Medical carrier, cost: infertility

From the beginning, Dr. Ariella Marshall, a hematologist at the Mayo Clinic in Minnesota, was confident that the harder he worked, the longer he worked, and the better he would succeed. And she did: she graduated as a high school graduate, attended an elite university, and was accepted by a prestigious medical school.

But one achievement missed her: giving birth to a baby. She had postponed her pregnancy until her career was firmly established, but when she finally decided to give birth, she was surprised at the age of 34 that she couldn’t get pregnant with fertility drugs. rice field. Dr. Marshall attributed it to frequent night shifts and stress and sleep deprivation that could affect the reproductive cycle.

When she contacted another female doctor to share her story, she found out she wasn’t alone.Many women in her job also have infertility Carry your baby to childbirth..

“For many doctors like me, everything is very planned,” said Dr. Marshall. “Many of us have decided to wait until training is complete and we are financially independent and have children. That doesn’t happen until we’re in our mid to late thirties.”

To raise awareness of this issue, Dr. Marshall helped create the Infertility Task Force with the American Association of Medical Women. In June, the association held the first National Physician Birth Summit with sessions on egg freezing, fertility benefits and insurance coverage, fertility and mental health. The association plans to hold a summit next year as well.

High fertility rates also apply to female surgeons. According to a survey of 692 female surgeons published in JAMA Surgery in July, 42 percent suffered a miscarriage — More than twice the proportion of the general population. Almost half experienced pregnancy complications.

Like other female doctors, many surgeons delay their pregnancy until they become residents and are vulnerable to health and infertility issues.

Physicians often need to navigate a 10-year medical school, internship, or fellowship. The average age at which women complete medical education is 31 years Most female doctors give birth first on average at the age of 32., According to a 2021 study. The median age at which non-doctors give birth is 27 years.

Through social media, Dr. Marshall connected with two other female doctors suffering from infertility last year. I wrote about this issue in the journal Academic MedicineCall for more fertility education and awareness among aspiring doctors, starting at the undergraduate level. They also proposed to insure the assessment and management of childbirth, access them and assist those receiving treatment for childbirth. (In December, Dr. Marshall gave birth to a healthy boy after a successful IVF cycle.)

Dr. Algarvan Salez, 41, tried to freeze the eggs for a year, but nothing was feasible. The article’s author and Stanford University surgeon, Dr. Salles, is also struggling with the cost of a procedure that can cost up to $ 15,000 per trial. She is considering endometrial insemination. This is more affordable, but less likely to succeed.

In 2019 she wrote Time essay About training her most fertile years to become a surgeon just to discover that she may be too late to give birth. After that, many female doctors contacted her and said she had also dealt with infertility.

“They all felt very lonely,” said Dr. Saleth. “People don’t talk about infertility, so they were all experiencing this roller coaster ride to deal with infertility on their own. We need to change the culture of medical schools and residents. We must do a better job of encouraging leaders in this field to say, “Please go and be aware of what you have to do.”

Lack of sleep, poor diet, and lack of exercise are inherent in the demands of medical training and medical professionals and can hurt women who are about to become pregnant.

Even finding a partner can be difficult given the hard working hours, such as nights and weekends.

“The problem is that you have to spend a lot of time in the hospital, which is very unpredictable,” said Dr. Saleth. “Looking back, I could say,’I needed frozen eggs in my early twenties,’ but the technology wasn’t very good at the time. In the news, a celebrity older woman is giving birth to a baby. I think it’s okay, but it’s not. Now we all realize that we can’t control our lives. “

Dr. Vineet Arora, Dean of Medical Education at the University of Chicago Pritzker School of Medicine and another author of this paper, gives her and other educators the best advice for medical leaders to address these issues. I’m considering a method.

“What surprised me most was that infertility was a quiet struggle for many of these women, but the data show that it’s not uncommon,” said many in their 40s. Dr. Arora, who experienced the IVF cycle, said. Finally, in March of last year, a second child was born.

She and Dr. Salles are analyzing data from a large study that asked doctors and medical students about their experience of building families and accessing fertility treatments.

Female residents who manage to become pregnant also have to fight the deterioration of their health. Many people experience premature labor and miscarriage as a result of long working hours and work stress. Nevertheless, pregnant female residents are expected to work in shifts for 28 hours without sleep. Dr. Arora and others want to see the change.

Dr. Roberta Gebhard, chair of governance and former president of the American Women’s Association of Medicine, said the group is advocating more accommodation for pregnant doctors. They want to try to have a baby later in the training.

“We educate medical and medical students about childbirth issues so they are aware of them,” she said. “People say you can’t be a mom or doctor, and we’re telling you that you can, but you need to keep your options open Yes, much of it isn’t just about being pregnant. Some of these women are so focused on their careers that they don’t build relationships. “

For female doctors with babies, it can be difficult to find time and even a private place to pump breast milk at work. Dr. Gebhard said one doctor who asked for time to pump was instructed to go behind potted plants in public areas to do so.

She is optimistic that the situation will begin to change in the near future, as more than 50% of all medical students are now women, but there are still more male doctors than females.

Dr. Racquel Carranza-Chahal, 30, has recently completed OB-GYN training and is currently in private practice in Tucson, Arizona. She has a son and daughter who gave birth while attending medical school.

“When I became a resident, I told me that if I wanted to associate, someone would have to divorce my husband and lose custody of my child,” said Dr. Karanza Chahar. I did.

On the day she spoke, she was on-call and had just completed her second 24-hour shift in seven days during the eight and a half months she was pregnant with her second child.

In 2019, she founded a non-profit organization called Mothers in Medicine. We hope that this will increase the awareness of pregnant or mother female doctors and their commitment to the community.

“I want trained mothers to know that they should take up space, that they belong to, and that they have resources at their disposal, including legal ones.” Dr. Karanza Chahar said. “Many residents give birth early and have complications. Someday they will change.”

Medical carrier, cost: infertility

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