Wo Luccie, Eidelson Sarah A, Zheng Caiwei, Mouhanna Joelle, Bussies Parker, Zhang Chi, Möller Mecker G
Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
Department of Surgery, University of Southern California, Los Angeles, California.
J Surg Educ. 2023 May;80(5):689-696. doi: 10.1016/j.jsurg.2023.02.012. Epub 2023 Mar 16.
Surgery trainees spend their prime fertility years in training, which leads to delays in childbearing, accompanying infertility challenges, and high-risk pregnancies. Literature report of institutional support for fertility preservation (egg/sperm freezing) and treatment is lacking. The cost is particularly prohibitive while receiving a resident physician salary. This study aimed to assess availability of fertility resources and institutional coverage of fertility services to US General Surgery Residents (GSR) and Breast Fellows.
We composed and distributed a 26-question survey to GS residency and fellowship program directors nationwide to survey residents and fellows. Summary and descriptive statistics were tabulated, and categorical variables were analyzed using Pearson's chi square test.
A total of 234 US surgical trainees (male n = 75, female n = 155, unreported n = 4) completed the survey. Total of 12 % of trainees reported having been counseled on family planning/fertility treatment during training, and only 5.1% were counseled on fertility preservation. Perceived lack of support from program (p = 0.027) and counseling of fertility preservation (p = 0.009) were significantly associated with female gender. A minority (12.5%) reported having insurance coverage for fertility preservation and 26% had coverage of fertility treatment. In addition, 2.6% respondents pursued fertility preservation while in training and 33% reported they would pursue fertility preservation if it was covered by insurance.
Fertility preservation is rarely discussed in US General Surgery residency programs. The large majority of GSR lacks awareness of insurance coverage of fertility preservation and treatment. Strong efforts are necessary to improve fertility education for GSR and insurance coverage to meet trainee's needs.
外科住院医师在培训期间度过其生育黄金期，这导致生育延迟，随之而来的是不孕挑战和高危妊娠。目前缺乏关于机构对生育力保存（卵子/精子冷冻）及治疗提供支持的文献报道。在领取住院医师薪水的情况下，相关费用尤其高昂。本研究旨在评估美国普通外科住院医师（GSR）和乳腺专科住院医师可获得的生育力资源以及生育力服务的机构覆盖情况。
我们编制并向全国普通外科住院医师培训项目及专科培训项目主任发放了一份包含26个问题的调查问卷，以调查住院医师和专科住院医师。汇总并列出描述性统计数据，使用Pearson卡方检验分析分类变量。
共有234名美国外科住院医师（男性n = 75，女性n = 155，未报告n = 4）完成了调查。总计12%的住院医师报告在培训期间接受过计划生育/生育治疗方面的咨询，而仅有5.1%接受过生育力保存方面的咨询。认为缺乏项目支持（p = 0.027）和生育力保存咨询（p = 0.009）与女性性别显著相关。少数人（12.5%）报告有生育力保存的保险覆盖，26%有生育治疗的保险覆盖。此外，2.6%的受访者在培训期间进行了生育力保存，33%报告称如果保险覆盖，他们会进行生育力保存。
在美国普通外科住院医师培训项目中，生育力保存很少被讨论。绝大多数普通外科住院医师缺乏对生育力保存和治疗保险覆盖的认识。需要大力加强对普通外科住院医师的生育力教育并改善保险覆盖，以满足住院医师的需求。
