Fertility planning for women in medicine: a call for an active approach.

BACKGROUND

Women in medicine often delay childbearing due to the competing priorities of training, finding a partner, and waiting for the "right time." Unfortunately, the steep decline in female fertility during a woman's mid to late 30s also often coincides with the completion of residency and/or fellowship training. Data show that women in medicine elect to have children later in life and that at least 1 in 4 female physicians suffer from infertility, a higher rate than in nonphysicians. It is essential to escalate the dialogue regarding family planning for female physicians and trainees.

OBJECTIVE

In this review, we discuss markers currently used to evaluate ovarian reserve, including anti-Müllerian hormone. We also discuss common methods for fertility preservation, including egg/oocyte and embryo cryopreservation, and unique logistical challenges this population faces in family planning.

METHODS

Narrative review of literature regarding fertility, markers of ovarian reserve, fertility preservation options, and family-planning challenges, particularly pertaining to the population of women in medicine.

RESULTS

Women in medicine experience higher rates of infertility compared with the general population and frequently delay childbearing due to training and career demands.

LIMITATIONS: This is a narrative review and is limited by the available published literature, including a relative paucity of data surrounding fertility and fertility preservation outcomes among female physicians and trainees.

CONCLUSIONS

Women in medicine must be viewed as a critical at-risk population for infertility with unique and multifactorial family-building challenges. This underrecognized group deserves heightened attention, with a special emphasis on the key elements of education, mentorship, and support.