Women’s knowledge about the impact of female and male age, weight, and smoking on fertility: results from a national survey

Women’s misconceptions about the impact of female and male age, weight, and smoking on a couple’s fertility likely lead to uninformed decisions regarding reproductive health and family planning; however, little research has examined women’s fertility knowledge. The goal of this study was to provide a large-scale assessment of women’s knowledge about the impact of risk factors on female and male fertility. A national, cross-sectional survey. 327 women were recruited through an e-newsletter in March 2019; no incentive was provided. Eligible participants were aged 18 to 59, identified as women, lived in the USA and provided informed consent. Participants completed an online survey that assessed their knowledge about the impact of female and male age, weight, and smoking on fertility. The data were analyzed using descriptive statistics and dependent sample t-tests; the power was excellent (.99). Participants ranged in age from 18 to 59 (M = 34.11, SD = 6.64) and the majority identified as heterosexual (95%) and had a partner (81%). 3 items assessed knowledge about the impact of age on female fertility, and 3 items assessed knowledge about the impact of age on male fertility (e.g., “female fertility significantly declines between the ages of 35 and 39” (T); “male fertility significantly declines between the ages of 45 and 49” (T)). Participant responses on all 6 items were coded as correct or incorrect. 21% answered all items about female age correctly; 13% answered all items about male age correctly. A dependent samples t-test revealed that women were less knowledgeable about the impact of male age on fertility (M = 0.95, SD = 2.07, range = 0 - 3) than female age on fertility (M = 2.00, SD = 0.69, range = 0 - 3); t(326) = 15.33, p < .001. 2 items assessed participants’ knowledge about the impact of weight and smoking on female fertility, and 2 items assessed knowledge about these impacts on male fertility (e.g., “a woman’s weight affects her chances of conceiving” (T); “a man’s weight does not impact his likelihood of impregnating his partner” (F)). Participant responses on all items were coded as correct or incorrect. 87% answered both items about female weight and smoking correctly; 49% answered both about males correctly. A dependent samples t-test revealed that women were less knowledgeable about the impact of male weight and smoking on fertility (M = 1.41, SD = 0.64, range = 0 - 2) than female weight and smoking on fertility (M = 1.86, SD = 0.38, range = 0 - 2); t(326) = 13.13, p < .001. These results suggest that women are relatively informed about the impact of their own age, weight, and smoking on fertility but less informed about the impact of male age, weight, and smoking on fertility. These misconceptions may disproportionately assign responsibility for preconception health to women. Providers should be aware of these misconceptions in order to educate patients on the role of male fertility risk factors. Correcting these misconceptions may be a critical step towards decreasing infertility by changing unhealthy behaviors and alleviating the emotional load on opposite-sex coupled women.