ATTITUDES TOWARD FERTILITY PRESERVATION AMONGST MEDICAL TRAINEES IN STATES WITH RESTRICTIVE ABORTION LEGISLATION

Document Type

Conference Proceeding

Publication Date

7-1-2025

Publication Title

Fertil Steril

Abstract

BACKGROUND: On June 24, 2022, the United States Supreme Court issued the landmark Dobbs v. Jackson decision, which overturned the longstanding protections for abortion established by Roe v. Wade (1973). The nation subsequently saw an immediate impact on access to abortion-related care. 1-3 Furthermore, there was concern for downstream effects to other areas of reproductive care, namely IVF. 3-8 With the introduction of “personhood” laws, states like Alabama experienced immediate interruption to IVF services and face significant uncertainty for the future of ART. 4,5 There is little to no data regarding how recent legislative changes have affected medical trainees’ plans to pursue fertility preservation. OBJECTIVE: This study aims to compare rates of residents and fellows who plan to pursue fertility preservation in states with restrictive vs. non-restrictive abortion legislation. MATERIALS & METHODS: This study utilized an anonymous online survey of residents and fellows within the United States. The survey consisted of multiple choice (with some questions allowing multiple selections) addressing demographic qualities and characteristics surrounding elective fertility preservation. A randomized list of 1,000 graduate medical education programs was selected with proportional distribution to geographical regions as designated by the Association of American Medical Colleges. The survey was sent to respective program coordinators with request to distribute to their residents and fellows. States with significant restrictions to abortion access were categorized as “strict” (AL, AR, AZ, FL, GA, ID, KY, LA, MS, MO, MT, NE, NC, ND, OH. OK, SC, SD, TN, TX, WV, WI) 9,10. East South Central and West South-Central regions fully contain these states. Middle Atlantic, New England, and Pacific regions do not contain any states with strict laws. Regions that included a mix of strict and non- strict states were excluded from our analysis. RESULTS: There was a total of 306 respondents from 29 different specialties. Most respondents were White (n=178), heterosexual (n=273), and cisgender women (n=248). There were 30 respondents from strict states and 83 respondents from states without significant restrictions. The remainder (n=193) resided in mixed regions that were excluded from analysis. About 20% (n=23/133) of respondents reported that they were planning to participate in fertility preservation during training. Of those respondents, 16 were from less restrictive regions and 7 were from strict regions. There was not a significant difference (p=0.4386) in planned participation between stricter (n=7/30) and less restrictive regions (n=16/83). Furthermore, there was a substantial group in both strict (n=9/30) and less restrictive regions (n=36/83) that were undecided about pursuing fertility preservation. CONCLUSION: Residency and fellowship often coincide with childbearing years, resulting in many trainees delaying pregnancy or altering career plans. Some choose to pursue assisted reproductive technologies (ART) to preserve their fertility and/or build their families. With the rapidly emerging threats to abortion access and the concern for subsequent effects on ART, this may lead to even more barriers for female medical trainees to pursue fertility preservation. Despite concerns for ART access in states with restrictive legislation, trainee interest in pursuing fertility preservation appears similar. Thus, protecting the reproductive rights of those practicing in stricter states may hold even greater value FINANCIAL SUPPORT: The authors have no financial interests to disclose. References: 1. Sharifi MF, Spurlin EE, Vatan N, Quinones H, Santana E, Omurtag KR, Jimenez PT. Attitudes, concerns, and perceptions of patients undergoing fertility treatments in an abortion restrictive state in the aftermath of the Roe v. Wade reversal.

Volume

124

Issue

1

First Page

e56

Last Page

e57

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