(53) Differences in Family Planning and Fertility Among Female and Male Oral and Maxillofacial Surgeons

Abstract: Surgeons often spend their childbearing years in residency or supporting a partner, leading to fertility concerns. While fertility experiences among female physicians have been studied, no literature addresses family planning, fertility, and career decisions specific to U.S. oral and maxillofacial surgeons. This study examines factors influencing OMS career decisions and family planning, highlighting gender differences.
A cross-sectional survey approved by the IRB at Thomas Jefferson University was conducted. A 34-question survey on fertility, family planning, and career decisions was distributed to AAOMS members via email using Qualtrics XM software. Questions were adapted from published studies in oncology, OBGYN, and surgery. Descriptive statistics summarized demographics. Chi-square or Fisher’s exact tests assessed gender associations with family planning, career decisions and fertility experiences.
Of 4,097 surveys sent, 892 were completed (22% response rate). Respondents were 22% female and 77% male, a higher female response rate than the 11% female OMS representation in the U.S. Most respondents were 26-45 years old, Caucasian, in private practice, and had been in training or practice for under 10 years.
More male oral and maxillofacial surgeons reported having children than female. Among those without children, more female oral and maxillofacial surgeons desired children. While 79% of females started trying after age 31, 50% of males started before. 86% of females had their first child after age 31, compared to 54% of males. Most females (77%) had their first child post-training, whereas most males (57%) had theirs during or before training. About 50% of both male and female oral and maxillofacial surgeons took over a year to conceive, which qualifies as infertile as defined by the American College of Obstetricians and Gynecologists. Female oral and maxillofacial surgeons more often cited lack of family support, absence of maternity/paternity policies, long work hours, and fertility concerns as negative factors in family planning. Male oral and maxillofacial surgeons cited a stay-at-home partner as a positive factor, while female oral and maxillofacial surgeons cited favorable maternity/paternity policies. Both genders valued supportive partners. More females reported career-driven family planning delays. Neither reported family planning influencing career choice. Fertility concerns were more prevalent among female oral and maxillofacial surgeons (48%) versus males (25%). About 60% of those concerned sought fertility consultation, with 24% of female oral and maxillofacial surgeons doing so during training versus 49% of male oral and maxillofacial surgeons. Conversely, most females (76%) sought consultation post-training. Additionally, most females reported fertility concerns affecting work life, with 58% noting minimal or no workplace support for fertility treatment, compared to 44% of males.
A career in OMS impacts family planning decisions. Female oral and maxillofacial surgeons are more likely than males to delay childbearing due to career factors. Delayed childbearing among female oral and maxillofacial surgeons mirrors trends in other surgical fields. The majority (86%) of females had their first child after 31, while the national average is 27.4 years (2022). Males were more likely to start families during training, while females postponed childbearing until post-training. Infertility prevalence is high, with about 50% of oral and maxillofacial surgeons taking over a year to conceive or ceasing attempts. More females reported fertility concerns affecting work life than males.
This study uniquely examines family planning, fertility, and career impact among oral and maxillofacial surgeons nationwide. However, generalizability may be limited due to a low response rate and potential selection bias, as those with fertility struggles may have been more likely to participate. Recall and interpretation bias may also affect responses.
Family planning and fertility experiences differ between female and male oral and maxillofacial surgeons. Women face additional pressure as optimal fertility years overlap with training and early career stages. The surgical community must acknowledge these challenges and provide support, policies and resources to create an inclusive environment for oral and maxillofacial surgeons managing fertility concerns.