JMIR Publications

ABSTRACT

Background:

Approximately one-third of Japanese couples worry about infertility. To develop strategies for the primary prevention of infertility as a population approach, it is important for the general population to be knowledgeable about fertility and infertility. The Internet may contribute to the dissemination of information regarding infertility and fertility. However, few studies have examined online information about fertility.

Objective:

This study aimed to quantitatively examine online Japanese-language information about lifestyle factors associated with reduced fertility.

Methods:

We conducted online searches, using the 10 search terms with the highest numbers of searches that people hoping to conceive are likely to input, into two major search engines in Japan (Google Japan and Yahoo! Japan). From the 2200 retrieved websites, 1188 duplicates and 493 websites that were unrelated to our objective were excluded, resulting in a final dataset of 519 websites. Coding guidelines were developed for the following lifestyle factors associated with reduced fertility: sexually transmitted diseases, psychological stress, cigarette smoking, alcohol use, nutrition and diet, physical activity and exercise, underweight, overweight and obesity, and environmental pollutants.

Results:

In terms of the website author’s professional expertise, 69.9% of the coding instances for the selected lifestyle factors were mentioned by hospital, clinics, or the media, whereas only 1.7% were mentioned by laypersons. Psychological stress (20.1%) and sexually transmitted diseases (18.8%) were the most frequently mentioned lifestyle factors associated with reduced fertility. In contrast, cigarette smoking, alcohol use, nutrition and diet, physical activity and exercise, underweight, overweight and obesity, and environmental pollutants were mentioned relatively infrequently. The association between reduced fertility and sexually transmitted diseases was mentioned significantly more frequently by hospitals and clinics than by the media (P < .001). The association between reduced fertility and nutrition and diet was mentioned significantly more frequently by the media than by hospital and clinics (P = .006). With regard to the sex of the target audience for the information, female-specific references to psychological stress, sexually transmitted diseases, nutrition and diet, underweight, physical activity and exercise, and overweight and obesity were significantly more frequent than were male-specific references to these lifestyle factors (psychological stress: P < .001, sexually transmitted diseases: P < .001, nutrition and diet: P < .001, underweight: P < .001, physical activity and exercise: P < .001, overweight and obesity: P < .001).

Conclusions:

Of the lifestyle factors known to be related to reduced fertility, cigarette smoking, alcohol use, and male-specific lifestyle factors are mentioned relatively infrequently in online information sources in Japan, and these factors should be discussed more in information published on websites. We believe that a public fertility-related information strategy should be established in Japan by producing websites to provide information about preconception care and by creating a policy regarding online media.