title: Fertility Awareness Counseling for Adolescent Girls; Guiding Conception: The Right Time, Right Weight, and Right Way.
abstract: OBJECTIVE
  To provide a detailed summary of fertility awareness counseling pearls for healthy teens and those with fertility-relevant comorbidities, and to assist providers in offering such counseling to adolescents and young adult women. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Comprehensive literature review of English-language studies relating to fertility in pediatric and adolescent female patients (ages 13-21 years), and evidence-based dialogue guide.
  
  
  RESULTS
  The literature indicates that although adolescents are interested in discussing sexuality and reproduction, this is commonly overlooked during the standard office medical visit. As a result, adolescents often turn to less reliable sources and hold a variety of reproductive misconceptions and a sense of lack of control over future fertility. We found no studies that examined the routine provision of fertility awareness counseling with healthy adolescents. There are a multitude of specific gynecologic and medical conditions that have ramifications for fertility. We detail these comprehensively, and provide a dialogue guide to assist with fertility awareness counseling for the female adolescent, containing specific information and indications for referral.
  
  
  CONCLUSIONS
  Providers caring for adolescent girls have the opportunity to enhance fertility awareness as part of a larger reproductive health conversation that adolescents desire, and from which they might benefit. Identifying potential future fertility issues, understanding age-related fertility decline, and aiding in health optimization before future conception might empower the adolescent to make informed reproductive decisions. We provide an algorithm to use with adolescents to discuss the "right time, right weight, right way" to pursue childbearing.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: rkudesia@rmany.com.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Kudesia
authors.affiliation: Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Hina J
authors.initials: HJ
authors.lastname: Talib
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Staci E
authors.initials: SE
authors.lastname: Pollack
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D001835:Body Weight; D003376:Counseling; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D005298:Fertility; D006801:Humans; D060728:Reproductive Health; D012725:Sexual Behavior / Q000523:psychology; D055815:Young Adult
keywords: Adolescents; Fertility; Fertility awareness; Gynecology; Menstrual disorders