OB-GYNs are uncomfortable counseling their patients on fertility, study shows

Reviewed by James Ives, M.Psych. (Editor)Sep 5 2019

A new study shows that many OB-GYNs are uncomfortable counseling their patients on fertility at a time when more women are delaying pregnancy and needing their doctors to be more vigilant about this education.

"We found that most OB-GYNs don't bring up fertility with every patient, often because they believe the patient would bring it up if she wanted to discuss it," said Rashmi Kudesia, M.D., reproductive endocrinology and infertility specialist at Houston Methodist and CCRM Houston and lead author on the study, published in The Journal of Reproductive Medicine. "It's a missed opportunity when OB-GYNs don't start the conversation because many women are routinely exposed to conflicting information about fertility, leading many to believe that they'll have no issues conceiving and delivering."

In fact, 82% of OB-GYNs surveyed believe women receive mixed messages about their optimal fertility window, and 68% said women seem to believe they can indefinitely postpone making childbearing plans.

It isn't unusual for women to believe that assisted reproductive technologies like IVF are their safety net because they hear so many success stories. The reality is that IVF only has a 5% success rate for women in their mid-40s."

Rashmi Kudesia, M.D., reproductive endocrinology and infertility specialist at Houston Methodist

Kudesia and her co-authors found that OB-GYNs were more likely to provide fertility counseling to married women between the ages of 27-40. For all age groups, single and lesbian women were less likely to receive fertility counseling than married women. It was also found that the 117 physicians who participated provided more counseling on contraception than fertility in nearly all age and relationship status groups.

"The results tell me that regardless of current relationship status or future plans for pregnancy, women need to bring up fertility at their next well-woman exam or ask for a referral to a fertility specialist," Kudesia said. "Women who want to wait several years and even those who think they don't want kids at all should still talk to their doctor about fertility so that they can make an informed decision about what is best for them."

Kudesia collaborated with Hina J. Talib, M.D., and Staci E. Pollack, M.D., from the Albert Einstein College of Medicine. A copy of the study is available upon request.

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