Introduction: Women in healthcare are faced with unique challenges that may increase their risk of infertility including irregular work hours, occupational hazards, and advanced maternal age. We therefore sought to investigate live birth rates of female healthcare workers presenting with infertility compared to their non-healthcare counterparts.
Methods: After obtaining IRB approval, a retrospective review of hospital employees and partners presenting for a fertility evaluation between 2013-2019 was conducted. Patient age, BMI, history of previous live birth, occupation, use of assisted reproductive technology and female fertility factor were recorded. Couples with at least 12 months of follow up from initial presentation as well as a documented semen analysis were included in the study. Normal semen parameters were defined by the World Health Organization 2010 criteria. Logistic regression analysis was conducted to identify factors associated with increased likelihood of live birth.
Results: Of the 934 female partners identified, 445 were healthcare workers and 489 non-healthcare workers. Female age, BMI, smoking status, and history of previous live birth were not statistically significant between groups. No differences in male partner age, BMI, semen parameters and presence of male factor were noted. As an overall group, female age, male age, and abnormal concentration were noted to impact live birth rates (p < 0.016). Live birth rates were higher in female health care workers compared to non-healthcare workers, 76.1 vs. 69.6%, respectively, p=0.042. The cohort was then further analyzed to determine if there was a difference in between females physicians and female non-physician healthcare workers (91 physicians vs 357 non-physicians). No differences in live birth rates, pregnancy complications, and preterm labor were noted. Physicians were older at time of initial evaluation as well as time of delivery, and utilized in-vitro fertilization at a higher rate (p < 0.005 for all).
Conclusions: Female healthcare workers seeking a fertility evaluation have a higher live birth rate despite no differences in age, BMI, female factor infertility, use of assisted reproductive technology, or male partner factors. In contrast, female physicians seeking evaluation were noted to be older and have a higher rate of utilization of in-vitro fertilization not attributable to a male factor. This finding has significant family planning implications for physicians, their partners, and their employers.