Anxiety, attitudes, and education about fertility among medical students in the United States.

BACKGROUND: As delayed family building is common among physicians, the goal of this study was to evaluate childbearing plans, anxiety related to future fertility, and interest in fertility education among medical students. METHODS: Using convenience and snowball sampling methods, an electronic REDCap survey was distributed via social media and group messaging applications to medical students enrolled in medical schools across the United States. Answers were collected, and analysis of the descriptive statistics was performed. RESULTS: The survey was completed by 175 participants, 72% of which were female (assigned at birth). The mean (± SD) age of participants was 24.9 ± 1.9 years. Of all participants, 78.3% desire to have children and 65.1% of these individuals plan to delay childbearing. On average, the planned age of first pregnancy is 31.0 ± 2.3 years. "Lack of time" was the greatest influence on decision regarding timing of childbearing. Of all respondents, 58.9% reported at least some anxiety related to future fertility. When females and males were compared, significantly more females (73.8%) versus males (20.4%) reported worrying about future fertility (p < 0.001). Participants reported that greater knowledge about infertility and potential treatments would help ease fertility related anxiety, and 66.9% of respondents showed interest in learning about how things such as age and lifestyle can impact fertility, preferably through medical curricula, videos, and podcasts. CONCLUSION: A majority of the medical students in this cohort intend to have children and most plan to delay childbearing. A large percentage of female medical students reported anxiety related to future fertility, but many students showed interest in receiving fertility education. This study highlights an opportunity for medical school educators to incorporate targeted fertility education into their curriculum with the intention of decreasing anxiety and improving future reproductive success.

Undergraduate students have low fertility knowledge and high anxiety regarding future fertility: An opportunity for education.

Objectives: To assess childbearing intentions, concerns about future fertility, knowledge about the age-related decline in fertility, and interest in receiving fertility education among undergraduate students. Design: From March to April 2021, a cross-sectional, web-based survey with 42 reproductive and fertility-related questions was administered to and completed by actively enrolled undergraduates at Northwestern University in the United States. Results: The survey was completed by 291 students (mean age 20.2 years). Of all participants, 62.5% plan to have children and 68.3% intend to delay childbearing. Significantly more females than males (70.7% vs 40.9%, P = 0.004) and premedical students compared to non-premedical students (78.2% vs 60.1%, P = 0.002) reported planning to delay childbearing due to educational or career aspirations. Significantly more females than males (43.5% vs 4.5%, P < 0.001) and premedical compared to non-premedical students (50.4% vs 31.5%, P = 0.002) also reported having anxiety about future fertility due to career aspirations.When surveyed about fertility knowledge, 31.1% of participants reported that females are as fertile in their forties as they are in their thirties, and 25.4% stated that female fertility does not dramatically decline until age 40 or later. When asked to estimate the oldest age a woman has conceived using autologous oocytes, 83.3% reported age 48 or older. Of all participants, 72.3% were interested in learning about fertility. Conclusions: The majority of surveyed undergraduates plan to delay childbearing, yet they have concerns about how career goals will impact future fertility. Notably, females and premedical students reported higher rates of anxiety when compared to their male and non-premedical counterparts. Knowledge about the age-related decline in fertility was limited, but students have a strong interest in learning about fertility, highlighting an opportunity for educational intervention at the undergraduate level. With education, students may be empowered to make informed decisions about future reproductive strategy earlier in time, potentially decreasing future anxiety.