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. 2025 Aug 13;45(9):197.
doi: 10.1007/s00296-025-05956-7.

Fertility and infertility knowledge among physicians caring for women with rheumatic diseases is suboptimal: a cross-sectional survey

Andres Manuel Ortiz-Rios  1 , Mara Alejandra Ponce-Santillán  1 , Braulio Rafael Avalos-Garcia  1 , Eva Abigaid Galindo-Calvillo  1 , Maria Eugenia Corral-Trujillo  1 , Carolina Treviño-Sanchez  1 , Samantha Lynn Salinas-Rodriguez  1 , Lourdes Michelle Pola-Lobo  1 , David Alejandro Ramirez-Cantu  1 , Jesus Mario Ortiz-Palafox  1 , Jesus Alberto Cardenas-de la Garza  1 , Dionicio Angel Galarza-Delgado  1 , Lorena Perez-Barbosa  1 , Cassandra Michele Skinner-Taylor  2
Affiliations

Fertility and infertility knowledge among physicians caring for women with rheumatic diseases is suboptimal: a cross-sectional survey

Andres Manuel Ortiz-Rios et al. Rheumatol Int. .

Abstract

Women with autoimmune rheumatic diseases (ARDs) face increased risks of infertility, yet fertility-related knowledge among physicians remains underexplored. We aimed to evaluate fertility and infertility knowledge among physicians treating women with rheumatic diseases, using the validated Fertility and Infertility Treatment Knowledge Score (FIT-KS). A cross-sectional web-based study was conducted among 102 physicians across different specialties in Mexico involved in the care of women with ARDs. Participants completed the FIT-KS, a 29-item questionnaire that assesses knowledge of natural fertility and infertility treatments. Recruitment occurred online between March and June 2025. Associations between participant characteristics and knowledge scores were analyzed. The mean FIT-KS score was 18.51 out of 29 (63.82%). Participants demonstrated good knowledge of basic fertility concepts (e.g., most fertile age, timing of conception). Still, notable gaps were observed in age-related fertility decline, IVF success rates, and treatment outcomes. Physicians under age 35 (95% CI 0.208-2.565) and females scored significantly higher (95% CI 0.646-2.99). Obstetrics and gynecology specialists had the highest scores (mean 19.87), while rheumatologists and internal medicine specialists scored lower (mean 17.95 and 17.85 (95% CI 0.24-3.80)). Fertility knowledge among physicians caring for women with ARDs is suboptimal, especially among non-reproductive specialists. To address these gaps, targeted education needs to be implemented through the integration of fertility and reproductive health topics into rheumatology fellowship curricula, offering continuing medical education sessions focused on fertility preservation and pregnancy planning, and conducting interdisciplinary workshops. These initiatives should aim to enhance knowledge, confidence, and communication in fertility counseling.

Keywords: Fertility; Medical education; Physicians; Reproductive health; Rheumatic diseases; Surveys and questionnaires.

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Conflict of interest statement

Declarations. Conflict of interest: Andres Manuel Ortiz-Rios, Mara Alejandra Ponce-Santillán, Braulio Rafael Avalos-Garcia, Eva Abigaid Galindo-Calvillo, Maria Eugenia Corral-Trujillo, Carolina Treviño-Sanchez, Samantha Lynn Salinas-Rodriguez, Lourdes Michelle Pola-Lobo, David Alejandro Ramirez-Cantu, Jesus Mario Ortiz-Palafox, Jesus Alberto Cardenas-de la Garza, Dionicio Angel Galarza-Delgado, Lorena Perez-Barbosa, Cassandra Michele Skinner-Taylor have no competing interests to declare that are relevant to the content of this article. Ethical approval: The study was conducted under the ethical principles of the 1964 Declaration of Helsinki and its later amendments. All health professionals were informed of the purpose of the survey, and informed consent was obtained digitally before participation. All responses were collected anonymously to ensure participant confidentiality and protect personal information. The research protocol was approved by the Research and Ethics Committee of the Hospital Universitario “Dr. José Eleuterio González” (Protocol No RE25-00001, approval date: February 27th, 2025). Informed consent: Digital informed consent was obtained from all participants included in the study.

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