title: Intentions and attitudes towards parenthood and fertility awareness among Chinese university students in Hong Kong: a comparison with Western samples.
abstract: OBJECTIVE
  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?
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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).
  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.
authors.affiliation: Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China chancelia@hku.hk.
authors.forename: C H Y
authors.initials: CH
authors.lastname: Chan
authors.affiliation: Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China.
authors.forename: T H Y
authors.initials: TH
authors.lastname: Chan
authors.affiliation: Crean College of Health and Behavioral Sciences, Chapman University, Orange, California, USA.
authors.forename: B D
authors.initials: BD
authors.lastname: Peterson
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Lampic
authors.affiliation: Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China.
authors.forename: M Y J
authors.initials: MY
authors.lastname: Tam
mesh_terms: D000328:Adult; D017668:Age of Onset; D000375:Aging; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005298:Fertility; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000628:therapy; D020407:Internet; D008297:Male; D016487:Parenting / Q000208:ethnology / Q000523:psychology; D043762:Reproductive Behavior / Q000208:ethnology / Q000523:psychology; D060728:Reproductive Health / Q000193:education* / Q000208:ethnology; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects; D013334:Students; D014495:Universities; D014504:Urban Health / Q000208:ethnology; D055815:Young Adult
keywords: Chinese; fertility awareness; infertility; involuntary childlessness; parenting attitudes