Presentation (CTI)

OBJECTIVES: Hong Kong has persistently low fertility rates, and delayed childbearing has become increasingly common. However, limited evidence exists on how women perceive childbearing, understand fertility screening and treatment, and weigh these options in relation to work, finances, relationships and family planning. This study explored fertility intentions, concerns and service-related preferences among women in Hong Kong to inform a subsequent discrete choice experiment.
METHODS: Six focus group discussions were conducted with 30 nulligravid women aged 25-38 years living in Hong Kong. Participants were purposively recruited to reflect variation in age, relationship status and employment background. Semi-structured discussions explored fertility intentions, concerns about having children in Hong Kong, fertility awareness, perceived benefits and concerns regarding fertility screening and treatment, service preferences, and feedback on draft DCE choice tasks. Discussions were conducted in Cantonese (n=2) or Mandarin (n=4), audio-recorded, transcribed verbatim and analysed thematically.
RESULTS: Five themes were identified. First, fertility intentions were shaped by competing priorities. Although many participants desired children, childbearing was often postponed because of career development, housing affordability, financial pressures and work-family balance. Second, fertility literacy was limited, with several participants confusing fertility screening with prenatal or fetal testing and showing limited understanding of ovarian reserve assessment, including AMH testing. Third, decisions about fertility screening and treatment were influenced by perceived benefits, costs and treatment burden, including side effects, procedural invasiveness, repeated clinic visits and work disruption. Fourth, participants valued clinician-led explanations, continuity of care and trusted fertility providers. Finally, feedback on draft DCE tasks highlighted the need to clarify success rates, terminology and treatment timelines.
CONCLUSIONS: Women’s fertility-related decision-making in Hong Kong is shaped by life priorities, knowledge gaps, socioeconomic pressures, treatment burden and trust in care providers. These findings provide empirical guidance for developing woman-centred fertility services and a context-sensitive DCE on fertility screening and treatment preferences.