#misinformation: The perils of using social media for medical advice regarding infertility

To systematically evaluate the quality, credibility, accuracy, and readability of fertility-related content generated by users providing education, advice, and medical information on Twitter/X and Instagram. We selected Instagram and Twitter/X for data collection, as these platforms are commonly used by women of reproductive age. Using the terms 'fertility' and 'infertility', we collected posts both prospectively and retrospectively between April 21 and 28, 2024, using Keyhole and Brand Mentions. Posts were screened for eligibility, excluding non-English language posts, personal stories, advertisements, non-medical opinions, and peer-support posts. We assessed the accuracy, credibility, quality, and readability of the posts using validated instruments. Accuracy was evaluated based on current guidelines and the authors' expertise in infertility. Credibility was measured using a 10-point system that considered the source, context, currency, and editorial review. Quality was assessed using the 16-item DISCERN criteria with a five-point Likert scale. Readability was measured using the Flesch-Kincaid reading-ease test, which assigns a U.S. grade level to each post. Of the 15,214 posts identified, 939 were included in the final analysis. Fertility doctors generated 29% of the posts; others came from doctors of other specialties (11%), holistic practitioners (17%), and laypeople (39%). Seventy-four percent (74%) of posts did not cite sources or academic references, and 45% of posts contained inaccurate information. Only 11% of the posts were deemed credible. Of posts related to treatment, 19% were of high quality, while 53% of non-treatment posts met the same standard. Most posts (80%) were categorized as difficult to read based on readability scores. Only two posts (0.2%) were accurate, credible, high-quality, and easily readable. Social media posts about fertility often provide incomplete or misleading information, with a significant focus on naturopathy, dietary advice, and unproven theories about the effect of the COVID-19 vaccine on fertility. Clinicians and social media platforms must take responsibility for improving the accuracy and accessibility of health information online.