Creation & Validation of the Fertility and Infertility Treatment Knowledge Survey (Fit-Ks)

Reproductive decision-making is complicated by a preponderance of fertility misconceptions. Low fertility knowledge has been demonstrated across educational levels, in the general population and even among physicians. We therefore sought to validate a novel instrument assessing fertility and infertility treatment knowledge for use in both patients and providers. Internet-based survey An internet-based survey regarding fertility knowledge and treatment, along with relevant demographics, was constructed by the research team and examined for clarity and thoroughness by a panel of reproductive endocrinologists. The pilot survey was distributed to female students and OB/GYN housestaff at two academic hospitals, as well as to females in the general population via Amazon Mechanical Turk. Item analysis and assessment for convergent and divergent validity was then performed. The study was IRB-exempted. 127 medical trainees (99 students, 28 housestaff) and 118 women participated. They represented a broad spectrum of geographic, ethnic and faith backgrounds. The mean scores were 18.8/29 (64.9%) among medical trainees (MT) and 16.2/29 (55.9%) among the general population (GP). Among both groups, a majority underestimated the miscarriage rate (50.4% MT, 59.3% GP), and over-estimated success in delayed-childbearing scenarios relating to IVF for a 44-year old woman (73.2% MT, 68.6% GP) and oocyte cryopreservation (96.1% MT, 91.5% GP). There were additional inaccuracies relating to fertility-impacting lifestyle choices, such as the impact of moderate alcohol consumption or lubricants. The instrument demonstrated an appropriate profile in item analysis and validity testing. This study demonstrated that the FIT-KS instrument is an appropriate tool to evaluate understanding of fertility and infertility treatment knowledge in both patients and providers. The validation process also reaffirmed that significant gaps remain among medical trainees and within the general population, and greater efforts to improve reproductive education must be undertaken.