Two-year follow-up of a randomized controlled trial: knowledge and reproductive outcome after online fertility education.
Level 2 - randomized trial
Randomized controlled trial follow-up
PubMed 30265305 · doi:10.1093/humrep/dey293
What was done
This 2-year follow-up (T3) of an online randomized controlled trial in Japan evaluated participants previously randomized to receive one of three digital brochures: fertility education (intervention), pre-pregnancy health focusing on folic acid (control 1), or family policies and childcare provision (control 2). From the original cohort of 1,455 participants, 743 individuals (383 men, 360 women) completed the T3 survey. Investigators assessed fertility knowledge via the Japanese Cardiff Fertility Knowledge Scale (CFKS-J) and reproductive outcomes, including new births, medical consultations, and birth timing.
What was found
Fertility knowledge gains remained significantly above baseline at 2 years in the intervention group (11.2% increase in men, 7.0% in women), whereas control groups showed no significant change. Across the total sample, overall rates of new births and medical consultations over 2 years did not differ significantly among groups. However, among individuals partnered at baseline, the proportion having a child within the first year was higher in the intervention group than control group 1 (folic acid): 8.8% vs. 1.4% in men (P = 0.09; adjusted OR 7.8, 95% CI: 0.86–70.7) and 10.6% vs. 2.3% in women (P = 0.03; adjusted OR 5.2, 95% CI: 1.09–25.0). Birth rates in the intervention group did not differ from control group 2 (family policy). New medical consultations were higher in intervention men (12.0%) compared to control group 2 (1.5%, P = 0.04), with no difference among women.
Why it matters
A brief, single digital fertility education intervention can produce modest knowledge retention for up to 2 years and may accelerate pregnancy timing among partnered individuals compared to general pre-pregnancy health information.
Limits
Attrition was substantial, with only 51% (743/1,455) responding at 2 years; responders were significantly older, more educated, and more often married than dropouts. Birth acceleration findings stem from subgroup analyses with wide confidence intervals. All fertility and pregnancy outcomes were self-reported, and unrecognized early pregnancies at baseline could not be definitively ruled out.
Cited by
- partial In a randomized controlled trial of married couples given fertility education seminars versus control info, the educated group had twice the odds of childbearing at a two-year follow-up.