Women's reproductive autonomy and attitudes toward social egg freezing in a low-fertility context: evidence from Shiraz, Iran.

backgroundFertility in Iran has been declining steadily since the mid-1980s, prompting policymakers to implement various pronatalist measures. Despite these efforts, fertility rates have not increased substantially, highlighting the need for alternative strategies to support women’s reproductive choices. Social egg freezing (SEF) has emerged as a potential option for women to preserve fertility and extend the reproductive window, particularly in the context of delayed marriage and childbearing.

methodsThis cross-sectional study investigated the relationship between reproductive autonomy and attitudes toward SEF among 384 married women of reproductive age in Shiraz, Iran. Attitudes toward SEF were assessed using a continuous score derived from five questionnaire items, rather than categorical levels. Multivariate linear regression examined associations between reproductive autonomy, sociodemographic factors, and SEF attitudes.

resultsWomen with greater reproductive autonomy and higher age demonstrated more positive attitudes toward SEF, whereas higher spouse age was associated with less favorable attitudes. Educational level and class identity were also positively associated with SEF attitudes. Specifically, greater reproductive autonomy was associated with a modest but statistically significant increase in positive attitudes toward SEF (b = 0.043, SE = 0.021, p = 0.042).

conclusionsThese findings suggest that reproductive autonomy contributes to women’s receptiveness to SEF, though its effect is relatively small. Enhancing women’s reproductive autonomy, access to education, and socioeconomic support may encourage broader acceptance of SEF as a fertility preservation strategy.