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WASHINGTON – Women surgeons have significantly fewer children, bear them later, and are three times more likely to use assisted reproductive techniques to achieve pregnancy, compared with the general U.S. population.
The findings probably speak to the time it takes to launch a surgical career, leading to delayed childbearing and the physiologic problems that accompany advanced maternal age, Dr. Elizabeth A. Phillips said in a poster at the annual clinical congress of the American College of Surgeons.
"Our survey found that 32% of women surgeons had difficulty with fertility at some point in their childbearing career, compared with 11% of women in the general population," said Dr. Phillips of Boston Medical Center. "When we compared the rates of fertility services to [national] data, we saw that 15% of women surgeons used assisted reproduction, compared to just 5% of the U.S. population."
She conducted an anonymous, 199-question survey on reproductive health, which was distributed to female surgeon interest groups in the areas of general surgery, gynecology, neurosurgery, ophthalmology, orthopedics, otolaryngology, plastic surgery, podiatry, and urology. She received 1,021 replies, which she compared with data from the CDC National Survey for Family Growth for 2006-2010, and the National Institutes of Health.
Of the total responses, 784 women had attempted to become pregnant. Of these, 251 (32%) reported fertility problems. Most of these (210; 84%) underwent a fertility work-up; 76% then attempted pregnancy using some form of assisted reproductive technology (ART). These women bore 185 children.
Most surgeons reported unexplained infertility (70%). Other causes were anovulation (23%); advanced maternal age or premature ovarian failure (22%); polycystic ovarian disease (19%); endometriosis (13%); and recurrent miscarriage (12%). Male factor infertility contributed to 19% of the cases.
Surgeons conceived at a significantly older age than did the general population (33 vs. 23 years) and had significantly fewer children (1.4 vs. 2.6 national average). Among those who used ART, the average maternal age at birth was even older – 35 years.
There may be several reasons why women surgeons may turn to ART more frequently than nonsurgeons, Dr. Phillips said in an interview. "One theory is that female surgeons have different relationships with fertility specialists, where they are receiving treatment that would not be offered for another 45-year-old who walked into the office. They also may have the financial means to pay for this treatment."
How should women surgeons factor childbearing into their lives? she asked. "With so many more women going into surgical subspecialties, should we have family planning tracks? Is there some way to encourage women who want to become pregnant to do so during training, or shortly thereafter?"
"I’ve talked to surgeons who have been pregnant during training, residency, and practice, and by far, the best time to have a child seemed to be during residency, when there were more people to absorb the absence. But most women will say, ‘There’s never a perfect time.’ If it’s a goal in life, you simply have to make it a priority."
Dr. Phillips had no financial disclosures.
I have several major problems with this article (and I ran this by two of our senior fellows to be sure I’m not just an old fogey).
Comparing female surgeons to the general U.S. population is ridiculous. No one would suggest that women with careers have the same opportunities to have children than those who don’t. So right from the start, I feel that it is unfair to specifically apply the findings to female surgeons. If they compared the results with other physicians or even other professional women, there might be something to talk about. It’s also just silly to say that as surgeons we have some kind of connection to fertility specialists. I don’t know any at all! And the fact that female surgeons had fewer children and conceived at an older age compared to all other U.S. women doesn’t have much meaning for me. I’m sure that this finding would be true for all career women. I actually do agree that pregnancy during residency might be the best time for many women since this is very well accepted. However, I think a family planning track is absurd; this hasn’t even been suggested by specialties such as Family Medicine and Pediatrics. As we all know, the best time to have a family is very individual, and depends on your own personal development, your partner, your career, as well as many other factors. Overall, I think this study detracts from our understanding of the issue by being inflammatory and oversimplifying the issue.
It can’t be denied that surgery is a demanding profession, both for men and women. As women who are parents, we have the added responsibility (and blessing) of both carrying and raising our children. No wonder, then, that we might find it challenging to fit this into our careers easily. The good news is that women surgeons ARE finding successful ways to have a family and that this is being embraced by the surgical community at large.
Dr. Cynthia Shortell is chief of vascular surgery at Duke University Medical Center, Durham, N.C., and an associate medical editor of Vascular Specialist.
I have several major problems with this article (and I ran this by two of our senior fellows to be sure I’m not just an old fogey).
Comparing female surgeons to the general U.S. population is ridiculous. No one would suggest that women with careers have the same opportunities to have children than those who don’t. So right from the start, I feel that it is unfair to specifically apply the findings to female surgeons. If they compared the results with other physicians or even other professional women, there might be something to talk about. It’s also just silly to say that as surgeons we have some kind of connection to fertility specialists. I don’t know any at all! And the fact that female surgeons had fewer children and conceived at an older age compared to all other U.S. women doesn’t have much meaning for me. I’m sure that this finding would be true for all career women. I actually do agree that pregnancy during residency might be the best time for many women since this is very well accepted. However, I think a family planning track is absurd; this hasn’t even been suggested by specialties such as Family Medicine and Pediatrics. As we all know, the best time to have a family is very individual, and depends on your own personal development, your partner, your career, as well as many other factors. Overall, I think this study detracts from our understanding of the issue by being inflammatory and oversimplifying the issue.
It can’t be denied that surgery is a demanding profession, both for men and women. As women who are parents, we have the added responsibility (and blessing) of both carrying and raising our children. No wonder, then, that we might find it challenging to fit this into our careers easily. The good news is that women surgeons ARE finding successful ways to have a family and that this is being embraced by the surgical community at large.
Dr. Cynthia Shortell is chief of vascular surgery at Duke University Medical Center, Durham, N.C., and an associate medical editor of Vascular Specialist.
I have several major problems with this article (and I ran this by two of our senior fellows to be sure I’m not just an old fogey).
Comparing female surgeons to the general U.S. population is ridiculous. No one would suggest that women with careers have the same opportunities to have children than those who don’t. So right from the start, I feel that it is unfair to specifically apply the findings to female surgeons. If they compared the results with other physicians or even other professional women, there might be something to talk about. It’s also just silly to say that as surgeons we have some kind of connection to fertility specialists. I don’t know any at all! And the fact that female surgeons had fewer children and conceived at an older age compared to all other U.S. women doesn’t have much meaning for me. I’m sure that this finding would be true for all career women. I actually do agree that pregnancy during residency might be the best time for many women since this is very well accepted. However, I think a family planning track is absurd; this hasn’t even been suggested by specialties such as Family Medicine and Pediatrics. As we all know, the best time to have a family is very individual, and depends on your own personal development, your partner, your career, as well as many other factors. Overall, I think this study detracts from our understanding of the issue by being inflammatory and oversimplifying the issue.
It can’t be denied that surgery is a demanding profession, both for men and women. As women who are parents, we have the added responsibility (and blessing) of both carrying and raising our children. No wonder, then, that we might find it challenging to fit this into our careers easily. The good news is that women surgeons ARE finding successful ways to have a family and that this is being embraced by the surgical community at large.
Dr. Cynthia Shortell is chief of vascular surgery at Duke University Medical Center, Durham, N.C., and an associate medical editor of Vascular Specialist.
WASHINGTON – Women surgeons have significantly fewer children, bear them later, and are three times more likely to use assisted reproductive techniques to achieve pregnancy, compared with the general U.S. population.
The findings probably speak to the time it takes to launch a surgical career, leading to delayed childbearing and the physiologic problems that accompany advanced maternal age, Dr. Elizabeth A. Phillips said in a poster at the annual clinical congress of the American College of Surgeons.
"Our survey found that 32% of women surgeons had difficulty with fertility at some point in their childbearing career, compared with 11% of women in the general population," said Dr. Phillips of Boston Medical Center. "When we compared the rates of fertility services to [national] data, we saw that 15% of women surgeons used assisted reproduction, compared to just 5% of the U.S. population."
She conducted an anonymous, 199-question survey on reproductive health, which was distributed to female surgeon interest groups in the areas of general surgery, gynecology, neurosurgery, ophthalmology, orthopedics, otolaryngology, plastic surgery, podiatry, and urology. She received 1,021 replies, which she compared with data from the CDC National Survey for Family Growth for 2006-2010, and the National Institutes of Health.
Of the total responses, 784 women had attempted to become pregnant. Of these, 251 (32%) reported fertility problems. Most of these (210; 84%) underwent a fertility work-up; 76% then attempted pregnancy using some form of assisted reproductive technology (ART). These women bore 185 children.
Most surgeons reported unexplained infertility (70%). Other causes were anovulation (23%); advanced maternal age or premature ovarian failure (22%); polycystic ovarian disease (19%); endometriosis (13%); and recurrent miscarriage (12%). Male factor infertility contributed to 19% of the cases.
Surgeons conceived at a significantly older age than did the general population (33 vs. 23 years) and had significantly fewer children (1.4 vs. 2.6 national average). Among those who used ART, the average maternal age at birth was even older – 35 years.
There may be several reasons why women surgeons may turn to ART more frequently than nonsurgeons, Dr. Phillips said in an interview. "One theory is that female surgeons have different relationships with fertility specialists, where they are receiving treatment that would not be offered for another 45-year-old who walked into the office. They also may have the financial means to pay for this treatment."
How should women surgeons factor childbearing into their lives? she asked. "With so many more women going into surgical subspecialties, should we have family planning tracks? Is there some way to encourage women who want to become pregnant to do so during training, or shortly thereafter?"
"I’ve talked to surgeons who have been pregnant during training, residency, and practice, and by far, the best time to have a child seemed to be during residency, when there were more people to absorb the absence. But most women will say, ‘There’s never a perfect time.’ If it’s a goal in life, you simply have to make it a priority."
Dr. Phillips had no financial disclosures.
WASHINGTON – Women surgeons have significantly fewer children, bear them later, and are three times more likely to use assisted reproductive techniques to achieve pregnancy, compared with the general U.S. population.
The findings probably speak to the time it takes to launch a surgical career, leading to delayed childbearing and the physiologic problems that accompany advanced maternal age, Dr. Elizabeth A. Phillips said in a poster at the annual clinical congress of the American College of Surgeons.
"Our survey found that 32% of women surgeons had difficulty with fertility at some point in their childbearing career, compared with 11% of women in the general population," said Dr. Phillips of Boston Medical Center. "When we compared the rates of fertility services to [national] data, we saw that 15% of women surgeons used assisted reproduction, compared to just 5% of the U.S. population."
She conducted an anonymous, 199-question survey on reproductive health, which was distributed to female surgeon interest groups in the areas of general surgery, gynecology, neurosurgery, ophthalmology, orthopedics, otolaryngology, plastic surgery, podiatry, and urology. She received 1,021 replies, which she compared with data from the CDC National Survey for Family Growth for 2006-2010, and the National Institutes of Health.
Of the total responses, 784 women had attempted to become pregnant. Of these, 251 (32%) reported fertility problems. Most of these (210; 84%) underwent a fertility work-up; 76% then attempted pregnancy using some form of assisted reproductive technology (ART). These women bore 185 children.
Most surgeons reported unexplained infertility (70%). Other causes were anovulation (23%); advanced maternal age or premature ovarian failure (22%); polycystic ovarian disease (19%); endometriosis (13%); and recurrent miscarriage (12%). Male factor infertility contributed to 19% of the cases.
Surgeons conceived at a significantly older age than did the general population (33 vs. 23 years) and had significantly fewer children (1.4 vs. 2.6 national average). Among those who used ART, the average maternal age at birth was even older – 35 years.
There may be several reasons why women surgeons may turn to ART more frequently than nonsurgeons, Dr. Phillips said in an interview. "One theory is that female surgeons have different relationships with fertility specialists, where they are receiving treatment that would not be offered for another 45-year-old who walked into the office. They also may have the financial means to pay for this treatment."
How should women surgeons factor childbearing into their lives? she asked. "With so many more women going into surgical subspecialties, should we have family planning tracks? Is there some way to encourage women who want to become pregnant to do so during training, or shortly thereafter?"
"I’ve talked to surgeons who have been pregnant during training, residency, and practice, and by far, the best time to have a child seemed to be during residency, when there were more people to absorb the absence. But most women will say, ‘There’s never a perfect time.’ If it’s a goal in life, you simply have to make it a priority."
Dr. Phillips had no financial disclosures.