EVALUATION OF FERTILITY AWARENESS AND EDUCATION IN WOMEN 40 YEARS AND OLDER

Document Type

Conference Proceeding

Publication Date

12-1-2025

Publication Title

Fertil Steril

Keywords

adult, awareness, birth rate, conference abstract, data analysis software, education, evidence based practice, female, fertility, health care personnel, human, in vitro fertilization, infertility therapy, knowledge, live birth, motivation, patient referral, pregnancy, spontaneous abortion

Abstract

OBJECTIVE: Women 40 years and older seeking fertility treatment continues to rise but there are no prior studies assessing fertility awareness and education in women of advanced reproductive age. Our objective was to evaluate and identify gaps in knowledge related to the age-related fertility decline (ARFD). This information will allow healthcare professionals to better educate patients of advanced reproductive age about their fertility potential and fertility treatment success. MATERIALS AND METHODS: Female patients 40 years and older at a private Reproductive Endocrinology and Infertility (REI) practice were recruited from August 2023 through April 2024. Participants were contacted via email and provided a voluntary, online survey evaluating infertility awareness and education. Descriptive statistics were generated. Chi-square was used to analyze categorical variables and Independent T-test and ANOVA to analyze continuous variables. SPSS version 29 (IBM Corp., Armonk, NY) was used to perform the analyses. Statistical significance was set at a p<0.05. This study was IRB approved. RESULTS: A total of 189 patients (response rate of 23.3%) was noted. Seventy percent of women desire an initial fertility discussion with an OB-GYN and 63% believe initial discussions about fertility should occur between 26-35 years old. Fifty-one percent of patients had received no prior fertility counseling about increased risks of miscarriage at 40 years and older prior to presenting to the REI clinic. Four fertility-based questions were utilized at the end of the survey to assess knowledge of ARFD. Forty-eight percent of patients believe there is an initial decrease in fecundability between ages 39-46. When asked about live birth rate with In-vitro fertilization at 40 years and older, close to eighty percent answered this incorrectly, overestimating treatment success rates in this age group. Patients who report having previous access to fertility resources or counseling were statistically more likely to correctly answer the four knowledge-based fertility questions compared to those with no prior counseling (p=0.02). CONCLUSIONS: Women over 40 lack knowledge regarding ARFD. The majority of participants in our study incorrectly believe that fertility begins to decline in their forties, highlighting the lack of understanding and overestimation of fecundability rates in this age group. However, patients who had previously accessed fertility resources were statistically more likely to answer the fertility quiz questions correctly as opposed to those with no prior use of resources (p=0.02). With increased access to verified resources and fertility counseling, ideally starting in the mid-twenties, there is an opportunity for improved education regarding ARFD, allowing patients to make informed choices about their current and future reproductive goals. IMPACT STATEMENT: There is an overestimation of fecundability and lack of fertility knowledge in those 40 years and older. With increasing numbers of patients choosing to delay childbearing, adequate counseling, evidence-based resources, and timely referrals are necessary to educate this patient population and help them achieve their fertility goals.

Volume

124

Issue

6

First Page

e161

Find It @ Sladen

Share

COinS