ACOG Issues New Recommendations for Counseling Patients on Fertility Decline

Washington, D.C. - Today the American College of Obstetricians & Gynecologists (ACOG) issued new guidance on anticipatory counseling regarding ovarian-factor fertility decline, underscoring the importance of patient counseling on the natural decline in fertility throughout a patient's reproductive life span. ACOG's new guidance comes as fertility and reproductive health receive increased attention in policy, legislation, and online discourse.

"Data show that many patients are not aware of how fertility naturally declines over the course of their lives and overestimate the likelihood of pregnancy at all ages. We want our patients to have a realistic understanding of their own fertility and the tools that exist within evidence-based obstetric and gynecologic care so they can make an informed decision about when and how they want to build their families. Anticipatory counseling on fertility decline can help people begin to consider how their family-building goals align with their reproductive life span," said Christopher M. Zahn, MD, FACOG, chief of clinical practice and health equity and quality at ACOG.

The new guidance stresses the importance of patient education on fertility in the face of growing medical misinformation on social media. In response to that misinformation, ACOG's guidance recommends that ob-gyns advocate for greater, more accessible evidence-based education resources and highlights the unique opportunity for physicians to have an evidence-based social media presence.

"Our patients are seeing more and more misleading and outright false information on social media around reproductive health. Fertility misinformation can be particularly pernicious because time can be of the essence when it comes to fertility. Additionally, ovarian function is complex, and its decline is influenced by multiple contributing factors. Opening up communication around fertility with our patients earlier can help us address their questions with scientific evidence and data instead of leaving them to search for answers on social media," said Nancy Sokkary, MD, FACOG, named author of the guidance.

ACOG recognizes the potential harm that misinformation online can have on both patients and clinicians and has developed a resource page to combat misinformation related to obstetric and gynecologic health care.

In addition to age-related fertility decline, ACOG's guidance recommends that clinicians familiarize themselves with and offer counseling on other factors that can affect fertility, such as familial and genetic factors, previous medical interventions such as pelvic radiation or unilateral oophorectomy, substance use, and environmental exposures such as endocrine disruptors.

"There are many, many factors that make up an individual's fertility, some of which remain unknown or not yet explained by the body of scientific literature currently available to us. Existing and emerging data do illuminate a few factors we know can affect someone's fertility, such as smoking, genetic mutations, and past medical interventions. The sheer variety of factors influencing fertility can be overwhelming to both patients and the clinicians who care for them. We're hopeful that this guidance helps clinicians begin an open, ongoing dialogue with patients who want to have children," said Danielle Carter, MD, named author of the guidance.

Committee Statement 22: "Anticipatory Counseling Regarding Ovarian-Factor Fertility Decline" is available now.