JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):112
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263746

P-100. Fertility awareness: perceptions, attitudes, and reproductive intentions among medical students and residents – a comparative analysis between 2017 and 2025

Maria Carmo Borges Souza¹, Gabriela Vidal Santos², Marcelo Marinho Souza¹, Roberto Azevedo Antunes^1,2, Ana Cristina Allemand Mancebo¹, Veronica Almeida Raupp¹, Ana Luisa Bruno Marinho Souza^1,2, Brenda Maria Loureiro Melo^1,2, Flavia Fernandes Sequeira¹, Karina Abelha Rabaço^1,2

¹ Fertipraxis – Centro de Reprodução Humana - Rio de Janeiro - RJ – Brasil
² UFRJ -Universidade Federal do Rio de Janeiro - Rio de Janeiro - RJ - Brasil

Objective: Infertility is recognized by the World Health Organization as a major global health issue. In recent decades, time to first conception has increased for both sexes, influenced by professional, educational, financial, and relational factors. Inadequate fertility knowledge may impact on reproductive decision-making. This study aimed to evaluate fertility awareness, attitudes, and reproductive intentions among medical students and residents in 2025, comparing results with a 2017 survey, and to assess whether these factors are influenced by stage of training, specialty, or gender identity.
Methods: A cross-sectional study was conducted using a 10-item multiple-choice questionnaire on the SurveyMonkey^® platform, distributed via WhatsApp^® between October–December 2024 and January–May 2025. Questions addressed fertility knowledge, reproductive intentions, sexual orientation, and gender identity. The instrument was pre-tested and refined for clarity. Participants included first- to third-year medical students, fourth- to sixth-year students, residents in obstetrics and gynecology (OBGYN), and residents in other specialties, recruited from public and private institutions in the state of Rio de Janeiro. Data were compared to a similar survey performed in 2017. Statistical analysis evaluated associations between variables, including stage of training, specialty, and demographic factors.
Results: A total of 315 responses were obtained in 2025: 65 first- to third-year students, 102 fourth- to sixth-year students, 74 OBGYN residents, and 74 non-OBGYN residents, compared to 2017: 171 responses, 35, 52, 43 and 41. Public institutions accounted for 57.46% of respondents versus 50% in 2017. In 2025, 6.35% (20) expressed a preference for a child-free life, compared with none in 2017, with residents reporting this choice four times more often than students. The perceived optimal age for childbearing remained between 26–34 years in both surveys; however, overestimation of the biological fertility window persisted, with 10,8% considering conception after age 35 or at any age without significant differences between training stages or specialties. Preference for two children declined (68% in 2017 vs. 61.6% in 2025), while preference for one child increased (9.7% vs. 14%). In 2025, 83% of early-year students and 68% of final-year students reported never having received counseling about family planning from a healthcare provider (the general number was 87% in 2017). There is a significative difference between students and residents (p=0,004), but not among residents, (50% of OBGYN and 59% non-OBGYN). In 2025, sexual orientation distribution was 86% heterosexual, 5.4% homosexual, and 8.57% bisexual; gender identity was predominantly cisgender (98.7%), with 0.32% transgender (one case) and 0.95% non-binary. However, discrepancies between declared gender identity and biological sex were detected since a further question when eventual transgenders were asked to declare their identification resulted in 8 responses (6 female and 2 male, 4 students and 4 residents). This led us to consider that students/residents can be hidding their identity due to fear of discrimination.
Conclusion: Despite increased discourse on reproductive health, fertility awareness among medical students and residents remains suboptimal, with persistent misconceptions about the biological fertility window and insufficient counseling from healthcare providers. Educational interventions addressing fertility knowledge and inclusive reproductive counseling for gender and sexual minorities are urgently needed, beginning in undergraduate training and extending into residency.