Demographics and fertility knowledge (Table One)
There were 177 residents who responded to the survey. Of these, 166 completed all questions in the survey. The other 11 residents opened the study, but did not complete all questions. The demographics of those who opened but did not complete all questions were consistent with the other responses from the survey per analysis by our statistician, and they were excluded from the final analysis.
Ninety-one percent of respondents were female. Sixty-nine percent were between the ages of 26-30. They represented an equal distribution between all four levels of training, with 40, 47, 39 and 40 representing each year of study (n=166).
The difference in mean score of each year of study was not statistically significant. In total, the highest score available was 29. Post-graduate year (PGY)-1 residents received a mean score of 20.73 (71%), PGY-2 a mean score of 21.64 (75%), PGY-3 a mean score of 20.95 (72%), and PGY-4 a mean score of 21.23 (73%). Gender was also not a significant predictor of score: females’ average score was 21.20 (73%) and males’ average scores was 20.57 (71%). Age category also failed to predict score, with 26-30 scoring 21.08 (73%), 31-35 scoring 21.32 (74%), and 36-40 scoring 21.50 (74%) (p=0.23).
Thirty-three percent stated they were not concerned about their own future fertility, and level of concern did not predict average FIT-KS score; those unconcerned about future fertility had a mean score of 21.36 (74%), while those with concerns scored an average of 21.15 (73%) (p=0.57).
The majority of residents (158, 95%) stated that they had ever discussed fertility with their patients. Mean score of those who did discuss fertility was 21.21 (73%), compared to 21.60 (75%) for those who did not, p=0.69. One hundred and thirty-three (82%) stated that they felt comfortable discussing fertility with their patients, with a mean score of 21.29(73%), compared to 20.9 (72%) for those who did not feel comfortable discussing fertility with their patients, p=0.41. Seventeen respondents currently have children, with a mean score of 21.59 (74%), not significantly higher than those who did not at 21.18 (73%), p=0.45.
Table One: Demographics and FIT-KS Score
Demographics
|
Number
|
Mean FIT-KS Score
|
PGY1
|
40
|
20.73 (71%)
|
PGY2
|
47
|
21.64 (75%)
|
PGY3
|
39
|
20.95 (72%)
|
PGY4
|
40
|
21.23 (73%)
|
Gender
|
|
|
Male
|
13
|
20.57 (72%)
|
Female
|
153
|
21.20 (73%)
|
Age
|
|
|
26-30
|
114
|
21.08 (73%)
|
31-35
|
50
|
21.32 (74%)
|
36-40
|
2
|
21.50 (74%)
|
Gaps in Knowledge
Significant gaps in knowledge were noted (Table 2 and 3). Many answered incorrectly regarding fecundity, age of precipitous fertility decline, and In Vitro Fertilization (IVF) success rates. Fifty-nine percent incorrectly identified pregnancy rate per cycle for a woman under thirty-five years old under going in vitro fertilization. Forty-three percent did not know the average survival time of normal sperm in the female reproductive tract. Only 73% knew that the male partner’s age affected fertility, 48% knew that moderate alcohol consumption did not affect fertility, and 70% knew that using certain types of sexual lubricants affects fertility.
Table Two: Fertility Items
Fertility item
|
Underestimating
|
Correct
|
Overestimating
|
Age (y) of maximal fertility decline
|
|
35-39
|
|
Responses
|
8
|
121
|
37
|
Fecundability at age 30
|
|
20%
|
|
Responses
|
16
|
95
|
55
|
Fecundability at age 40
|
|
<5%
|
|
Responses
|
N/A
|
111
|
55
|
Miscarriage rate
|
|
16-25%
|
|
Responses
|
50
|
80
|
36
|
IVF success rate at under age 35
|
|
41-60%
|
|
Responses
|
80
|
62
|
18
|
IVF success rate at age 44
|
|
<5%
|
|
Responses
|
N/A
|
77
|
84
|
IVF twinning rate
|
|
21-35%
|
|
Responses
|
131***
|
27
|
3
|
Live birth per thawed egg after oocyte cryopreservation
|
|
<10%
|
|
Responses
|
N/A
|
8
|
155
|
Sperm survival time
|
|
3-5 days
|
|
Responses
|
71
|
93
|
2
|
** numbers may not add to total respondent population as some questions were left unanswered
***correct answer per latest SART data
Table Three: Risk Factors
Risk factor
|
Correct Answer
|
N (%) answering correctly
|
Smoking
|
TRUE
|
163 (98%)
|
Being underweight
|
TRUE
|
165 (99%)
|
Prior use of oral contraceptive pills
|
FALSE
|
163 (98%)
|
Gonorrhea or Chlamydia infection
|
TRUE
|
161 (97%)
|
Occasional caffeine intake
|
FALSE
|
154 (93%)
|
Obesity
|
TRUE
|
165 (99%)
|
Safely-conducted pregnancy termination
|
FALSE
|
162 (98%)
|
Using certain types of sexual lubricants
|
TRUE
|
116 (70%)
|
Moderate alcohol consumption
|
FALSE
|
79 (48%)
|
Male partner’s age
|
TRUE
|
122 (73%)
|