Let's Talk about Physician Infertility

An anonymous reader recently posted a piece on fertility and medical education. She posed some important questions to this community of brilliant and inspiring physicians:

What your journey was like?

For those that balanced being supermom during residency, HOW?

For those physicians struggling with infertility, looking back, was it worth it? Will it be worth it for me?

What advice would you give young trainees for whom having children is a top priority in their lives just like medicine?

Let’s see if I can tackle some of these questions.

What your journey was like?

I started my EM residency planning on having a child during my training. I was ready to start my family. The FIRST day of my residency orientation I was singled out as the only married female in my class and instructed, in front of all my peers, that I would NOT get pregnant. I went home that day and told my husband that we would decidedly not be starting a family any time soon. I ended up getting a divorce at the end of my residency training, which put all attempts at child-bearing on hiatus.

When I married again, it was to a man with his own set of fertility issues - a vasectomy that was not reversible. IVF was my only option for pregnancy. I spent two years and tens of thousands of dollars attempting to conceive. At the time I am writing this, I am 22 weeks pregnant with my rainbow baby. To read more about my infertility story, click here.

What I learned along the way:

As doctors, we suffer from ALL of the medical complications, more than any other patients I’ve seen. I had an ectopic pregnancy. My embryo failed to survive the thawing process. I had a subchorionic hemorrhage. Don’t expect the process to be easy.

Our careers are not friendly to having children at any stage, during training or in our early career. We often think that we should not have children during our training - whether that is to not impede training or to never have anyone question our allegiance to the field of medicine. We think that early in our career will be more advantageous. Honestly, as a medical student, you are NOT medically necessary to the team. As a resident, you may disrupt your training, but you are NOT disrupting your career. You may have less time that you can take for maternity leave. You may have less financial stability. As a physician, you may disrupt starting your practice, or the growth of your practice, or your academic productivity. You may have more financial resources and be able to take more leave, but that leave may more significantly impact your future. You may have more time on your hands. You may not. You will probably be able to afford more help. These are all the factors that each individual needs to take into account to figure out what is best for them.

Female physicians have increased rates of infertility compared to the general population - DOUBLE in fact. One in FOUR female physicians (24.1%) will struggle with infertility compared to the general population, which is one in eight (12.1%). And while some of this may be due to increased maternal age, that is NOT the entire story. One study in Hungary compared female physicians to an age-adjusted control group of other professional women who delayed child-bearing for their career and still found that the physicians had a statistically significant increase in their infertility.

For those that balanced being supermom during residency, HOW?

I can’t speak to this one…

For those physicians struggling with infertility, looking back, was it worth it? Will it be worth it for me?

My infertility journey was worth the struggle. My journey made me stronger. It enriched my marriage. It gave me a purpose and some serious drive. So much good came out of the process - SheMD, a large research project, a network on social media and more!

But I think that the author was really asking if becoming a physician was worth going through infertility.

Absolutely YES.

I have a job that I love.

I have a job that I am pretty sure I will look forward to returning to after maternity leave.

I have a job that I know makes a difference in the lives of other people DAILY.

What advice would you give young trainees for whom having children is a top priority in their lives just like medicine?

My advice for young trainees has certainly changed as I’ve gone through the process. Here it is:

When you are ready for children - physically, emotionally, and financially - then start trying. Don’t wait for the perfect time… it will NEVER arrive. (There is NEVER a time where you will not feel like you are inconveniencing others. But you will cover your colleagues for their illnesses, for their family emergencies, for the deaths of loved ones. We need to make maternity leave become FAMILY leave. We need our male colleagues to take time off too. This will level the playing field and allow us to all cover one another as a team).

If you are not at a place where you are ready for children during your training, consider freezing your eggs while in your 20’s. It’s expensive. So is medical school. What is another $10,000 dollars in loans to know that you have improved your chances of starting a family? That ten-thousand may be considered a savings if you compare it to the cost of repeated rounds of IVF later in life. That being said, egg-freezing is not perfect. It does not guarantee you a child. For more facts on egg-freezing, check out this article.

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