Overview
This study evaluates the impact of preventive ovarian reserve screening and artificial intelligence (AI)-enabled counseling on fertility awareness and reproductive anxiety among women in Hong Kong. Hong Kong faces low birth rates, and reproductive anxiety regarding the biological clock remains a key barrier to family planning. Participants aged 25 to 38 years will be allocated to receive either anti-Müllerian hormone (AMH) blood testing combined with counseling or standard health education materials. The study compares an interactive AI conversational agent ("Shelby") with traditional written reports to evaluate whether AI communication improves comprehension of medical results, reduces anxiety, and enhances fertility intentions. Findings aim to inform future public health screening policies.
Description
This joint study by the City University of Hong Kong (CityU) and The Chinese University of Hong Kong (CUHK) investigates the impact of preventive ovarian reserve screening and artificial intelligence (AI)-enabled health counseling on reproductive anxiety and family planning intentions among women in Hong Kong.
Hong Kong currently faces record-low fertility rates. While the government has implemented various financial subsidies and tax incentives, these measures fail to address the underlying psychological barriers and medical uncertainties surrounding biological clocks. To address this gap, the study employs a 2 x 2 quasi-experimental design using propensity score matching and RCT applied to evaluate 660 nulliparous women aged 25 to 38 years:
- Intervention Group (n = 300): Participants receive an Anti-Müllerian Hormone (AMH) blood test to quantify ovarian reserve. Results are delivered either through an interactive, culturally tailored AI conversational agent named "Shelby" (Group 2A) or a traditional static PDF laboratory report (Group 2B).
- Control Group (n = 300): Participants receive standard reproductive health education without biomarker testing, comparing interactive AI engagement (Group 1A) against standard educational brochures (Group 1B).
Key outcome measures evaluated at baseline and at a 2- to 4-week follow-up include medical comprehension accuracy, psychological distress assessed via the State-Trait Anxiety Inventory (STAI-6), patient enablement (PEI), willingness to pay, and long-term fertility intentions. Strict ethical safeguards and distress protocols are integrated to automatically escalate any acute psychological distress to professional counselors. The findings will provide empirical evidence to support policy recommendations for territory-wide subsidized fertility screening in public healthcare.
Eligibility
Inclusion Criteria:
- Biologically female (assigned female at birth, with intact ovaries)
- Aged 25 to 38 years
- Fluent in written and spoken Chinese (Traditional or Simplified) or English
- Has access to an internet-enabled smartphone or computer
- Able to give electronic or written informed consent
Exclusion Criteria:
- Currently pregnant or breastfeeding
- Known active, severe psychiatric or cognitive disorder that prevents informed - consent or completing the questionnaire
- History of gynecological cancer
- Currently receiving gonadotoxic chemotherapy or pelvic radiotherapy
