One-third of women oncologists experience infertility
Key takeaways:
- Twenty percent reported spending $30,000 or more on ART.
- More than half of oncologists who had experienced infertility felt fertility preservation could have been beneficial had it been available and affordable.
CHICAGO — One-third of women oncologists surveyed reported experiencing infertility, according to study results presented at ASCO Annual Meeting.
In addition, survey respondents reported feeling fertility preservation could have been helpful if it were available and affordable.
Rationale and methods
“The rate of infertility among female physicians is known to be higher than that of the general public, presumably because women are deciding to delay childbearing due to the demands of their training,” Emily MacDuffie, MD, a third-year resident physician in the department of radiation oncology at University of Pennsylvania, told Healio. “This is one piece of a large overall study where we aimed to get a sense of what the barriers are for family planning among oncologists at all career stages.”
Researchers designed a 39-question survey and gathered cross-sectional data on attitudes towards family planning and use of assisted reproductive technology.
They collected 1,003 responses from U.S. women oncologists at all career levels (81% attending/practicing physicians; 19% trainees) and across oncologic specialties, including surgery, medical, and radiation oncology.
Findings
Results showed 138 (32%) of survey respondents reported infertility requiring treatment. Among them, 9% reported no out-of-pocket expenses for assisted reproductive technology (ART), whereas 39% reported spending more than $10,000 and 20% reported spending $30,000 or more.
Researchers additionally found that 22% of women reported adverse effects from infertility treatment that led to missed work, and 25% experienced mental health concerns associated with infertility.
Six percent of attendings and 4% of trainees reported elective cryopreservation of eggs or embryos. Twenty-five attendings reported plans or desire to pursue fertility preservation in the future, of whom 76% reported feeling unsure about feasibility. Similarly, 72% of the 32 trainees who reported plans or desire to undergo fertility preservation were not confident that it would be feasible for them to do so.
A majority of trainees (73%) and practicing physicians (65%) reported feeling that fertility preservation should be discussed during medical training. More than half (58%) of trainees and 47% of attendings reported feeling fertility concerns negatively influenced their decision on when to start a family.
Overall, 21% of respondents reported feeling that ART could have benefited them. Of those who had previously experienced infertility, more than half (52%) felt fertility preservation could have been beneficial to them if available and affordable during medical training.
“The amount of money that individuals paid for fertility treatment was shocking. Forty percent of the study population that experienced infertility paid more than $10,000 and one-fifth paid more than $30,000 for fertility treatment” MacDuffie said.
Key takeaways
There are three main takeaways of the findings for oncologists, MacDuffie told Healio.
“For one, there is an education gap. Family building is not something that is discussed in medical school and it isn’t always discussed in residency training, either,” she said. “Much of the discussion is peer-to-peer. Given the lack of early and accurate education, fertility discussions are not necessarily happening for everyone. Individuals are not thinking about all options at an early time point when all options are still likely available.”
Medical schools could consider developing an abbreviated curriculum on the subject, MacDuffie said.
“The same can be said for residency,” she added. “Why not make it a requirement to discuss what a normal fertility timeline looks like compared with our training timeline? The fact that residents are at risk for infertility, given how much education they go through prior to residency, is something they should know and think about in order to make early decisions that are right for them.”
Another key takeaway is the need for economic support for women in medicine, according to MacDuffie.
“For example, we do not know what the insurance coverage is for fertility treatments, which can make or break the ability to build a family for those that desire biological children,” she said. “We also need a cultural shift. Many women delay parenthood because they don’t feel they can start a family while they are in training or in medical school.”
Institutions need to create an environment where women feel comfortable starting families whenever they would like, MacDuffie continued.
“The real solution comes from institutions taking a look at what they are requiring of their trainees and the types of policies that they have to allow families to be built at any time,” she said.
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MacDuffie E, et al. Abstract 11001. Presented at: ASCO Annual Meeting; June 2-6, 2023; Chicago.
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