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Women fertility is rated by the average number of children a woman will have during her childbearing years. Malaysia is now facing a population crisis and the fertility rate continues to decline. This situation will have implications for the age structure of the population. Malaysia is expected to reach aging population status by the year 2035. As the aging population has a very long average life expectancy, the government needs to spend a lot on medical costs for senior citizens and need to increase budgets for pensions. The government may be required to increase tax revenues to support the growing older population. The falling fertility rate requires proper control by relevant authorities, especially through planning and implementation of strategic and effective measures. Hence, this paper aims to develop a fertility index using correlation and Shannon's entropy method. There are two main results from this analysis which are the factor rank and fertility index for each state. The three most important factors that influence fertility in Malaysia based on correlation method listed the number of females living in urban areas, number of females employed, and family planning methods while Shannon's entropy method listed female tertiary education attainments, number of divorces, and family planning methods. Next, the fertility index show that Selangor, Johor, and Sarawak are among the states with the highest values. On the other end of the spectrum, Terengganu, W.P. Labuan, and Perlis are ranked in the last positions. As a summary, the weighted calculation based on the correlation and entropy give different results in terms of rank the factors influencing the fertility. However, the results of both methods show that Selangor has the highest fertility index. From this study, the government may design the appropriate policies to mitigate dwindling fertility rates among Malaysian women.

Most countries have been experiencing changes in fertility pattern over the last few decades. Fertility transition from high to low is a relatively recent phenomenon in Malaysia. The total fertility rate (TFR) had declined from 4.9 children per woman in 1970 to 4.0 in 1980. It has continued to fall and has reached the replacement level of 2.1 in 2010. This chapter provides the trend analysis and a comparative analysis of fertility trends to explain the fertility transition of Malaysia’s population. Data used in this study were obtained from Department of Statistics, Malaysia and Fifth Malaysian Population and Family Survey, 2014. The result of this study showed that the fertility rate between age groups was higher among Malay than other ethnics since 1991–2010. Across all ages, the fertility rate has a negative correlation with the educational level where women with tertiary education tend to have fewer children compared to less educated women. This study also presents the fertility desire in Malaysia. There is a negative correlation between age group and fertility desire. In addition, the desire to stop childbearing is found to be stronger when women have had three living children. The findings of this study will help policy makers to plan programmes to improve the fertility rate in Malaysia.

Population aging and the health status of the community are the primary agenda in the achievement of the Sustainable Development Goals 2030 (SDG, 2030). However, current trends in the world have shown a rapid increase in the aging population rate, whereas the birth rate has shown a downward trend. Malaysia is no exception in this regard, which is expected to become an old country status by 2030 when the population aged 60 years and above reaches 15% of the total population.

Total Fertility rate (TFR) is a demographic indicator used to estimate the average number of children a woman should give birth to during her reproductive period. The findings of a poll in Sarawak found that the total TFR for the state of Sarawak is decreasing drastically. 12.6% of couples have had or are experiencing fertility problems and it is difficult to conceive within a year after marriage.

Couples are considered infertile if they are unable to conceive after one year of regular unprotected sex. The impact of lifestyle and environment on human fertility may vary depending on aetiology, demographic characteristics, genetic variation and other factors. As used by previous researchers, semen parameters were used to measure male infertility. Therefore, a decrease in semen quality is considered as a major factor in male infertility (http://en.wikipedia.org/wiki/Semen_quality). Previous studies (Kidd et al.2001,Eskenazi et al.2003, de La Rochebrochard and Thonneau 2003) have found that older men tend to have lower semen quality than younger ones. Testicular hyperthermia (elevated temperature) also has been known to affect male fertility. Men who like taking hot baths or sit in a sedentary position for a long time are at risk of having infertility. The objectives of this study are to identify the relationship between socio-demographic profile, lifestyle and environmental factors and semen quality, and to identify risk factors of poor semen quality among men attending the National Population and Family Development Board's (NPFDB) Subfertility Clinic. This study was done in Andrology Laboratory, NPFDB. Five hundred men from couples having their first infertility consultation between September 2010 abd June 2011 were recruited. Each patient was required to register, deposit semen and fill in the quesstionnaire. Sperm concentration, morphology and motility from semen analysis were used to study the relationship between semen quality and independent variables. Reference limits used were 15 cells x 10'6/ml, 4% and 40 %, respectively (World Health Organization, 2010). For statistical analysis, descriptive statistic, t test and ANOVA were used; 0.05 alpha value was chosen. Results showed that one-third of the study population were between 26 to 30 years of age and another one third were aged between 31 to 35 years old; mean age was 33.2. majority were Malays (71.2%), resided in Selangor (64.3%) and professionals (41.6%). Semen quality showed a negative relationship (p<0.05) with age. Meanwhile, sperm motility varied significantly for different ethnic group. Chinese (57.75%) had the highest motile-sperm compared to Malays (53.44%) and Indians (46.60%). Among lifestyles variables, frequency of sexual intercourse had a posive relationship (p<0.05) with sperm motility, whilst sedentary position had negative relationship (p<0.05) with the latter. Regression analysis was used to predict the risk factors of poor semen quality. This study found that men above 30 years old were two times more likely to have low sperm motility than men in the twenties. Moreover, less frequent sexual activity between couples was more likely (p<0.05) to have abnormal sperm compared to those who had sexual intercourse more frequently. In conclusion, this study suggested that age over 30 years and infrequent sexual activity were the risk factors to lower semen quality. Even though not regarded as a risk factor, sedentary work position had a negative impact on sperm motility. These factors may affect male fertility and cause difficulty in conception. Public awareness through advocacy programs and talks on infertility and its risk factors should be carried out regularly. Public education should be carried out to advice men to practice a healthy lifestyle and work life balance. This study has shown encouraging results, and should be replicated in the general population in Malaysia