Abstract
BACKGROUND: Treating subfertility continues to remain a low priority area in developing countries; a period of twelve months must elapse before a couple is labeled subfertile. This study aims to assess the attitude and practice of Women’s healthcare specialists for starting fertility investigations and treatment within 12 months of marriage for social reasons. METHODS: In this online survey, a self-administered questionnaire was administered to 464 women’s health care specialists in Pakistan. There were only three inclusion criteria: 1)Being a Pakistani resident 2) practicing obstetrics and gynaecology with a formal qualification in their specialty and 3) having a special interest in subfertility. All other healthcare professionals were excluded. RESULTS: Our study population comprised of 230(49.6%) gynecologists, 218(47.0%) obstetricians and 16 (3.4%) reproductive endocrinologists. Only one tenth (10.3%) had a positive attitude towards screening and offering treatment. Less than half (40.1%) had good practices. Those who had a local higher qualification (FCPS), (p = 0.001), worked as consultants(p = 0.001), and self-estimated themselves proficient in providing ovulation induction (p ˂ 0.001) were more likely to have positive attitude scores. Those whose area of expertise was gynaecology (p = 0.001), who had training in fertility (p = 0.005), and worked in a teaching hospital (p ˂ 0.001), were more likely to have good practice scores. CONCLUSION: Our study shows that healthcare providers have negative attitude and suboptimal practices regarding considering social reasons for starting fertility treatment within 12 months of marriage. Social grounds for starting fertility treatment in developing countries need to be established and local guidelines should be revised to include care for such couples. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40834-025-00421-z.