Effectiveness of fertility health awareness strategies on fertility knowledge and childbearing: a randomized controlled trial

Chan, Sze Ling, Thumboo, Julian, Boivin, Jacky ORCID: https://orcid.org/0000-0001-9498-1708, Zhan, Stella Jinran, Saffari, Seyed Ehsan, Yeo, Samantha Rachel, Chan, Jerry Kok Yen, Ku, Chee Wai, Chua, Ka-Hee and Yu, Su Ling 2026. Effectiveness of fertility health awareness strategies on fertility knowledge and childbearing: a randomized controlled trial. Reproductive BioMedicine Online , 105659. 10.1016/j.rbmo.2026.105659

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Abstract

Research Question What is the effect of Fertility Health Screening (FHS) and Fertility Awareness Tools (FAT) on parenthood intentions, as measured by the wife’s intended age at first birth compared to no intervention, at six months post-randomization? Design This was an effectiveness-implementation hybrid type I trial with a multicenter three-arm parallel group open-label randomized controlled trial (RCT). Married Singaporean couples with wives aged between 25 and 34 years were randomized to FHS, FAT or no intervention. The primary outcome was the wife’s intended age at first birth. Secondary outcomes included fertility knowledge, attempts to conceive, pregnancy, and pursuing further fertility screening and/or treatment at six months post-randomization. Results A total of 778 couples were randomized to the FHS (n = 226), FAT (n = 238), and control (n = 314) groups, respectively. Both FHS and FAT did not result in a significant difference in the primary outcome of the wife’s intended age at first birth at follow-up (0.07 years (95% CI: -0.17 to 0.32) and -0.01 years (95%CI: -0.25 to 0.23), respectively). However, both interventions significantly increased fertility awareness in both wives (mean increase in Cardiff Fertility Knowledge Score (CFKS) score = 0.38 (95% CI: 0.03 to 0.73) for FHS and 0.44 (95%CI: 0.10 to 0.79) for FAT and husbands (mean increase in CFKS score = 0.41 (95% CI: 0.04 to 0.78) for FHS and 0.71 (95% CI: 0.35 to 1.10) for FAT. Conclusion Both FHS and FAT did not significantly modify parenthood intentions at six months post-randomization.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Psychology
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by-nc-nd/4.0/, Start Date: 2026-02-28
Publisher:	Elsevier
ISSN:	1472-6483
Date of First Compliant Deposit:	9 March 2026
Date of Acceptance:	19 February 2026
Last Modified:	09 Mar 2026 11:15
URI:	https://orca.cardiff.ac.uk/id/eprint/185585

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