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“The elephant in the (exam) room”: Pregnant reproductive endocrinology and infertility physicians’ experiences in clinical care
Journal article   Open access   Peer reviewed

“The elephant in the (exam) room”: Pregnant reproductive endocrinology and infertility physicians’ experiences in clinical care

Emily Capper, Stacey A. Pawlak, Karen M. Summers and Rachel M. Whynott
F&S Reports (Online)
02/2026
DOI: 10.1016/j.xfre.2026.02.006
url
https://doi.org/10.1016/j.xfre.2026.02.006View
Published (Version of record) Open Access

Abstract

To determine the impact of being pregnant while working as a reproductive endocrinology and infertility (REI) physician. A qualitative study based on semi-structured interviews conducted between March 2021 and January 2022. Twelve U.S. REI physicians who were recruited through purposive sampling. Experienced a pregnancy while providing patient care in an infertility clinic setting as a fellow or attendingPurposive sampling was utilized to recruit reproductive endocrinology and infertility physicians who experienced a pregnancy while providing patient care in an infertility clinic setting as a fellow or attending. Interview transcripts were thematically analyzed to produce basic codes, organized into sub-themes and themes. Qualitative thematic analysis of interview transcripts to produce basic codes , organized into sub-themes and themes. Respondents experienced pregnancies while practicing infertility medicine in 11 states. Five reproductive endocrinologists used assisted reproductive technology to conceive their own pregnancies. A majority discussed how increased awareness of the fertile window and potential pregnancy complications impacted them. Most acknowledged that seeing a pregnant physician could be difficult for a sub-fertile patient and took steps to protect the patient, including intentionally trying to hide physical manifestations of pregnancy via clothing or scheduling. Emotional experiences discussed included: anxiety about their own pregnancy, self-consciousness of physical manifestations of pregnancy or personal fertility journey, survivor guilt related to conceiving while their patients struggle and anxiety over patient interactions. The majority noted patient-initiated conversations about physician pregnancy and described these as positive interactions. Many reported dialogues with colleagues or mentors about personal family-building and impacts on patient interaction. This study highlights the need for improved support for personal family building within the REI field. Opportunities for improvement include maternity leave, collegial collaboration, and guidance for management of challenging patient interactions. Improvements in these areas have the potential to result in improved support, empathy, and clinical care for REI patients and physicians.
 Infertility patient interactions patient provider rapport physician pregnancy qualitative study

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