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      Can Reproductive Life Plan-based counselling increase men’s fertility awareness?

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          Abstract

          Background: Many men have limited knowledge about reproductive health and fertility. The aim of the study was to evaluate if Reproductive Life Plan (RLP)-based counselling during a sexual health visit could increase men’s fertility awareness.

          Material and methods: The study was a randomized controlled trial including 201 men aged 18–50 who visited either of two participating sexual health clinics in Sweden for sexually transmitted infection testing during 2014–2016. All men received standard care, and men in the intervention group (IG) also received oral and written RLP-based information about lifestyle and fertility. Awareness about fertility and lifestyle-related factors were the main outcomes, measured through a questionnaire before the intervention and through a telephone survey after three months. Impressions from the counselling were also assessed at follow-up.

          Results: A majority (71%) of men wanted children in the future. General fertility awareness increased from a mean score of 4.6 to 5.5 out of 12 ( P = 0.004) in the IG. The mean number of accurate lifestyle factors (that could affect fertility) mentioned increased from 3.6 to 4.4 ( P < 0.001) in the IG. There were no improvements in the control group. Among the men in the IG, 76% had a positive experience of the counselling, and 77% had received new information.

          Conclusion: The intervention managed to increase different aspects of men’s fertility awareness. In the future, the format for preconception care for men needs further development. Including men in preconception health policy guidelines and identifying suitable actors for care provision would be important first steps.

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          Most cited references29

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          Constructions of masculinity and their influence on men's well-being: a theory of gender and health.

          Men in the United States suffer more severe chronic conditions, have higher death rates for all 15 leading causes of death, and die nearly 7 yr younger than women. Health-related beliefs and behaviours are important contributors to these differences. Men in the United States are more likely than women to adopt beliefs and behaviours that increase their risks, and are less likely to engage in behaviours that are linked with health and longevity. In an attempt to explain these differences, this paper proposes a relational theory of men's health from a social constructionist and feminist perspective. It suggests that health-related beliefs and behaviours, like other social practices that women and men engage in, are a means for demonstrating femininities and masculinities. In examining constructions of masculinity and health within a relational context, this theory proposes that health behaviours are used in daily interactions in the social structuring of gender and power. It further proposes that the social practices that undermine men's health are often signifiers of masculinity and instruments that men use in the negotiation of social power and status. This paper explores how factors such as ethnicity, economic status, educational level, sexual orientation and social context influence the kind of masculinity that men construct and contribute to differential health risks among men in the United States. It also examines how masculinity and health are constructed in relation to femininities and to institutional structures, such as the health care system. Finally, it explores how social and institutional structures help to sustain and reproduce men's health risks and the social construction of men as the stronger sex.
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            Fertility knowledge and beliefs about fertility treatment: findings from the International Fertility Decision-making Study.

            How good is fertility knowledge and what are treatment beliefs in an international sample of men and women currently trying to conceive?
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              The impact of lifestyle factors on reproductive performance in the general population and those undergoing infertility treatment: a review.

              This evidence-based review focuses on the impact of potentially modifiable, non-communicable lifestyle factors on reproductive performance in the general population and the infertile population undergoing assisted reproductive technology (ART) treatment. The impact of several lifestyle factors including; age, weight, smoking, diet, exercise, psychological stress, caffeine consumption, alcohol consumption and exposure to environmental pollutants are included in the review. The databases of Medline, PubMed and Cinahl were searched to identify relevant publications. There is strong evidence that age, weight and smoking impact on general health and adversely on reproductive performance. However there is a need for further research focusing specifically on the relationship between diet and various levels of exercise on reproductive performance. There are several other factors such as psychological stress, caffeine consumption, alcohol consumption and exposure to environmental pollutants that have been implicated but the evidence is equivocal. It is concluded that lifestyle modification can assist couples to conceive spontaneously or optimize their chances of conception with ART treatment.
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                Author and article information

                Journal
                Ups J Med Sci
                Ups. J. Med. Sci
                IUPS
                iups20
                Upsala Journal of Medical Sciences
                Taylor & Francis
                0300-9734
                2000-1967
                December 2018
                13 December 2018
                : 123
                : 4
                : 255-263
                Affiliations
                [a ]Department of Women’s and Children’s Health, Uppsala University , Uppsala, Sweden;
                [b ]Centre for Gender Research, Uppsala University , Uppsala, Sweden
                Author notes
                CONTACT Maja Bodin maja.bodin@ 123456kbh.uu.se Department of Women’s and Children’s Health, Uppsala University , SE-751 85Uppsala, Sweden.

                Supplemental data for this article can be accessed here .

                Author information
                http://orcid.org/0000-0003-4647-5709
                http://orcid.org/0000-0002-2172-6527
                http://orcid.org/0000-0003-3313-4235
                http://orcid.org/0000-0001-8050-621X
                Article
                1541948
                10.1080/03009734.2018.1541948
                6327788
                30541376
                d3cdb7c2-83fd-45a9-9105-5b29462f062a
                © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 September 2018
                : 23 October 2018
                : 25 October 2018
                Page count
                Figures: 2, Tables: 3, Pages: 9, Words: 6576
                Funding
                Funded by: The Family Planning Fund, Uppsala
                Funded by: Faculty of Medicine, Uppsala University
                The Family Planning Fund, Uppsala; Faculty of Medicine, Uppsala University.
                Categories
                Article

                Medicine
                counselling,fertility awareness,lifestyle,men,preconception care,reproduction,clinicaltrials.gov identifier,nct02736214

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