见的妇科疾病,发病率高,且有年轻化的趋势。因其治疗困难且复发率高,严重影响了女性的生活质量和生育能力。研究发现趋化因子CXCL12与其受体CXCR4和CXCR7在恶性肿瘤中起重要作用。虽然EMT为良性疾病,但有恶性肿瘤的生物学特征,近来发现CXCL12/CXCR4/CXCR7轴可以影响子宫内膜异位症的定植、侵袭和转移。本文就当前国内外研究CXCL12/CXCR4/CXCR7轴在EMT发生发展过程中的作用进行了综述,旨在为EMT的治疗找到新靶点。     

Fitness and fertility among Kalahari !Kung

In this paper we develop a model that examines fertility and childhood mortality patterns and their relationship to environmental variables. Interactions among environmental variables can account for different fertility patterns and different mixes of these variables can produce similar patterns of fertility. Our model attempts to quantify the idea that there is a trade-off between producing a few children likely to survive to reproductive age and producing a greater number of children with lower chances for survival. The optimum mix of these strategies depends on environmental characteristics. We use the model to make predictions about fertility and mortality patterns among two Bushmen populations of southern Africa--the Ghanzi and Ngamiland !Kung--using data collected by Harpending in 1967-1968. The results do not support explanations of the low fertilities observed among !Kung Bushmen women, in whom it is thought that fitness is maximized by limiting fertility, and show no relationship between mortality and family size in either !Kung population. Instead, the number of offspring reaching reproductive age in both populations increases as their completed family size increases. We examine the effects of sex, birth order, and paternal investment on mortality. No sex ratio differences and no differences in mortality by sex or birth order are present. Infant mortality among women who married more than once is significantly higher than among women who married once, suggesting that paternal care has a significant effect.     

Age and social position moderate the effect of stress on fertility

There is now compelling evidence that psychosocial stress is a cause of reproductive suppression in humans. However, women continue to conceive in the harshest conditions of war, poverty, or famine, suggesting that suppression can be bypassed. The reproductive suppression model (RSM) proposes that natural selection should favor factors that reliably predict conditions for reproduction. In this study, we examine two such factors, age and social position, in women undergoing fertility treatment. We hypothesized that stress-related reproductive suppression would be more likely in younger compared to older women and in women in lower compared to higher social positions. The final sample consisted of 818 women undergoing fertility treatment. Psychosocial stress and sociodemographic data were collected prior to the start of treatment (Time 1), whereas fertility, as indexed by pregnancy or live birth, was assessed 12 months later (Time 2). The results showed that younger women were four times more likely to suppress than older women, and that unskilled and manual workers were more likely to suppress than those in middle social positions (e.g., white collar workers). However, significant associations between stress and fertility were also observed for women in higher social positions (e.g., professionals and executives). The findings provide support for the RSM.     

Frequency of detection of Ureaplasma urealyticum and Mycoplasma hominis in cervical canal and the Douglas pouch of infertile and fertile women

The group of organisms commonly referred to as genital mycoplasmas comprise species most often found in genitourinary tract of sexually active adults as common commensal inhabitants, or pathogens which can possibly cause many different pathologies like: non-gonococcal urethritis, bacterial vaginosis, cervicitis, endometritis or pelvic inflammatory disease. The problem of their morbidity and the possible influence they have on human fertility is still not clear. The aim of this study was to find out whether two investigated species- Ureaplasma urealyticum and Mycoplasma hominis can be detect more often in a group of infertile women. 74 women participated in the study and were assigned to one of 2 groups of patients: infertile women and fertile women without any sign of genital tract infection. Swabs from the cervical canal of the uterus and the fluid from the Douglas pouch were taken during the gynecological examination and laparoscopic procedure. Two diagnostic methods were used: biochemical method- commercial diagnostic kit- Mycoplasma IST 2 and PCR method. The results showed that Ureaplasma urealyticum and Mycoplasma hominis were detected among both fertile and infertile women with nearly the same frequency, much more often in cervical canal than in the Douglas pouch. Ureaplasma urealyticum was more common pathogen than Mycoplasma hominis in both groups and locations. The achieved results point out that the role of genital mycoplasmas in human infertility is still unclear and require further investigations.     

Widowhood, illegitimacy, marital reproduction and female longevity in a rural Spanish population

Using data from parish and civil registers in a rural community in northwest Spain (Los Nogales), family reconstitution provided 1502 complete reproductive histories, of which 584 corresponded to first marriages of women dying after their 50th birthday. A homogeneous sample consisting of women married in the period 1877–1899 (N = 311) provided information concerning their reproductive performance, including ages at first and last maternity and number of children born alive and surviving, which was related to the mother's post-menopausal longevity, also considering premarital fertility and her marital status (widow/married). The results obtained indicate that mothers with a lower proportion of children dying before the first birthday and the age of 15 (mainly males) have a greater post-reproductive longevity. Moreover, women with a more protracted end to their reproductive period and greater fertility live for more years beyond their 50th birthday. These results do not prove a causality between maternal longevity and more successful reproduction; instead, they are indicative of a holistic condition of health. A wide spectrum of favorable biological and environmental factors will have positive consequences for a woman's life trajectory, affecting both her reproductive performance and her own likelihood of surviving.     

Fertility decline driven by poverty: the case of Addis Ababa, Ethiopia

Demographic transition theory states that fertility declines in response to development, thus wealth and fertility are negatively correlated. Evolutionary theory, however, suggests a positive relationship between wealth and fertility. Fertility transition as a result of industrialization and economic development started in the late 19th and early 20th centuries in Western Europe; and it extended to some of the Asian and Latin American countries later on. However, economic crises since the 1980s have been co-incident with fertility decline in sub-Sahara Africa and other developing countries like Thailand, Nepal and Bangladesh in the last decade of the 20th century. A very low level of fertility is observed in Addis Ababa (TFR=1.9) where contraceptive prevalence rate is modest and recurrent famine as well as drought have been major causes of economic crisis in the country for more than three consecutive decades, which is surprising given the high rural fertility. Detailed socioeconomic and demographic characteristics of 2976 women of reproductive age (i.e. 15-49 years) residing in Addis Ababa were collected during the first quarter of 2003 using an event history calendar and individual women questionnaire. Controlling for the confounding effects of maternal birth cohort, education, marital status and accessible income level, the poor (those who have access to less than a dollar per day or 250 birr a month) were observed to elongate the timing of having first and second births, while relatively better-off women were found to have shorter birth intervals. Results were also the same among the ever-married women only model. More than 50% of women currently in their 20s are also predicted to fail to reproduce as most of the unmarried men and women are 'retreating from marriage' due to economic stress. Qualitative information collected through focus group discussions and in-depth interviews also supports the statistical findings that poverty is at the root of this collapse in fertility. Whilst across countries wealth and fertility have been negatively correlated, this study shows that within one uniform population the relationship is clearly positive.     

A delay in age at first mating results in the loss of future reproductive potential via apoptosis

Summary Women who delay childbearing risk subfertility. However, this loss of fertility is not a simple function of aging. Women who have had children early in life tend to maintain fertility longer, measured as a later age at menopause. But why should otherwise healthy women lose reproductive capacity? Loss of fertility independent of senescence, menopause, has been approached from two perspectives: evolution and development. Evolutionary biologists focus on how natural selection favors survival after reproductive ability has ceased, whereas reproductive biologists examine mechanisms by which women lose fertility with age and factors that influence the rate of reproductive aging. Combining mechanistic studies with evolutionary theory should allow us to define principles of the evolution of postembryonic development of ovaries, including the role of reproductive timing relative to sexual maturation. Achieving this will require identifying appropriate, and more experimentally tractable, taxa in which to study how early reproductive events influence lifetime fertility. We work with an invertebrate species, the cockroach Nauphoeta cinerea, with a complex reproductive biology in which females experience reproductive cycles, give live birth, and show age‐related decline in fertility. Thus, N. cinerea provides an opportunity to use an experimental approach to examine mechanisms by which females lose reproductive potential as they delay reproduction. Our results demonstrate that the loss of both oocytes ready for fertilization and future oocytes in females that delay mating is because of apoptosis. We suggest that loss of fertility because of delayed mating may originate in a nonadaptive response in control of apoptosis through mistiming of reproduction.     

Reproduction: the Canadian family in transition

3 trends suggest that the reproductive function of the Canadian family is in transition. 1st, fertility has fallen and remains below the replacement level. In 1985, the total fertility rate was 1.67, the lowest in 60 years. Since 1971, it has not risen above 2.1 births/woman, the replacement level. 2nd, an increasing proportion of women are spending a larger part of their lives without having any children. In the 1981 census, 22% of ever-married women between 15 and 44 years had not yet borne children, compared with only 14% recorded in the 1961 census. While the proportion of women who are childless at the end of their reproductive years has risen only slightly, a larger number of women are postponing having children even as the risk of becoming sterile in the interim becomes greater. The combined effect of postponing both marriage and childbearing will most probably be to increase the proportion of women remaining without children. The 3rd trend is the increasing proportion of women who are having children without getting married. Among the consequences of premarital pregnancy are the stress on single mothers, the need for social assistance, the cost of maintenance programs, and the need for more child care. These changes in attitude toward marriage and family formation could have major implications for individuals and society. A fertility rate below replacement level could be stressful for society, resulting in population decline, and changes in age structure that could negatively affect the economy.     

新疆乌苏市育龄妇女生殖健康现况调查研究

目的:了解新疆乌苏市育龄妇女生殖健康现状,生殖保健知识水平和生殖保健意识,为提高育龄妇女的生殖健康水平提供理论依据。方法:采用单纯随机抽样的方法,选择乌苏市育龄妇女1000名,应用自填问卷并结合妇科各项相应检查进行调查分析。结果:(1)妇科健康情况:52.6%被调查者认为自身目前妇科健康状况一般;仅有14.0%的被调查者没有出现过白带异常、下身瘙痒等症状;而平时对生殖道进行日常护理的人仅占57.4%。(2)妇科常见病患病情况:妇科常见疾病按患病率高低排列分别为阴道炎(70.2%)、痛经(25.5%)、宫颈糜烂/乳腺增生(19.2%、19.1%)、子宫肌瘤(11.9%),各因素对痛经的影响均无统计学意义(P>0.05);各因素对阴道炎的影响均无统计学意义(P>0.05);但不同年龄段有宫颈疾病的患病情况差别有统计学意义(P<0.01),其中40～50岁年龄组患病率最大(65.3%),30岁以下年龄组患病率最低(37.6%);城市患病率(57.7%)高于农村(45.6%),差异有统计学意义(P<0.05);小学文化程度患病率(69.0%)高于其他各组差异有统计学意义(P<0.05)。(3)求医行为:37.5%的人选择去药店买药,41.5%的人选择就医;对就医单位的选择中,75.3%的人采取就近原则选择医疗单位,9.1%的人则是通过报纸媒体广告选择相关医疗单位;选择就医单位影响因素中42.3%的人认为专家资质较重要,26.3%的人则认为有先进设备较重要。结论:乌苏市育龄妇女生殖健康水平一般,妇女患常见妇科病比率较大的为阴道炎及痛经,其次为宫颈糜烂/乳腺增生,子宫肌瘤,40～50岁、文化程度较低妇女对宫颈其他疾病的患病情况影响较大,妇女生殖保健知识较全面、自我护理较好的妇女患病率较低。乌苏市育龄妇女需要加强生殖健康宣传教育,提高自我保健意识,掌握基本的生殖保健常识,对40～50岁围绝经期妇女要加强体检力度,以降低妇女病发病率,提高妇女健康水平,改善乌苏市各年龄段的妇女生活质量为关键。     

Achievement of reproductive intentions in Sri Lanka, 1982-1985: a longitudinal study.

The achievement or reproductive intentions of Sri Lankan women was examined by using longitudinal data for the period 1982-85. Aggregate consistency between reproductive intentions and behavior was almost perfect, but at the individual level there were inconsistencies. Among those who wanted to have no more children, 23 per cent reported a birth in the intersurvey period of 3 years and 2 months, while failures to have a wanted birth stood at 36 per cent. There was a clear declining trend in the former type of inconsistencies in Sri Lanka, but the latter type has increased, possibly due to a continuing decline in family size ideals or due to deferred childbearing. Even though inconsistencies existed, expressed fertility intentions in 1982 significantly influenced the fertility outcome. The study also has a methodological focus on whether to include sterilized women when fertility intentions and behavior are examined longitudinally, but no specific problems were found with their inclusion. Results indicate that, apart from the intention variable, age, marital duration, family size, and education of husband and wife variables all influenced fertility in the follow-up period.