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OBJECTIVE: The objective of our study is to further quantify the impact a career in medicine has on reproductive outcomes.
Over the past two decades there has been a change in the family dynamic related to childbirth and infertility. The average age at onset of childbearing has increased from 23.7 to 28.5, with over 50% of births occurring over the age of 30. Aligned with the increased age, is an increase in age associated infertility and pregnancy complications. Multiple studies have highlighted that American surgeons have an increased rate of infertility (32.0% vs. 10.6%) and early losses (35% vs. 11.6%) compared to the general population. There is limited data on the infertility and pregnancy complications amongst Canadian physicians. As a result, our goal is to characterize the incidence of adverse pregnancy outcomes and infertility in Canadian female physicians.

MATERIALS AND METHODS: Our study population included 909 fe- male physicians who completed a survey between March and August 2022. The survey was disseminated through various social media platforms, interest groups, organizational societies and through the faculty and program emails at all major Canadian academic institutions. A combination of infer- ential and descriptive analyses were used to highlight relationships between patient factors and pregnancy outcomes.

RESULTS: The average age at first pregnancy was 31.8
3.8 with 45.9% of women experiencing difficulty conceiving, 79.3% pursuing fertility inves- tigations and 33% requiring assisted reproductive technologies to success- fully conceive. After conception, 35.1% experienced an early loss with an average of 1.8
1.2 losses per person. After a loss only 33% of women were able to take time off with an average of 6.0
1.4 days to recover. During pregnancy 22% of women described antenatal complications and 14% expe- rienced neonatal complications. In terms of family planning only 50.5% had achieved their ideal family size with 52.5% having delayed childbearing due to training secondary to their careers for an average of 3.8
2.5 years with a 25.2% rate of regret.

CONCLUSIONS: This study demonstrated that Canadian female physi- cians have significantly higher rates of infertility and adverse pregnancy out- comes compared to the general population.
IMPACT STATEMENT: It is our hope that by drawing attention to these outcomes, this study may help guide future institutional, legislative, and lon- gitudinal supports for reproductive aged female Canadian physicians.