Infertility in the digital age: an opportunity for REI physicians to combat the spread of misinformation and fill support gaps in infertility care online

Emily A. Jacobs; Ginny L. Ryan

doi:10.1016/j.fertnstert.2019.07.262

Objective To examine infertility related content posted on Instagram, including content of posts and identity of content posters. Design Retrospective content analysis. Materials and Methods Data from Instagram were obtained on April 20, 2019. One author queried 42 popular hashtags, including both medical and lay person terminology, related to infertility diagnosis, treatment and procedures. The total number of posts from each hashtag was recorded. Each of the top ten posts (as determined by Instagram’s internal algorithm) for the 42 hashtags was then analyzed to qualitatively identify the content of each post. The post category was determined by the lead author based on the content of the post and the overall message it sent to its readers. The number of likes and comments were also recorded for each post. Lastly, data on the individual who posted were also recorded by analyzing that poster’s Instagram profile. Results A total of 5,814,691 posts were tagged with the 42 unique hashtags queried for this study. 315 of the 420 “top posts” met inclusion criteria. Of the hashtags, #PCOS had the highest number of posts associated with it (2,000,000 posts). From the 315 included posts, 271 unique posters were identified. 239 of these posters were non-healthcare related individuals (88%) and 32 (12%) were healthcare related persons. There were 14 self-identified US physicians. All but one had verified credentials. By far, the most common type of post for non-healthcare related individuals was related to their infertility journey (60%). In contrast, the majority of posts created by healthcare-related individuals were educational (41%). When comparing US verified physician posting versus all other posters, US physicians were more likely to post educational (33% vs 9%, p= 0.0006) and promotional posts (33% vs 1%, p= <0.0001) and less likely to post about a personal infertility journey (5% vs 58%, p= <0.0001). There was no significant difference in ‘likes’ between the two groups (194±200 for US physicians vs 430±787 for all other posters, p=1.71). There was a significant difference in the number of comments between the two groups, with fewer comments in response to US physicians than all other posters (12±16 vs 36±51, p=0.015). No infertility postings by verified US physicians contained medical advice or medical questions. In contrast, 5% and 2% of postings by all other individuals gave medical advice or asked a medical question, respectively. Some of the medical advice given included taking 40mg/day of black cohosh for ovulation induction, using cannabis suppositories to shrink fibroids, and recommending supplements to increase fertility (who were often sold by the poster). Conclusions Instagram and other social media platforms have the potential to be highly influential in the infertility population. Physicians, particularly board-certified reproductive endocrinologists, should consider taking steps towards having a stronger presence online to combat the spread of misinformation that currently dominates these highly used platforms, and to help bridge gaps in access to infertility care.

Infertility in the digital age: an opportunity for REI physicians to combat the spread of misinformation and fill support gaps in infertility care online

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