Abstract
Study Objective
We aimed to describe fertility desires in healthy adolescent females and to explore
associations of fertility desire with conditions and therapies potentially compromising
fertility.
Design
This was a cross-sectional, anonymous survey.
Setting and Participants
A total of 323 female adolescents aged 13-19 years were recruited from clinic waiting
areas at a children's hospital. We oversampled on days when clinics serving adolescents
with potential fertility compromise were scheduled.
Main Outcome Measures
We measured fertility desire by agreement with the statement “I want to have children
someday.” To measure compromised fertility we asked “In the past year, has a doctor,
nurse or other medical professional ever talked to you about the possibility that
you may have decreased fertility and may not be able to have your own biological child
someday?” To measure depression severity, we used a validated scale, the PHQ-9, scores
were dichotomized into no/mild and moderate/severe depression.
Results
Mean age was 16.06 ± 1.87 years. Of the 323 participants, 57% identified as Hispanic,
24% as Black, 93.5% as cisgender, 6.5% as transgender/gender diverse, 70% as heterosexual,
and 30% as sexual minority. A total of 35% had moderate/severe depression, and 12%
had compromised fertility. Overall, 89% wanted children. Fewer transgender/gender
diverse than cisgender participants wanted children (67% vs 93%, P < .001), as did fewer with moderate/severe versus no/mild depression (83% vs 93%,
P < .05), whereas those with compromised fertility versus those without and heterosexual
versus sexual minority participants had similar fertility desires. Transgender/gender
diverse identity (odds ratio, 0.33; 95% confidence interval, 0.11-0.97; P < .05) and moderate/severe depression (odds ratio, 0.45; 95% confidence interval,
0.22-0.93; P < .05) were independently associated with lower fertility desire.
Conclusions
We found a high overall proportion of female adolescents desiring future children,
and only 2 independent predictors of decreased fertility desire, namely, transgender/gender
diverse identity and moderate/severe depression.
Key Words
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Article info
Publication history
Published online: September 11, 2020
Footnotes
MDL, EJS, NAD, and SMC have no conflicts to disclose. HJT discloses that she is an Associate Editor of the Journal of Pediatric and Adolescent Gynecology.
Identification
Copyright
© 2020 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
