Fertility planning for women in medicine: a call for an active approach

Background: Women in medicine often delay childbearing due to the competing priorities of training, finding a partner, and waiting for the "right time." Unfortunately, the steep decline in female fertility during a woman's mid to late 30s also often coincides with the completion of residency and/or fellowship training. Data show that women in medicine elect to have children later in life and that at least 1 in 4 female physicians suffer from infertility, a higher rate than in nonphysicians. It is essential to escalate the dialogue regarding family planning for female physicians and trainees. Objective: In this review, we discuss markers currently used to evaluate ovarian reserve, including anti-Müllerian hormone. We also discuss common methods for fertility preservation, including egg/oocyte and embryo cryopreservation, and unique logistical challenges this population faces in family planning. Methods: Narrative review of literature regarding fertility, markers of ovarian reserve, fertility preservation options, and family-planning challenges, particularly pertaining to the population of women in medicine. Results: Women in medicine experience higher rates of infertility compared with the general population and frequently delay childbearing due to training and career demands. Limitations: This is a narrative review and is limited by the available published literature, including a relative paucity of data surrounding fertility and fertility preservation outcomes among female physicians and trainees. Conclusions: Women in medicine must be viewed as a critical at-risk population for infertility with unique and multifactorial family-building challenges. This underrecognized group deserves heightened attention, with a special emphasis on the key elements of education, mentorship, and support.