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So You Think You Can’t Have Kids?

Properties of infertility perceptions over time
Source: Chinnapong

Infertility is not a stable trait and can change over time, which means it is not synonymous with being sterile, a permanent situation. To better understand and to shine more light on infertility, Jasmin Passet-Wittig and Martin Bujard (German Federal Institute for Population Research), Julia McQuillan (University of Nebraska-Lincoln) and Arthur L. Greil (Alfred University) looked specifically at individuals’ perceptions about their ability to reproduce in Germany. They sought out to describe the current prevalence of perceived inability to procreate among women and men; the stability and instability in one’s perceived inability; and looked to understand factors associated with overall level and change in perceived inability to reproduce naturally. 

Data from seven waves of the Panel Analysis of Intimate Relationships and Family Dynamics (pairfam) was used, covering the period of 2008/09-2014/15. Participants were of reproductive age, which meant between the ages of 21-43. This is the only dataset of western industrialised countries available that includes repeated measures of perceived procreative ability for more than two waves, making it possible to have enough cases for a panel analysis of within- and between-person differences. The authors point out that it would be important to routinely include such measures in social science (panel) surveys to learn more about people’s fertility behaviour in case of perceived or actual fertility problems. 

From their analysis, on average, one in 20 individuals of reproductive age believe they cannot procreate (5.6% of women and 4.9% of men). Early on, at age 21, prevalence rates of perceived inability are low (2.0% for women and 2.5% for men). Rates increase at a moderate pace up to age 37 with negligible differences by gender. After that, women’s perceived inability to procreate continues to grow, reaching a maximum of 12.6% at the age of 42. Men reach a plateau between the ages of 35 and 39, but perceived inability to procreate begins to rise again and reaches a maximum of 10.8% by age 43. 

Change in self-perception as unable to procreate is common. Most respondents who sometimes or always believed they could not procreate did change their minds at least once over seven years (71.2% of women and 71.7% of men). Approximately 29% of men and women consistently believed they could not reproduce. The wave-to-wave probability of change from perceiving a problem to not perceiving a problem is 39% for women and 48% for men, on average. 

Passet-Wittig and colleagues also found that changing life circumstances as well as structural conditions help understand variability in perceived inability to procreate over time. Increases in age are associated with an increased likelihood of perceiving an inability to reproduce by men and women, with women having a steeper trajectory. The chances of perceiving fertility problems also increase when no contraceptives are used. Interestingly, just being in a relationship does not mean one has greater chances of perceiving procreation problems; most people assume they are fertile, regardless of relationship status. But individuals in relationships are more likely to think about their own ability and their partner’s ability to procreate more and if they believe there is a problem, it is seen as a couple’s problem. Unsurprisingly, women who already had a biological child at the time of the first survey were significantly less likely to perceive an inability to procreate. Medium and high levels of education were also associated with a lower chance of perceiving oneself as being unable to reproduce. Men with a high education actually had a significantly lower perception than women. First generation immigrants were also found to have higher odds of perceiving an inability to reproduce than native born respondents.

The authors stress the importance of fertility researchers to not assume an individual’s single report of perceived infertility indicates permanent infertility. Instead, this perceived inability should be incorporated into research on fertility behaviours more to better understand the development of fertility intentions over time, fertility behaviours such as contraceptive use, and outcomes.

Author(s) of the original publication: 
Writer: 
Emily Lines