Abstract

Background: Previous international studies suggest professional women are more likely to delay childbearing whilst pursuing career goals. Due to prolonged education and training pathways, female medical students may be particularly at risk of fertility difficulties from delayed childbearing. Aim: To explore, among female medical students, the understanding of age-related fertility decline, attitudes toward prophylactic fertility interventions, and beliefs about potential effects of childbearing on training and career opportunities. Method: Cross-sectional online survey of female medical students at The University of Queensland, Brisbane, Australia. Results: The average response rate was 81% (n=113). 95% of respondents were aged 18 to 29, and most (98%) did not have children. 72% intend to have children; 24% within five years, and over 60% intending to delay for 10-15 years. 62% of respondents intend to undertake specialty training, 29% planning to delay childbearing until after training. Of these, 50% perceive that having children sooner would negatively impact career prospects or compromise financial security. Half of respondents reported their fertility knowledge as sound or high. Age of significant fertility decline was well understood, although 90% overestimated the chance of spontaneous pregnancy at age 30. 88% respondents recognise oocyte cryopreservation in their 20’s as a fertility preservation option, though only 28% would consider this in next 10 years with 21% not considering it at all. Respondents strongly believe they should be informed of age-related fertility decline (100%) and of fertility preservation options (98%). 79% believe medical students should seek individualised assessment. Conclusion: Future fertility is important to these at-risk women, who intend to undertake a prolonged education and training pathway. Despite reasonable understanding of age-related fertility decline, most intend to delay childbearing, perceiving financial and career disadvantages of earlier childbearing. Information about age-related fertility decline and fertility preservation strategies is strongly desired by this group.

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