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Access to Ovulation Monitoring and Strategic Timing of Sexual Activity in a Low-Fertility Setting

Poh Lin Tan, National University of Singapore

Family planning programmes have made important contributions to global development, but few studies have examined the impact of increasing access to fertility management methods in low-fertility settings. This paper uses data from a randomised controlled trial involving 657 heterosexual married women in Singapore, one of the world’s lowest fertility countries. Half of participants were randomly selected to receive ovulation tests. 97.7% of participants completed online diaries recording dates of sexual activity, menstrual cycles and ovulation test results over the next 14 weeks. Around 41% reported at least one test result, with lower usage among participants who were pregnant or on birth control. Random-effects panel regression model results suggest that participants who used the tests responded to the provided information by strategically timing intercourse in accordance with their fertility ideals. When wives’ and husbands’ fertility ideals were not aligned, timing of intercourse facilitated wives’ ideals, suggesting that the asymmetric distribution of information favours women’s fertility preferences. The evidence suggests that increasing access to fertility management methods may be worth further exploration as a relatively low-cost addition to the current policy toolkit to reduce average waiting times to desired pregnancies, thereby reducing potential risks of involuntary childlessness and underachievement of childbearing intentions.

Keywords: Fertility and childbirth, Family demography, Policy, Randomized controlled experiments

See paper.

  Presented in Session 89. Health and Fertility