Abstract
Purpose. To investigate the prevalence of and experience related to infertility and fertility preservation during training for United States (US) medical residents and fellows. Methods. Cross-sectional online-based survey study of US postgraduate residents and fellows. Results. Respondents included 732 residents and fellows, with the highest percentage in Obstetrics & Gynecology (24.2%), Pediatrics (14.1%), and Internal Medicine (13.9%). In total, over half of respondents (56.6%) reported delaying childbearing plans due to medical training, 51 (7.0%) reported infertility, while 11 (1.5%) reported recurrent pregnancy loss (RPL). 208 respondents (28.4%) had considered oocyte or embryo cryopreservation. Respondents reported lack of time/flexibility (35.4%) and financial concerns (29.4%) as the top reasons for being unable to pursue fertility treatment. Conclusions. The majority of residents and fellows in our survey delayed childbearing due to medical training, with time/flexibility and financial concerns the greatest barriers to fertility treatment during training. Specific measures are needed in order to increase access to fertility services for US medical trainees.
Highlights
Issues relating to infertility and recurrent pregnancy loss (RPL) are highly relevant for medical trainees due to the timing, length, and inflexibility of medical training schedules, with many of them occurring during prime fertile years
The reported infertility rate in postgraduate medical trainees is comparable to the general population, though it may be underestimated as individuals which may further delay childbearing until established in practice
Time/flexibility and financial concerns were identified by residents and fellows as the greatest barriers to seeking and pursuing medical assistance while in training
Summary
Issues relating to infertility and recurrent pregnancy loss (RPL) are highly relevant for medical trainees due to the timing, length, and inflexibility of medical training schedules, with many of them occurring during prime fertile years. Prior survey studies focused on Obstetrics & Gynecology residents have reported infertility rates comparable to the general population, low utilization of fertility preservation services, limited support from training programs for fertility preservation issues, and a high rate of postponement of childbearing due to medical training [9, 10, 11]. Several other survey-based studies in other medical fields (primarily surgical specialties) have reported qualitatively similar findings, including high rates of postponement of childbearing, concerns about maternal or fetal health as a result of training, and related career dissatisfaction [12, 13, 14, 15, 16]. While reproductive age trainees postponing fertility are likely the prime target population for fertility preservation, the rate of uptake of this option and its accessibility in this group are unknown
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