A new study by Yale School of Medicine researchers provides insight into how much women of reproductive age in the United States know about reproductive health. Published in the journal Fertility & Sterility, the study found that about 50% of reproductive-age women had never discussed their reproductive health with a medical provider and about 30% visited their reproductive health provider less than once a year or never.

The study is based on an online anonymized survey conducted in March 2013 of 1,000 women between the ages of 18 and 40 representing all ethnic and geographic regions of the U.S. census. The survey included questions to assess knowledge, attitudes, beliefs, and practices regarding conception, pregnancy, and basic reproductive health-related concepts.

"This study, on one hand, brings to the forefront gaps in women's knowledge about their reproductive health, and on the other, highlights women's concerns that are often not discussed with health providers," said senior author Jessica Illuzzi, M.D., associate professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine. "It is important that these conversations happen in this ever-changing family landscape."

The major findings by Illuzzi and colleagues include: 40% of the reproductive-age women surveyed expressed concern about their ability to conceive. Half were unaware that multivitamins with folic acid are recommended to reproductive-age women to prevent birth defects. More than 25% were unaware of the adverse implications of sexually transmitted infections, obesity, smoking, or irregular menses on fertility. One-fifth were unaware of the adverse effects of aging on reproductive success, including increased miscarriage rates, chromosomal abnormalities, and increased length of time to achieve conception.

Illuzzi said the survey also revealed some misperceptions about optimizing conception. Half of the respondents believed that having sex more than once per day would increase their chances of conception, while separately, more than one-third believed that specific sexual positions and elevating the pelvis would similarly increase their success with achieving pregnancy. Only 10% of women in the survey were aware that intercourse needed to occur before ovulation, rather than after, to optimize conception.

Co-author Lubna Pal, associate professor in the section of Reproductive Endocrinology and Infertility at Yale, noted, "We found that 40% of women in the survey believed that their ovaries continue to produce new eggs during reproductive years. This misperception is of particular concern, especially so in a society where women are increasingly delaying pregnancy."