title: Does a surgical career affect a woman's childbearing and fertility? A report on pregnancy and fertility trends among female surgeons.
abstract: BACKGROUND
  Increases in pregnancy complication rates and use of assisted reproductive technology (ART) have been demonstrated in female urologists and orthopaedic surgeons when compared with the general US population. To determine if childbearing differences exist across specialties, we evaluated female surgeons in all fields, particularly with regard to fertility.
  
  
  METHODS
  An anonymous, 199-item survey was distributed via specialty female surgeon interest groups and word of mouth to general surgery, gynecology, neurosurgery, ophthalmology, orthopaedics, otolaryngology, plastic surgery, podiatry, and urology. The 1,021 responses were analyzed and compared with Centers for Disease Control National Survey for Family Growth and National Institute of Health data to identify differences between populations.
  
  
  RESULTS
  Of women surgeons, 32% reported fertility difficulty; 84% of whom underwent infertility workup. Seventy-six percent of these women used ART to attempt pregnancy. In comparison, only 10.9% of women in the general US population report infertility, and 11% seek infertility services. Of all babies born to female surgeons, at least 13% were conceived using ART. Surgeons had 1.4 biological children, less than the national average. Age at first pregnancy was 33 years, compared with a national average of 23. If ART was implemented, surgeon age at first birth increased to 35.4 years. Highest rates of infertility existed in otolaryngology (29%), general surgery (22%), and orthopaedics (18%).
  
  
  CONCLUSIONS
  Female surgeons have first pregnancies later in life, fewer children, and report more issues with infertility. Assisted reproductive technology is implemented more often by female surgeons than the general population. Differences in fertility exist between specialties and warrant additional study.
authors.affiliation: Department of Urology, Boston Medical Center, Boston, MA. Electronic address: elizabeth.phillips@bmc.org.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Phillips
authors.affiliation: Department of Surgery, VA Boston Healthcare System, Boston, MA.
authors.forename: Tony
authors.initials: T
authors.lastname: Nimeh
authors.affiliation: Department of Obstetrics and Gynecology, Dartmouth Hitchcock, Lebanon, NH.
authors.forename: Julie
authors.initials: J
authors.lastname: Braga
authors.affiliation: Department of Surgery, VA Boston Healthcare System, Boston, MA.
authors.forename: Lori B
authors.initials: LB
authors.lastname: Lerner
mesh_terms: D000328:Adult; D002321:Career Choice; D005260:Female; D006306:Health Surveys; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000209:etiology*; D016014:Linear Models; D008875:Middle Aged; D011247:Pregnancy / Q000706:statistics & numerical data*; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D066231:Surgeons / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology