Many medical trainees report delaying childbearing, express interest in fertility preservation

Key takeaways:

• Women trainees were more likely to report fertility concerns and less likely to have children during training.
• Medical trainees reported an interest in cryopreservation, but uncertainty about coverage options.

DENVER — In a survey of U.S. medical trainees, many respondents reported concerns about their or their partner’s future fertility and expressed interest in oocyte cryopreservation, but were unaware of available treatment options.

The average age of first-time parents has increased from 24.9 years in 2000 to 27.3 years in 2022, Rachel Nelson, MD, MS, PhD, a third-year resident in the department of obstetrics and gynecology at the University of Tennessee College of Medicine, said during a presentation at the ASRM Scientific Congress & Expo. The reasons for this are multifactorial, Nelson said, and include personal and interpersonal factors, economic factors, and health and fertility factors.

In 2019, the average ave of new medical students was 29 years. Nelson and colleagues aimed to evaluate knowledge and opinions about infertility, fertility-related care and barriers to care among medical trainees in the U.S. The researchers distributed an anonymous, cross-sectional online survey to 395 medical students, residents and fellows (80.3% women; 50% residents; 36% located in Southeast U.S.). Seventy-eight percent of respondents were aged 26 to 35 years.

More than half of respondents (62.6%) cited concerns regarding their or their partner’s future fertility. Women more likely to report concern about their or their partner’s future fertility (86.2% vs. 13%; P = .000087). Concern about future fertility was not associated with age or training level, according to the results.

Medical trainees were more likely to delay childbearing than their training. Sixty-two percent of medical trainees reported delaying childbearing due to medical training while 1.5% reported delaying medical training to start a family, according to the results. Men were more likely than women to have children during medical training (P = .0114), but were equally likely to delay childbearing, Nelson said.

Most respondents (96.2%) reported awareness of elective oocyte cryopreservation, or egg freezing, and 52.7% reported wanting more information on cryopreservation options for future fertility.

Most respondents were unaware of their fertility benefits, according to the researchers. Twenty-seven percent of respondents were unsure if they had access to a local reproductive endocrinologist and 73.1% were unsure if their residential state mandates infertility coverage via insurance benefits, according to the results.

Only 6.8% of respondents reported undergoing cryopreservation, of whom 88.9% reported that the decision was influenced by their medical training and career. In addition, 42.6% of respondents considering cryopreservation, of whom 94.6% reported that their medical education and training influenced their decision.

Most respondents (78.3%) reported being more likely to consider cryopreservation as an option if it were offered by employers and 86.2% answered that residency programs should provide insurance coverage for elective cryopreservation.

In other results, “a majority of respondents are in support of graduate medical education-sponsored fertility preservation and would be more likely to undergo fertility treatment if offered through employer-sponsored insurance,” Nelson said during the presentation.

A strength of these data is that the survey was not restricted by sex, level of training, specialty or geographic location, according to the researchers. Nelson said future directions might include surveying trainees and program directors to compare responses from programs with and without cryopreservation benefits; comparing responses in surgical subspecialties and nonsurgical specialties; and exploring avenues for advocacy through platforms highly utilized by medical trainees.