Abstract
OBJECTIVE: To study fertility awareness and infertility treatment awareness among Generation Z women in the United States. DESIGN: Cross-sectional survey study. SUBJECTS: A total of 212 women, ages 18-27, participated in an online survey. EXPOSURE: Not applicable. MAIN OUTCOME MEASURES: Levels of fertility awareness were categorized as low (0%-40%), moderate (41%-70%), or high (71%-100%). Knowledge differences were analyzed using frequency tables to evaluate the number of correct and incorrect responses. RESULTS: Generation Z women demonstrated moderate awareness of basic information about menstruation and fertilization. Knowledge of age-related infertility treatment success rates varied, with 29% knowing the in vitro fertilization success rate for a 35-year-old and 48% for a 44-year-old. Only 27% identified the likelihood of a miscarriage, reflecting a 9% decline from millennial women surveyed in 2017 by Kudesia et al. using the same instrument. While 87% knew the correct age range for peak fertility, far fewer (54%) knew the age range for fertility decline. Fecundability knowledge was limited (40% at age 30; 42% at age 40). Respondents showed high levels of awareness toward basic definitions of three infertility treatments. Whereas 74% wanted children in the future, 59% felt uninformed about fertility, and 69% reported varying levels of concern toward their future fertility. CONCLUSION: Fertility knowledge has improved by a modest 3% when comparing women in Generation Z with millennials. This increase is not substantial enough to indicate meaningful progress. Failing to address these ongoing knowledge gaps may hinder young women's abilities to make informed decisions and can lead to involuntary childlessness. To help increase reproductive autonomy, tailored fertility health education should target women in Generation Z before they age out of the peak fertility age range.