Intentions and attitudes towards parenthood and fertility awareness among Chinese university students in Hong Kong: a comparison with Western samples

Hum Reprod. 2015 Feb;30(2):364-72. doi: 10.1093/humrep/deu324. Epub 2014 Dec 5.


Study question: What are the levels of awareness regarding female fertility and the intentions and attitudes towards parenthood among Chinese university students in Hong Kong compared with their counterparts in the West?

Summary answer: Chinese university students in Hong Kong were similarly over-optimistic about the age-related fertility decline, although they were less inclined to have children and undergo fertility treatment compared with their Western counterparts.

What is known already: Past studies of highly educated young adults in Europe and the USA have found that they are not sufficiently aware of the age-related decline in female fertility, and falsely believe that advanced reproductive treatments such as IVF will overcome fertility problems associated with age. Little is known about the perceptions of Chinese students in Hong Kong, a modernized Chinese city where the fertility rate is among the lowest in the world.

Study design, size, duration: An online cross-sectional survey of Chinese university students in Hong Kong was conducted in 2013. Results were compared with two similar studies in Sweden and the USA.

Participants/materials, setting, methods: A total of 367 university students in Hong Kong (275 female, 92 male; mean age 23) responded to an e-mail invitation to participate in an online survey. Intentions and attitudes towards parenthood and awareness regarding female fertility were assessed using the Swedish Fertility Awareness Questionnaire.

Main results and the role of chance: Like their Western counterparts, a large proportion of Chinese university students underestimated the age-related fertility decline (92%) and overestimated the fertility treatment success rate (66%). However, they were less inclined to have children, were more aware of and less concerned with infertility and were less motivated to seek solutions in the event of a fertility problem. These comparisons were significant at P < 0.05.

Limitations, reasons for caution: Self-selection bias was inevitable in the questionnaire survey, and the anonymous nature of the survey did not permit the collection of characteristics of non-responders. International comparisons warrant caution because the Hong Kong sample was older than the US sample (mean age 20), but not older than the Sweden sample (mean age 24).

Wider implication of findings: While this study was consistent with past Western studies on the lack of fertility awareness among highly educated young people, the findings reveal significant cultural differences in family planning and responses to infertility between Asia and the West.

Keywords: Chinese; fertility awareness; infertility; involuntary childlessness; parenting attitudes.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Aging*
  • China / epidemiology
  • Cross-Sectional Studies
  • Female
  • Fertility*
  • Health Knowledge, Attitudes, Practice* / ethnology
  • Humans
  • Infertility, Female / epidemiology
  • Infertility, Female / ethnology
  • Infertility, Female / etiology
  • Infertility, Female / therapy
  • Internet
  • Male
  • Parenting* / ethnology
  • Parenting* / psychology
  • Reproductive Behavior* / ethnology
  • Reproductive Behavior* / psychology
  • Reproductive Health / education*
  • Reproductive Health / ethnology
  • Reproductive Techniques, Assisted / adverse effects
  • Students
  • Universities
  • Urban Health* / ethnology
  • Young Adult