Family size preference and factors affecting the fertility rate in Hyogo, Japan.

BACKGROUND: Japan has consistently shown a low fertility rate, which has been lower than the replacement level since 1974, and represents one of the least fertile countries in the world. This study was designed to determine the family size preference of and its effect on Japanese women. METHODS: We conducted a questionnaire survey among women who visited the obstetrics and gynecology department of 18 hospitals and clinics in the Hyogo Prefecture, Japan, between October 2011 and February 2012. All the women were categorized according to age group and area of residence, and the survey results were statistically analyzed using a t test. RESULTS: A total of 1616 women were included in this study. There was no significant difference between the mean desired and actual marital ages (26.70 and 26.67 years, respectively). The mean desired number of children was 2.55, which was significantly more than the mean actual number of children (1.77) in all generations. The mean desired and actual numbers of children were more in the rural areas (2.73 and 2.09, respectively) than in the urban (2.54 and 1.70, respectively) and semi-urban areas (2.49 and 1.60, respectively). The mean number of family members was significantly greater in the rural areas (3.84) than in the urban (3.25) and semi-urban areas (3.05).The most important concern among women who had never delivered a baby was childbearing itself, followed by the expenses related to pregnancy and childbearing. CONCLUSIONS: The family size preference of the women in our study was higher than the actual numbers of children. The fertility intentions were low among the younger women but high among those living in rural areas with larger families.

Perception of oral contraceptives among women of reproductive age in Japan: a comparison with the USA and France.

AIM: In order to reveal the differences between oral contraceptives (OC) perceptions and actual needs, we performed a web-based study in the USA, France, and Japan. MATERIALS AND METHODS: The study was carried out using a web-based questionnaire in May 2009. Two hundred women each from the three countries who were in their 20s, 30s, or 40s were randomly selected and asked about contraception. RESULTS: The most frequently used contraceptive method was OC in the USA and France and condoms in Japan. The most commonly used OC information source was doctors in the USA and France, but the media in Japan. The main reason for taking OC was 'contraception' in the USA and France, but it was relief from menstruation-related problems in Japan. Partner agreement was highest in France, and partner disagreement was highest in the USA. The most common reason for discontinuing OC use was 'contraception became unnecessary' in all three countries. The second most common reason was 'troublesome to take everyday' in the USA and France but 'troublesome to get a doctor's prescription' in Japan. The most common reason for never taking OC was also 'troublesome to get a doctor's prescription' in Japan. As a non-contraceptive benefit, 'relief of dysmenorrhea' was well known in all three countries; however, other non-contraceptive benefits were little known among Japanese. CONCLUSIONS: There are several differences in the patterns of OC use in the three countries studied. Providers should know more about current OC usage patterns in order to improve the quality of care.

Impact of use of combined oral contraceptive pill on the quality of life of Japanese women.

AIM: To evaluate the impact of combined oral contraceptive pill (OC) use on quality of life (QOL) among Japanese women, we performed a prospective study using the Japanese version of the World Health Organization Quality of Life (WHOQOL) questionnaire. METHODS: Women who consulted Chayamachi Lady's Clinic to get a prescription for OC for the first time were recruited for our questionnaire study and asked to complete the WHOQOL questionnaire twice, before taking OC and more than 3 months after beginning OC use. Two hundred and seventeen women responded to our questionnaire before taking OC and 110 patients completed the questionnaire. The patients were divided into six groups based on the reason they wanted to take OC: contraception, relaxation of dysmenorrhea, regulation of menstrual cycles, improvement of acne, remission of menorrhagia, and improvement of premenstrual tension syndrome (PMS). RESULTS: WHOQOL scores showed significant improvement in all domains of the dysmenorrhea group, all domains but the social of over all participants, the social and overall domain of the irregular cycle group, physical, environmental, and overall domain of the acne group, and psychological and overall domain of the PMS group. The WHOQOL score worsened in the social domain of the contraception group; however, the score in the overall domain of that group improved. CONCLUSIONS: These results indicate that OC can provide higher QOL for women with problems involving menstrual pain and/or hormonal abnormalities. However, those using OC for contraception only were found to be unsatisfied with taking OC in a relationship with their partners.

Vaginoplasty with Interceed absorbable adhesion barrier for complete squamous epithelialization in vaginal agenesis.

OBJECTIVE: The purpose of this study was to present our experiences of an innovative surgical approach for vaginal agenesis with the use of Interceed absorbable adhesion barrier (Ethicon) to achieve a satisfactory neovagina. STUDY DESIGN: The current study involved 10 subjects who were diagnosed with vaginal agenesis. After the creation of a vaginal tunnel, a mold that had been wrapped with Interceed was placed in the neovagina. RESULTS: No operative and postoperative complications were encountered. The duration of the operation was < or =30 minutes, and blood loss was minimal. The postoperative hospital stay was only 2 days. Epithelialization of the neovagina was achieved 1 to 4 months after the operation, and all patients were satisfied with the outcome. The neovagina that was created with this procedure was not much different from the normal adult vagina as far as histologic and physiologic conditions are concerned. CONCLUSION: This innovative surgical procedure may be a potential alternative approach for the therapy of vaginal agenesis with the use of the absorbable adhesion barrier Interceed with excellent results.