A survey study to assess the impact of roe v. wade reversal on reproductive endocrinology and infertility fellows

The objective of this study was to understand if and how the overturn of Roe v. Wade has impacted the training and the career decisions of current Reproductive Endocrinology and Infertility (REI) fellows in the U.S, as they will be faced with new uncertainties to our future scope of practice. A 12-question survey focused on the impact of Roe v. Wade reversal was distributed electronically to current REI fellows nationally. Questions included how Roe v. Wade reversal has affected their training such as how they counsel patients and whether it will affect their future career decisions such as location of their job after graduation. A standard Likert scale was used for responses. Data was evaluated using GraphPad Prism. Kruskal-Wallis tests were performed to evaluate the ordinal data stratified by fellowship location region. Mann-Whitney U tests were utilized to evaluate responses based on gender and age. This study is approved by IRB at our local institution. A total of 54 of 168 (32%) REI fellows responded to the survey. Of those who responded, 44 (81%) were female, and 10 (19%) were male, with most aged 30-35 (87%). Geographical breakdown included 25 (46%) in the Northeast, 13 (24%) in the Midwest, nine (17%) in the West, four (7%) in the Southwest, and three (6%) in the Southeast. Most (44%) disagreed that the overturn of Roe v. Wade had affected their counseling of patients. In terms of preimplantation genetic testing for aneuploidies (PGT-A) use, 59% of fellows disagreed that the overturn of Roe v. Wade increased PGT-A use in their practice. Fellows from the Southeast were significantly more likely to agree with this statement (67% agree/strongly agree) than fellows from the northeast (80% disagree/strongly disagree) (p=0.03). Most respondents (69%) disagreed that the overturn of Roe v. Wade affected their embryo freezing, storage and discard practice. Fifty-two percent disagreed that their medical legal documentation had changed. Interestingly, seventy-four percent of fellows agreed that the overturn of Roe v. Wade will impact their final choice of practice location. This did not vary by geographic region (p=0.90), gender (p=0.47), or age (p=0.82). Twenty-five (46%) respondents commented that they would not consider practicing in a state with restrictive abortion laws. While some fellows report changes in patient counseling, PGT-A use, embryo handling, and medical legal documentation, the majority do not report these changes in their fellowship training. Moreover, most current REI fellows report that the overturn of Roe v. Wade will impact their final choice of practice location.