Dados do Trabalho

Title

MEDICINE STUDENTS' KNOWLEDGE ABOUT LATE REPRODUCTIVE PLANNING AND ITS IMPLICATIONS

Objective

A medical career requires long preparation from young people, which often involves immersion in a preparatory course for college entrance exams, taking a long university medical college and a few years of specialization through medical residency. Therefore, the tendency to postpone family planning leads to the emergence of social dilemmas and challenges arising from the need to acquire financial and professional stability in the life that precedes pregnancy. The present investigation aimed to evaluate the knowledge of medical students in the metropolitan region of Salvador, regarding the possible challenges facing late reproductive planning.

Methods

cross-sectional and descriptive study, developed in accordance with the current regulations, submitted to the Research Ethics Committee and approved through the consolidated opinion number 5.238.222. The convenience sample composed of 216 medical students from the metropolitan region of Salvador aged between 18 and 40 years old was evaluated through the application of a questionnaire in Google Forms, containing 12 initial questions about the profile of the students, and 9 questions about the knowledge of the topic being discussed. Sociodemographic inquiries (marital status, age, age that intends to have children, the first or the next; and age that will graduate); regarding interest in future residencies/specializations and their approximate duration; about carrying out tests to investigate fertility and the use of contraceptive methods were also discussed. The participants received an awareness booklet on reproductive aspects, associated with advanced age and assisted reproduction to read, in order to generate increased knowledge and possible changes in behavior regarding the reproductive planning of the medicine school student in question.

Results

Most participants were single (95.83%), without children (98.61%), using contraceptive methods (72.69%) and intending to have children in the future (85.65%). Students of the 7th semester of the course (26%), with the objective of doing medical residency (95.4%) with a duration of 3 years (45.9%) were the most predominant; 98.6% of the participants never underwent tests to investigate their ovarian reserve. In the second stage of the questionnaire, the participants demonstrated, in general, expertise on the proposed topic; of the 9 questions asked, 8 were mostly answered correctly. Predominantly, the participants are aware of the negative influence of aging on female fertility; know that assisted reproduction procedures may not fully compensate for an age-dependent loss of fertility; understand that assisted reproduction procedures can be performed exceptionally in women over 50 years old; are aware that in women over 40 years of age, there is a reduction in implantation rates and an increase in spontaneous abortions, low response to ovarian stimulation and poor quality of the collected oocytes; they also understand the process of follicular atresia. In addition, the students showed that they understood the proportion, in numbers, of follicle loss with advancing age and expressed knowledge about the need, especially for women aged 35 and over, to pay attention to ovarian reserve tests and consider the preservation of fertility through egg freezing. However, the academics showed a lack of informational regarding the percentage drop, measured at 50%, in fertility in the age range between 20 and 30 years, when they erroneously stated that it was around 10%.

Conclusion

Despite confirming knowledge about the decrease in female fertility due to aging, the generation of medicine school students was unaware of the magnitude of this impact. This panorama may denote future challenges due to the age group that intends to start planning to become pregnant.

Keywords

Relative fertility. Late gestation. Contraceptive methods. Assisted reproduction. Ovarian reserve.