Putting numbers behind the anecdotes: infertility and pregnancy complications among physicians and medical students

In this study, we assessed the prevalence of infertility, miscarriage, and pregnancy complications among women US physicians and medical students. Using a cross-sectional study design, an electronic questionnaire was administered to physicians and trainees from April-May 2021. Participants were recruited through social media and professional email listservs. The survey included questions regarding their prior pregnancies and complications such as preterm birth, NICU admission and postpartum depression, fertility choices, and general demographic data. Inclusion criteria for this analysis were those assigned female sex at birth. Subanalysis was completed on those with at least one prior pregnancy. There were 3079 female respondents with 50.9% (n=1566) reporting at least one prior pregnancy. The prevalence of infertility among all female respondents was 23.3% (n=716), and 11.7% (n=84) utilized assisted reproductive technology (ART). Among those who had been pregnant (n=1566, 50.9 %), mean gravidity was 2.5 ± 1.5 and mean parity was 1.6 ± 1. Mean age at first pregnancy was 30.1 ± 5.0 years. Respondents reported their first pregnancy occurred at the following point in their career: independent practice (n=506, 32.7%), residency (n=480, 30.6%), medical school (n= 232, 15.0%), fellowship (n=171, 11.0%), or before medical school (n=151, 9.7%). Among those with a prior pregnancy, 69.7% (n=1092) experienced a pregnancy complication. 38.9% (n=609) experienced at least one miscarriage. The other most commonly reported pregnancy complications included cesarean delivery for any reason (24.6%), sciatica (16.5%), postpartum depression (16.0%) preterm delivery (14.7%), NICU admission (10.0%), hypertensive disorder of pregnancy (10.5%), and hyperemesis (10.0%). This large survey of female physicians and trainees highlights the complexities of family building and pregnancy for this group. The prevalence of infertility in this study was 23.3%, and ART was utilized by approximately 12% of those individuals. Almost 40% of respondents with prior pregnancies experienced a miscarriage and almost 70% reported any pregnancy complication.