Understanding Patient Perspectives on Fertility Counseling During Annual Generalist Obstetrics and Gynecology Visits: A Survey-Based Study.

Women are increasingly delaying childbearing and utilizing assisted reproductive technology to achieve pregnancy. As the demand for reproductive endocrinology and infertility (REI) care increases, there is potential for sharing responsibility for fertility counseling and care with generalist obstetrics and gynecology physicians (OB/GYNs). The American College of Obstetrics and Gynecology (ACOG) recommends discussing reproductive plans during annual visits; however there are concerns about the feasibility of guideline implementation due to the comprehensive nature of these visits. The purpose of this study was to explore whether OB/GYN generalists at our outpatient clinic are addressing patients' needs for fertility counseling. An Institutional Review Board (IRB)-approved electronic survey was distributed by Quick Response (QR) code on exam room posters at our clinic between April 1 and August 30, 2024 with a $5.00 gift card incentive. Of the 166 patients who met inclusion criteria, the minority of patients (33%) responded "yes" when asked, "In the last two years, did you discuss your fertility with an OB/GYN at an annual/routine visit?" Those who had not discussed their fertility with their OB/GYN were significantly more likely to be under age 32 than 32 or older (80% vs. 20%). The majority of patients (64%) who had not discussed fertility responded "yes" when asked "Would you like to discuss fertility at annual visits?" These findings suggest that generalist OB/GYNs may not be meeting the needs of patients, particularly younger patients, who desire fertility counseling. Concerningly many patients are obtaining information on fertility from sources other than their clinicians.