Are OB/GYN’s educated about Infertility
Posted on May 3, 2023
Are OB/GYN’s educated about Infertility?
Many women visit general OB/GYN’s believing those who help deliver babies, are also trained to address infertility, or delaying pregnancy. When patients are not correctly evaluated, or counseled in a timely manner they may risk never becoming a mother/father.
A cross-sectional survey of fertility knowledge in obstetrics and gynecology residents
Background: To evaluate fertility knowledge among current Obstetrics and Gynecology (OB-GYN) residents using a recently published validated instrument, the Fertility and Infertility Treatment Knowledge Score (FIT-KS).
Methods: OB-GYN residents in the United States were recruited through an email to all residency coordinators nationwide. They were asked to voluntarily respond to a short questionnaire including demographic information and the FIT-KS instrument, through an online survey platform. Of approximately 5000 OB-GYN residents in the country, 177 responded.
Results: The sample was 91% female, with 69% between the ages of 26 and 30. Participants evenly represented all 4 years of training. Mean FIT-KS score was 21.2 (73% correct; range 17–26). No statistically significant differences were noted across the level of training. Several knowledge gaps were noted. Residents could define the common assisted reproductive technologies; however overestimated their success rates per cycle.
Conclusions: Substantial gaps exist in fertility knowledge among OB-GYN residents, with understanding of male fertility and success rates of Assisted Reproductive Technologies (ART) being particularly limited. Knowledge of fertility does not change throughout residency training, demonstrating consistent gaps in fertility knowledge. Knowledge during post graduate year (PGY)-1 year is consistent with mean scores found in prior research in Internal Medicine residents (65%), as well as a cohort of female medical students and obstetrics and gynecology residents and fellows (64.9%) (Fertil Steril 108:711-7, 2017; Fertil Steril 110:e239, 2018).
Discussion
Substantial gaps exist in fertility knowledge among OB- GYN residents. Without a strong understanding of this topic, they may not be prepared to properly counsel patients and have family planning discussions during routine visits, an essential part of well woman care. Our findings should be viewed by residency program direc- tors as a starting place to encourage more exploration of this gap in knowledge in their own programs.
Knowledge of fertility does not change throughout residency training, with this study demonstrating consistent gaps in fertility knowledge. Knowledge during residency is only slightly higher than mean scores found in prior research in Internal Medicine residents (65%), as well as a cohort of female medical students and obstetrics and gynecology residents and fellows (64.9%). In prior studies, the median score for reproductive-aged women was 16/29 (55.2%) and in medical trainees the median score was 19/29 (65.5%). Lack of time dedicated to education on this topic during both medical school and residency may be con- tributing to the patterns seen in physicians’ childbearing choices. This may also cause insufficient counseling and engagement of patients on family planning choices. Less than a quarter of reproductive-aged women have had discussions regarding reproductive health with their health care providers. Although it is encouraging that the majority of residents stated that they discuss fertility with their patients, and the majority feel comfortable having this discussion, it remains concerning that several key areas of misinformation were identified, particularly regarding the overestimation of ART success rates.
As women choose to delay childbearing, they will increasingly rely on ART, and should be sufficiently counseled on success rates that also decrease with aging. In this study, there was a large overestimation of success of IVF after the age of 44. The misconception that ART can be used successfully with a couple’s own genetic material to compensate for the natural decline of fertility with aging should be counteracted by consistent discussion well before women reach the natural limits of their reproductive capacities. In order for gynecologists to lead these conversations with their future patients, they must receive adequate training on fertility counseling during training.
Conclusion
Knowledge of age related fertility decline among obstet- rics and gynecology residents is limited. Misconceptions about natural fertility, risk factors, and success of treat- ments may significantly affect the lives of both physi- cians and the patients they treat.
Keywords: Fertility, Fertility awareness, Infertility, Medical education, Residency education
Citation:
Roberts LM, Kudesia R, Zhao H, Dolan S, Rose M. A cross-sectional survey of fertility knowledge in obstetrics and gynecology residents. Fertil Res Pract. 2020;6(1):22. Published 2020 Dec 9. doi:10.1186/s40738-020-00091-2
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