Fertility Preservation Knowledge, Perceptions, and Expectations Among Military Health Care Students

The rising demand for assisted reproductive technology and the expansion of health care coverage by Congress underscores the need to equip future military clinicians with knowledge about reproductive care and fertility preservation. Medical and graduate nursing students at the Uniformed Services University of the Health Sciences (USUHS) are uniquely positioned to both personally engage with and professionally educate patients about these services. This study's objective was to evaluate health care students' perceptions of age-related fertility decline, knowledge of fertility preservation services, and military considerations influencing family planning goals.

An anonymous 51-item questionnaire was distributed to USUHS medical and graduate nursing students over 3 months. Questions covered demographics, reproductive physiology, oocyte cryopreservation, and military-specific family planning considerations. Aggregate percentages and statistical analyses using chi-squared tests were reported. This survey was approved by our institution's IRB.

A total of 121 students from the Graduate School of Nursing (n = 47) and School of Medicine (n = 74) completed the survey. Demographics and health care affiliations were not significantly associated with survey responses. Most respondents (97%) were aware of oocyte cryopreservation, but fewer (28.6%) correctly identified future pregnancy success rates, and only three (2.5%) knew what is widely considered to be the most cost-effective age for oocyte cryopreservation. Those who indicated personal consideration of oocyte cryopreservation were 2.5 times (P = .033) more likely to correctly identify the fertility timeline, and younger respondents were statistically less likely to correctly identify oocyte cryopreservation's impact on future fertility (P = .039). A majority of respondents (69%-77%) would consider oocyte cryopreservation for deployment, a partner's deployment, or concerns about genitourinary injury during military service, with no statistical differences by health care profession or rank. Greater than three quarters of participants (75.5%) reported feeling pressure to delay childbearing for professional reasons, with younger participants (P = .019) and those with unpartnered status (P = .021) statistically more likely to feel this way. Although income overall was not found to produce a significant difference (P = .111), specific comparison of the highest earning households to the lowest showed a 8.03 higher odds of feeling pressure to delay childbearing (P = .030).

The results highlight a high personal interest in fertility preservation services among military health care providers but reveal significant knowledge gaps, especially among younger respondents. Curriculum interventions are recommended to ensure that well-trained health care providers can offer early counseling on fertility expectations and available services within the military population.