Skip to main content
Top
Published in: Journal of Assisted Reproduction and Genetics 9/2018

01-09-2018 | Fertility Preservation

Counseling patients on reproductive aging and elective fertility preservation—a survey of obstetricians and gynecologists’ experience, approach, and knowledge

Authors: Rani Fritz, Susan Klugman, Harry Lieman, Jay Schulkin, Laura Taouk, Neko Castleberry, Erkan Buyuk

Published in: Journal of Assisted Reproduction and Genetics | Issue 9/2018

Login to get access

Abstract

Purpose

What are the experience, approach, and knowledge of US Obstetricians and Gynecologists’ (ob-gyn) towards counseling patients on reproductive aging (RA) and elective fertility preservation (EFP).

Methods

A cross-sectional survey emailed by the American College of Obstetricians and Gynecologists (ACOG) to 5000 ACOG fellows consisting of 9 demographic and 28 questions relating to counseling patients on RA and EFP.

Results

Seven hundred and eighty-four responders completed the survey. Although 82.8% agreed that conversations relating to RA should take place with patients desiring future childbearing and delaying due to social reasons, only 27.6% stated that they frequently counsel these women aged 18–34 years old, compared to 75.8% aged 35–44 years old (P < 0.01). Limited time (75.8%) and limited knowledge (41.4%) were amongst the most frequent reported barriers towards counseling patients on RA. Fifty-eight percent stated that they have been asked about EFP by patients. Although 74.8% agreed that conversations should take place related to EFP in women desiring future childbearing and delaying due to social reasons, only 27.6% stated that they frequently counsel these patients on EFP (P < 0.01). Limited time (75%) and limited knowledge (59.9%) were amongst the most frequent barriers towards counseling on EFP.

Conclusions

In the USA, methods to improve patient counseling and provider knowledge on RA and EFP are warranted and further studies are needed to address optimal methods to improve counseling and knowledge related to these topics.
Appendix
Available only for authorised users
Literature
1.
go back to reference Block E. Quantitative morphological investigations of the follicular system in women; variations at different ages. Acta Anat (Basel). 1952;14(1–2):108–23.CrossRef Block E. Quantitative morphological investigations of the follicular system in women; variations at different ages. Acta Anat (Basel). 1952;14(1–2):108–23.CrossRef
2.
go back to reference Baker TG. A quantitative and cytological study of germ cells in human ovaries. Proc R Soc Lond B Biol Sci. 1963;158:417–33.CrossRefPubMed Baker TG. A quantitative and cytological study of germ cells in human ovaries. Proc R Soc Lond B Biol Sci. 1963;158:417–33.CrossRefPubMed
4.
go back to reference Martin JA, Hamilton BE, Osterman MJ, Driscoll AK, Mathews TJ. Births: final data for 2015. Natl Vital Stat Rep. 2017;66(1):1.PubMed Martin JA, Hamilton BE, Osterman MJ, Driscoll AK, Mathews TJ. Births: final data for 2015. Natl Vital Stat Rep. 2017;66(1):1.PubMed
6.
go back to reference Heck KE, Schoendorf KC, Ventura SJ, Kiely JL. Delayed childbearing by education level in the United States, 1969-1994. Matern Child Health J. 1997;1(2):81–8.CrossRefPubMed Heck KE, Schoendorf KC, Ventura SJ, Kiely JL. Delayed childbearing by education level in the United States, 1969-1994. Matern Child Health J. 1997;1(2):81–8.CrossRefPubMed
7.
go back to reference Hammarberg K, Clarke VE. Reasons for delaying childbearing--a survey of women aged over 35 years seeking assisted reproductive technology. Aust Fam Physician. 2005;34(3):187–8. 206PubMed Hammarberg K, Clarke VE. Reasons for delaying childbearing--a survey of women aged over 35 years seeking assisted reproductive technology. Aust Fam Physician. 2005;34(3):187–8. 206PubMed
16.
go back to reference Cobo A, Rubio C, Gerli S, Ruiz A, Pellicer A, Remohi J. Use of fluorescence in situ hybridization to assess the chromosomal status of embryos obtained from cryopreserved oocytes. Fertil Steril. 2001;75(2):354–60.CrossRefPubMed Cobo A, Rubio C, Gerli S, Ruiz A, Pellicer A, Remohi J. Use of fluorescence in situ hybridization to assess the chromosomal status of embryos obtained from cryopreserved oocytes. Fertil Steril. 2001;75(2):354–60.CrossRefPubMed
17.
go back to reference Noyes N, Porcu E, Borini A. Over 900 oocyte cryopreservation babies born with no apparent increase in congenital anomalies. Reprod BioMed Online. 2009;18(6):769–76.CrossRefPubMed Noyes N, Porcu E, Borini A. Over 900 oocyte cryopreservation babies born with no apparent increase in congenital anomalies. Reprod BioMed Online. 2009;18(6):769–76.CrossRefPubMed
20.
go back to reference Chian RC, Huang JY, Tan SL, Lucena E, Saa A, Rojas A, et al. Obstetric and perinatal outcome in 200 infants conceived from vitrified oocytes. Reprod BioMed Online. 2008;16(5):608–10.CrossRefPubMed Chian RC, Huang JY, Tan SL, Lucena E, Saa A, Rojas A, et al. Obstetric and perinatal outcome in 200 infants conceived from vitrified oocytes. Reprod BioMed Online. 2008;16(5):608–10.CrossRefPubMed
31.
go back to reference Howe G, Westhoff C, Vessey M, Yeates D. Effects of age, cigarette smoking, and other factors on fertility: findings in a large prospective study. Br Med J (Clin Res Ed). 1985;290(6483):1697–700.CrossRef Howe G, Westhoff C, Vessey M, Yeates D. Effects of age, cigarette smoking, and other factors on fertility: findings in a large prospective study. Br Med J (Clin Res Ed). 1985;290(6483):1697–700.CrossRef
32.
go back to reference Stovall DW, Toma SK, Hammond MG, Talbert LM. The effect of age on female fecundity. Obstet Gynecol. 1991;77(1):33–6.PubMed Stovall DW, Toma SK, Hammond MG, Talbert LM. The effect of age on female fecundity. Obstet Gynecol. 1991;77(1):33–6.PubMed
33.
go back to reference Maroulis G. Effects of aging on fertility and pregnancy. Seminars in Reproductive Aging. 9(3):165–74. Maroulis G. Effects of aging on fertility and pregnancy. Seminars in Reproductive Aging. 9(3):165–74.
36.
go back to reference Dunson DB, Colombo B, Baird DD. Changes with age in the level and duration of fertility in the menstrual cycle. Hum Reprod. 2002;17(5):1399–403.CrossRefPubMed Dunson DB, Colombo B, Baird DD. Changes with age in the level and duration of fertility in the menstrual cycle. Hum Reprod. 2002;17(5):1399–403.CrossRefPubMed
38.
go back to reference Cramer DW, Xu H, Harlow BL. Family history as a predictor of early menopause. Fertil Steril. 1995;64(4):740–5.CrossRefPubMed Cramer DW, Xu H, Harlow BL. Family history as a predictor of early menopause. Fertil Steril. 1995;64(4):740–5.CrossRefPubMed
40.
go back to reference Augood C, Duckitt K, Templeton AA. Smoking and female infertility: a systematic review and meta-analysis. Hum Reprod. 1998;13(6):1532–9.CrossRefPubMed Augood C, Duckitt K, Templeton AA. Smoking and female infertility: a systematic review and meta-analysis. Hum Reprod. 1998;13(6):1532–9.CrossRefPubMed
41.
go back to reference Barnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization. Fertil Steril. 2002;77(6):1148–55.CrossRefPubMed Barnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization. Fertil Steril. 2002;77(6):1148–55.CrossRefPubMed
46.
go back to reference Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M. Maternal age and fetal loss: population based register linkage study. BMJ. 2000;320(7251):1708–12.CrossRefPubMed Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M. Maternal age and fetal loss: population based register linkage study. BMJ. 2000;320(7251):1708–12.CrossRefPubMed
Metadata
Title
Counseling patients on reproductive aging and elective fertility preservation—a survey of obstetricians and gynecologists’ experience, approach, and knowledge
Authors
Rani Fritz
Susan Klugman
Harry Lieman
Jay Schulkin
Laura Taouk
Neko Castleberry
Erkan Buyuk
Publication date
01-09-2018
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 9/2018
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-018-1273-7

Other articles of this Issue 9/2018

Journal of Assisted Reproduction and Genetics 9/2018 Go to the issue