Factors Affecting Family Planning and Fertility Preservation Decisions among US General Surgery Residents: A Nationwide Survey

Zheng, C.; Wo, L.; Eidelson, S. A.; Mouhanna, J.; Bussies, P.; Moller, M. G.

Introduction: General surgery trainees (GSTs) spend their prime fertility years in training. As more women enter the surgical workforce, family planning and fertility preservation considerations are of utmost relevance. The needs of fertility preservation/treatment and factors contributing to family planning decisions are unknown. This study aimed to examine potential barriers to family planning/childbearing among US GSTs. Methods: We composed and distributed a 26-question survey to all general surgery and fellowship program directors nationwide to survey GSTs. Summary and descriptive statistics were tabulated and categorical variables were analyzed using Pearson’s chi-square test or Fisher’s exact test. Results: A total of 234 US GSTs completed the survey (male 32.1%, female 66.2%, unreported 1.7%). Average age of respondents was 32.3 years. Trainee work hours (p=0.007) and female gender (p=0.002) were found to be associated with delay of childbirth. More women trainees reported having considered fertility preservation (p<0.001). Of those who answered questions regarding prohibitive factors for childbearing (n=74), balancing time (93.2%), career/education goals (63%), and cost (59.5%) were the most commonly reported prohibitive factors. More female trainees reported time (p=0.021) and career/education goals (p=0.001) as “moderately prohibitive” or “very prohibitive” compared with their male counterparts. In addition, 9% of trainees reported that their family planning was affected by the COVID pandemic. Conclusion: Balancing time and career goals are more prohibitive factors for childbearing among female GST. Institutional resources should tailor to gender-specific needs and address barriers to family planning, fertility treatment, and childbearing during surgery training. [Formula presented]