title: Knowledge, attitudes, and intentions toward fertility awareness and oocyte cryopreservation among obstetrics and gynecology resident physicians.
abstract: OBJECTIVE
  What knowledge, attitudes and intentions do US obstetrics and gynecology (OB/GYN) residents have toward discussing age-related fertility decline and oocyte cryopreservation with their patients?
  
  
  CONCLUSIONS
  Most OB/GYN residents believe that age-related fertility decline, but not oocyte cryopreservation, should be discussed during well-woman annual exams; furthermore, nearly half of residents overestimated the age at which female fertility markedly declines.
  
  
  BACKGROUND
  Oocyte cryopreservation can be utilized to preserve fertility potential. Currently, no studies of US OB/GYN residents exist that question their knowledge, attitudes, and intentions toward discussing age-related fertility decline and oocyte cryopreservation with patients.
  
  
  METHODS
  A cross-sectional online survey was conducted during the fall of 2014 among residents in American Council for Graduate (ACOG) Medical Education-approved OB/GYN residency programs. Program directors were emailed via the ACOG Council on Resident Education in Obstetrics and Gynecology server listing and asked to solicit resident participation.
  
  
  METHODS
  Participants included 238 residents evenly distributed between post-graduate years 1-4 with varied post-residency plans; 90% of residents were women and 75% were 26-30 years old. The survey was divided into three sections: demographics, fertility awareness, and attitudes toward discussing fertility preservation options with patients. Descriptive and inferential statistics were conducted.
  
  
  RESULTS
  A strong majority of residents (83%) believed an OB/GYN should initiate discussions about age-related fertility decline with patients (mean patient age 31.8), and 73% percent believed these discussions should be part of an annual exam. One third of residents overestimated the age at which there is a slight decline in female fertility, while nearly half of residents overestimated the age at which female fertility markedly declines. Over three-quarters of residents (78.4%) also overestimated the likelihood of success using assisted reproductive treatments (ARTs). Residents were likely to support oocyte cryopreservation in cancer patients irrespective of the woman's age, but much less likely to support elective oocyte cryopreservation. For elective oocyte cryopreservation, 40% believed OB/GYNs should initiate discussions with patients (mean age 31.1), while only 20% believed this topic should be part of an annual exam.
  
  
  CONCLUSIONS
  Because the study invitation was sent through US OB/GYN residency program directors rather than directly to residents, it is possible that some residents did not receive the invitation to participate. This limits the generalizability of the findings.
  
  
  CONCLUSIONS
  Within the USA, there appears to be a critical need for improved education on fertility decline in OB/GYN residency programs. To promote informed reproductive decision-making among patients, efforts should be made to help OB/GYNs provide comprehensive fertility education to all women, while also respecting patient choices.
  
  
  BACKGROUND
  None.
authors.affiliation: Yale University School of Medicine, Obstetrics Gynecology and Reproductive Sciences, New Haven, CT, USA.
authors.forename: L
authors.initials: L
authors.lastname: Yu
authors.affiliation: Chapman University, Crean College of Health and Behavioral Sciences, Orange, CA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Peterson
authors.affiliation: Department of Anthropology, Yale University, New Haven, CT, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Inhorn
authors.affiliation: Department of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA, USA.
authors.forename: J K
authors.initials: JK
authors.lastname: Boehm
authors.affiliation: Yale University School of Medicine, Obstetrics Gynecology and Reproductive Sciences, New Haven, CT, USA Yale University Fertility Center, New Haven, CT, USA pasquale.patrizio@yale.edu.
authors.forename: P
authors.initials: P
authors.lastname: Patrizio
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D015925:Cryopreservation; D005260:Female; D059247:Fertility Preservation / Q000523:psychology; D006176:Gynecology / Q000193:education; D006801:Humans; D007247:Infertility, Female / Q000523:psychology*; D033182:Intention; D007396:Internship and Residency; D009774:Obstetrics / Q000193:education; D009865:Oocytes; D010820:Physicians / Q000523:psychology*; D014481:United States
keywords: age-related fertility decline; elective oocyte cryopreservation; fertility awareness; fertility preservation; medical oocyte cryopreservation; obstetrics and gynecology residents; oocyte storage; ovarian aging; physicians; reproductive health education