Taking the pulse of America's women's health nurses: a survey of knowledge and opinions on fertility and oocyte donation

Abstract

The use of technologies such as oocyte donation (OD) by women and men beyond the natural reproductive agespan is controversial. The age when fertility begins to decline may be misperceived by healthcare professionals. This study surveyed the knowledge and opinions of nurses on these topics. Voluntary written survey of attendees at a 2006 national OB/GYN nursing meeting. A one-page questionnaire was offered to meeting participants at an exhibit hall booth. Questions covered demographics; pregnancy history; knowledge about age-related fertility decline and its management; and opinions about OD for menopausal women and partners. Only responses from female RNs were analyzed. 353 registrants responded to the surveys from 40 states, DC and Canada. 336 respondents were RNs, of whom 11% were APNs. Practice areas were 49% OB, 24% GYN ± OB, 19% education; with 83% hospital- and 10% university-based. Respondents were 21–75 (median 47) yr old and had practiced from 1–44 (median 22) yr. 27% had difficulty conceiving, with half seeing a specialist. 16% were childless (median age 40 yr; 22% involuntarily infertile) and 72% had 1–3 children. Respondents indicated female fertility begins to decline at age 35 yr (range 14–50). Although the median stated age for male fertility decline was 45 yr, 30% did not respond and 19% said male fertility never declines. Responses did not correlate with respondent age, but those with infertility gave a lower age for female fertility decline. Two-thirds felt specialist referral was warranted after 1 yr of infertility, but 28% delayed referral for ≥1.5 yr. Expedited infertility evaluation was recommended at a median female age of 35 yr, yet treatment success was not felt to decline until a median age of 40 yr. Most felt OD appropriate for menopausal women (Yes 57%; No 38%). Of those saying Yes, 20%, 28%, and 50% felt recipients aged Any, ≤55, and ≤50 were “appropriate.” Most (55%) did not think male age should be considered for OD and of those who did, 33% felt the male age limit should be 55 yr. Women's health nurses grasp age-related effects on fertility but underestimate when female fertility begins to decline. A substantial minority would not recommend specialist care after a year's infertility. Substantial minorities opposed menopausal oocyte recipients and older male partners. OB/GYN nurses need additional education about reproductive difficulties and options.