Increasing awareness of age-related fertility and elective fertility preservation among medical students and house staff: a pre- and post-intervention analysis

Will, Erica Anspach; Maslow, Bat-Sheva L.; Kaye, Leah; Nulsen, John

doi:10.1016/j.fertnstert.2017.03.008

Cited by 34 publications

(26 citation statements)

References 20 publications

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“…The length of exposure to a formal REI program did not affect comfort in counseling patients in EF, indicating that brief focused REI rotations exposing residents to Assisted Reproductive Technology could help improve patient access to OB/GYN physicians who are comfortable in discussing EF. This finding supports Anspach-Will et al’s interventional study, which found that an hour-long educational session on EF was sufficient to significantly improve medical professionals’ knowledge-based scores about EF [3] and suggests that a brief but focused curriculum in EF could help improve resident confidence in discussing EF with patients. Female residents’ input regarding what they consider important for prospective patients to know could also guide training on EF.…”

Section: Discussionsupporting

confidence: 83%

“…Despite their central role in counseling patients on EF, little is known about medical trainees’ views on the procedure. Among medical students and house staff with prior knowledge of EF, 80% reported acquiring this knowledge through their formal education [3], indicating that EF is not well-covered in medical schools. A survey of U.S. Obstetrics and Gynecology (OB/GYN) residents indicated that 83% felt that they should begin conversations with their patients regarding fertility, and most felt that these conversations should occur during annual exams [4].…”

Section: Introductionmentioning

confidence: 99%

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Egg freezing for fertility preservation and family planning: a nationwide survey of US Obstetrics and Gynecology residents

Esfandiari

Litzky

Sayler

et al. 2019

Reprod Biol Endocrinol

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BackgroundLittle is known about resident attitudes toward elective egg freezing (EF) or how educational exposure to EF affects residents’ views and ability to counsel patients. This study aimed to evaluate US OB/GYN residents’ views on elective EF, decisions regarding family planning, and whether education on EF affects these views and self-reported comfort discussing EF with patients.MethodsA 32 question survey was emailed to program directors at all US residency programs for distribution to residents. Chi-square tests were used to evaluate the relationship between educational factors and views on EF and comfort counselling patients.ResultsOf those surveyed, 106 residents and 7 fellows completed the survey (103 female). Almost three quarters of female respondents reported postponing pregnancy due to residency (71.8%). Non-exclusive reasons for this choice included career plans (54.4%) and concern for childcare (51.5%) and for fellow residents and their program (50.5%). Of the male and female residents who reported educational exposure to EF (57.5%), almost all of them (95.4%) received this in an REI rotation. Only half of female residents reported being comfortable counseling a patient on EF (49.5%). For female residents, education on EF (p = 0.03) and more advanced level of residency (p = 0.02) were significantly associated with comfort counseling a patient on EF.ConclusionsFemale OB/GYN residents are choosing to delay pregnancy during residency for career and social support reasons. Few residents feel comfortable counseling patients on EF, but appropriate curricular content on EF during residency could improve residents’ comfort in assisting patients with reproductive planning.Electronic supplementary materialThe online version of this article (10.1186/s12958-019-0459-x) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Egg freezing for fertility preservation and family planning: a nationwide survey of US Obstetrics and Gynecology residents

Esfandiari

Litzky

Sayler

et al. 2019

Reprod Biol Endocrinol

View full text Add to dashboard Cite

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“…Moreover, Anspach et al surveyed medical students and house staff on their professional and personal perception of fertility before and after an educational intervention. They found that both groups increased their score post-intervention in the knowledge-based questions [35]. While this study assessed a distinct population of medical students and staff, it demonstrates the value of education to promote fertility-related knowledge.…”

Section: Discussionmentioning

confidence: 67%

Disparities in fertility knowledge among women from low and high resource settings presenting for fertility care in two United States metropolitan centers

Hoffman

Delaney

Valdés³

et al. 2020

Fertil Res and Pract

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Background: Few studies have examined health literacy and fertility knowledge among women from low income, socio-culturally diverse communities presenting for fertility care in the United States. Our study sought to examine demographic predictors of fertility-related knowledge among infertile women from low and high-resource communities in two major metropolitan centers in the United States. Methods: Fertility Knowledge Assessments were administered to women presenting for fertility care at county medical centers serving low-resource, largely immigrant patients and to women from largely affluent populations presenting to comprehensive fertility centers in two cities. The influence of demographic predictors on fertility knowledge was examined through regression analysis. Results: A total of 143 women were included in our analysis. In the county hospital/low resource clinic (LR, n = 70), the mean age was 32.8 ± 6.1 years vs 35.0 ± 5.0 years in the fee-for-service/high resource clinic (HR, n = 73). Among the LR patients, 74% were immigrants, 71% had an annual income <$25,000 and 52% had completed high school. Among HR patients, 36% were immigrants, 60% had an annual income >$100,000, and 95% had some college or above. On average, women from HR settings scored 3.0 points higher on the Fertility Knowledge Assessment than their LR counterparts (p < 0.001). Upon multivariate analysis, education level remained the sole independent factor associated with fertility knowledge assessment score (p < 0.001). Stratifying by resource level revealed that income was highly associated with fertility knowledge (p < 0.01) among high resource individuals even when adjusting for education level. Conclusions: Women from low resource, largely immigrant communities, seeking fertility care have greater disparities in fertility knowledge and lower health literacy compared to women from high resource clinical settings. Further studies are needed to understand these barriers and to develop targeted inventions to lower disparities and improve care for these vulnerable populations.

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“…Awareness of OFNMR was consistently evident in a significant proportion (over 75%) of women in five studies 21,23,25,28,29 . In four other included studies the reported rates of awareness were lower, 18,30‐32 with only 34% of students having heard of the procedure in one study conducted in Italy 32 .…”

Section: Resultsmentioning

confidence: 87%

Exploring women’s attitudes, knowledge, and intentions to use oocyte freezing for non‐medical reasons: A systematic review

Platts

Trigg

Bracewell‐Milnes

et al. 2020

Acta Obstet Gynecol Scand

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Introduction Women are postponing childbearing and preventing age‐related fertility decline with oocyte freezing for non‐medical reasons (OFNMR). The objective of this systematic evaluation was to gain an understanding of women's attitudes and knowledge of, and intentions to use OFNMR among users of OFNMR and the general public. Material and methods A systematic search of MEDLINE, EMBASE, and PyschINFO databases was undertaken, for studies that examined the psychosocial attitudes among women toward OFNMR. The search was limited to English language and no time restriction was set for publications. Extracted data were analyzed using thematic analysis and the study was performed according to PRISMA guidelines with prospective PROSPERO registration (CRD4201912578). Results Overall, 35 studies met the inclusion criteria. Studies were broadly categorized into studies investigating users or potential users of OFNMR, and studies examining the views of members of the general public. Users of OFNMR have good knowledge of age‐related fertility decline and awareness of the OFNMR procedure. Lack of partner was identified as the most common motivating factor to undertake OFNMR, with cost as a predominant concern. Knowledge among the general public of OFNMR is highly variable. Underestimation of age‐related fertility decline is common among the general public. Intentions of women to use OFNMR also varied drastically between studies. Conclusions Women are predominantly motivated to freeze eggs by the lack of a suitable partner, but cost is a significant barrier. Increasing the number of women pursuing OFNMR at an earlier stage may positively impact upon the risk of future involuntary childlessness. Better information should be made available to both women and men about their fertility and options to inform their reproductive decision‐making.

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Increasing awareness of age-related fertility and elective fertility preservation among medical students and house staff: a pre- and post-intervention analysis

Cited by 34 publications

References 20 publications

Egg freezing for fertility preservation and family planning: a nationwide survey of US Obstetrics and Gynecology residents

Egg freezing for fertility preservation and family planning: a nationwide survey of US Obstetrics and Gynecology residents

Disparities in fertility knowledge among women from low and high resource settings presenting for fertility care in two United States metropolitan centers

Exploring women’s attitudes, knowledge, and intentions to use oocyte freezing for non‐medical reasons: A systematic review

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