Support for Parents of Deaf Children: Common Questions and Informed, Evidence-based Answers

Publication date: Available online 29 December 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Tom Humphries, Poorna Kushalnagar, Gaurav Mathur, Donna Jo Napoli, Christian Rathmann, Scott Smith

Abstract

To assist medical and hearing-science professionals in supporting parents of deaf children, we have identified common questions that parents may have and provide evidence-based answers. In doing so, a compassionate and positive narrative about deafness and deaf children is offered, one that relies on recent research evidence regarding the critical nature of early exposure to a fully accessible visual language, which in the United States is American Sign Language (ASL). This evidence includes the role of sign language in language acquisition, cognitive development, and literacy. In order for parents to provide a nurturing and anxiety-free environment for early childhood development, signing at home is important even if their child also has the additional nurturing and care of a signing community. It is not just the early years of a child's life that matter for language acquisition; it's the early months, the early weeks, even the early days. Deaf children cannot wait for accessible language input. The whole family must learn simultaneously as the deaf child learns. Even moderate fluency on the part of the family benefits the child enormously. And learning the sign language together can be one of the strongest bonding experiences that the family and deaf child have.

http://bit.ly/2s31iyx

A modified reconstructive technique for paediatric congenital alar rim deformity

Publication date: Available online 29 December 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Atheer B. Ujam, Neil W. Bulstrode

Abstract

Alar subunit retraction or notching whether acquired or congenital, can be challenging to reconstruct. Congenital cysts and benign lumps involving the nasal alar region can also result in acquired alar deformity once resected. Published reports describe different surgical methods, but we demonstrate a simple and highly satisfying technique. We present four paediatric cases with alar rim defects and demonstrate our modified surgical technique.

All patients had an unremarkable recovery. Our outcomes demonstrate a minimal yet effective one-stage technique for correction of alar defects in paediatric patients that results in high patient satisfaction and allows for future secondary surgery if required.

http://bit.ly/2LFobkR

Racial and socioeconomic disparities associated with 90-day mortality among patients with head and neck cancer in the United States

Publication date: February 2019

Source: Oral Oncology, Volume 89

Author(s): Matthew E. Gaubatz, Aleksandr R. Bukatko, Matthew C. Simpson, Katherine M. Polednik, Eric Adjei Boakye, Mark A. Varvares, Nosayaba Osazuwa-Peters

Abstract

Objectives

To quantify head and neck cancer (HNC) mortality rates and identify racial and socioeconomic factors associated with 90-day mortality.

Methods

The National Cancer Database (2004–2014) was queried for eligible HNC cases (n = 260,011) among adults treated with curative intent. Outcome of interest was any-cause 90-day mortality. Kaplan-Meier curves (Log-rank tests) estimated crude survival differences. A Cox proportional hazards model with further adjustments using the Šidák multiple comparison method adjusted for racial, socioeconomic and clinical factors.

Results

There were 9771 deaths (90-day mortality rate = 3.8%). There were crude differences in sex, race/ethnicity, comorbidity, distance, income, and insurance (Log-rank p-value < 0.0001). In the final model, blacks (aHR = 1.10, 95% CI 1.00, 1.21) and males (aHR = 1.07; 95% CI 1.00, 1.15) had greater 90-day mortality hazard, as did those uninsured (aHR = 1.72; 95% CI 1.48, 1.99), covered by Medicaid (aHR = 1.72; 95% CI 1.53, 1.93) or Medicare (aHR = 1.40; 95% CI 1.27, 1.53). Residence in lower median income zip code was associated with greater 90-day mortality [(aHR <$30,000 = 1.30; 95% CI 1.18, 1.44); (aHR $30,000–$34,999 = 1.24; 95% CI 1.13, 1.36); (aHR $35,000–$45,999 = 1.18; 95% CI 1.08, 1.27)]; and farther travel distance for treatment was associated with decreased 90-day mortality [(aHR 50–249.9 miles = 0.86; 95% CI 0.77, 0.97); (aHR > 250 miles = 0.70; 95% CI 50, 0.99)].

Conclusions

There are significant race and socioeconomic disparities among patients with HNC, and these disparities impact mortality within 90 days of treatment.

http://bit.ly/2QZJkfu

The Co-occurrence of Pitch and Rhythm Disorders in Congenital Amusia

Publication date: Available online 30 December 2018

Source: Cortex

Author(s): Marie-Élaine Lagrois, Isabelle Peretz

Abstract

The most studied form of congenital amusia is characterized by a difficulty with detecting pitch anomalies in melodies, also referred to as pitch deafness. Here, we tested for the presence of associated deficits in rhythm processing, beat in particular, in pitch deafness. In Experiment 1, participants performed beat perception and production tasks with musical excerpts of various genres. The results show a beat finding disorder in six of the ten assessed pitch-deaf participants. In order to remove a putative interference of pitch variations with beat extraction, the same participants were tested with percussive rhythms in Experiment 2 and showed a similar impairment. Furthermore, musical pitch and beat processing abilities were correlated. These new results highlight the tight connection between melody and rhythm in music processing that can nevertheless dissociate in some individuals.

http://bit.ly/2QZ6tOW

Brainstem auditory evoked potentials with speech stimulus in neonates

Publication date: Available online 29 December 2018

Source: Brazilian Journal of Otorhinolaryngology

Author(s): Elaine Soares Monteiro Pinto, Maria Cecília Martinelli

Abstract

Introduction

Brainstem auditory evoked potentials in response to complex sounds, such as speech sounds, investigate the neural representation of these sounds at subcortical levels, and faithfully reflect the stimulus characteristics. However, there are few studies that utilize this type of stimulus; for it to be used in clinical practice it is necessary to establish standards of normality through studies performed in different populations.

Objective

To analyze the latencies and amplitudes of the waves obtained from the tracings of brainstem auditory evoked potentials using speech stimuli in Brazilian neonates with normal hearing and without auditory risk factors.

Methods

21 neonates with a mean age of 9 days without risk of hearing loss and with normal results at the neonatal hearing screening were evaluated according to the Joint Committee on Infant Hearing protocols. Auditory evoked potentials were performed with speech stimuli (/da/ syllable) at the intensity of 80 dBNA and the latency and amplitude of the waves obtained were analyzed.

Results

In the transient portion, we observed a 100% response rate for all analyzable waves (Wave I, Wave III, Wave V and Wave A), and these waves exhibited a latency <10 ms. In the sustained portion, Wave B was identified in 53.12% of subjects; Wave C in 75%; Wave D in 90.62%; Wave E in 96.87%; Wave F in 87.5% and Wave O was identified in 87.5% of subjects. The observed latency of these waves ranged from 11.51 ms to 52.16 ms. Greater similarity was observed for the response latencies, as well as greater amplitude variation in the studied group.

Conclusions

Although the wave morphology obtained for brainstem evoked potentials with speech stimulation in neonates is quite similar to that of adults, a longer latency and greater variation in amplitude were observed in the waves analyzed.

Resumo

Introdução

Os potenciais evocados auditivos de tronco encefálico para sons complexos, como por exemplo, sons de fala, investigam a representação neural destes sons em níveis subcorticais, e refletem com fidelidade as características do estímulo. No entanto, existem ainda poucos estudos que utilizam este tipo de estímulo, e para que este possa ser utilizado na prática clínica é necessário estabelecer padrões de normalidade por meio de estudos em diferentes populações.

Objetivo

Analisar, as latências e as amplitudes das ondas obtidas nos traçados dos potenciais evocados auditivos de tronco encefálico por estímulo de fala em neonatos brasileiros com audição normal e sem risco auditivo.

Método

Foram avaliados 21 neonatos com idade média de 9 dias, sem risco auditivo segundo o Joint Committe on Infant Hearing e com resultado normal para triagem auditiva neonatal. Realizou-se potenciais evocados auditivos por estímulo de fala (sílaba /da/) na intensidade de 80 dBNA e analisou-se a latência e a amplitude das ondas obtidas.

Resultados

Na porção transiente observou-se 100% de ocorrência de resposta para todas as ondas analisáveis (Onda I, Onda III, Onda V e Onda A), e este conjunto de ondas apresentou latência inferior a 10 ms. Na porção sustentada à frequência de ocorrência da Onda B foi de 53,12%; da Onda C 75%; da Onda D 90,62%; da Onda E 96,87%; da Onda F 87,5% e da Onda O 87,5% e a latência observada destas ondas variou de 11,51 ms a 52,16 ms. Observou-se maior similaridade nas latências das respostas e maior variação da amplitude no grupo estudado.

Conclusões

Embora a morfologia das ondas obtidas para os potenciais evocados de tronco encefálico para o estimulo de fala em neonatos, seja bastante semelhante às dos adultos, observou-se maior latência e maior variação da amplitude das ondas analisáveis.

http://bit.ly/2GMHqdg

Predicting bacteria causing acute bacterial rhinosinusitis by clinical features

Publication date: Available online 29 December 2018

Source: Brazilian Journal of Otorhinolaryngology

Author(s): Dussawan Suwannawong, Kachorn Seresirikachorn, Songklot Aeumjaturapat, Supinda Chusakul, Jesada Kanjanaumporn, Wirach Chitsuthipakorn, Winyu Ruksakul, Kornkiat Snidvongs

Abstract

Introduction

Clinicians rely on clinical presentations to select therapeutic agents for acute bacterial rhinosinusitis. Streptococcus pneumoniae and Haemophilus influenzae are common in acute bacterial rhinosinusitis. Drug resistant S. pneumoniae and H. influenzae require different antibiotics.

Objective

This study aimed to evaluate the associations between clinical features of acute bacterial rhinosinusitis and pathogenic bacteria.

Methods

Sixty-four patients with acute bacterial rhinosinusitis were enrolled. Clinical features including nasal obstruction, discolored discharge, facial pain, smell disturbance, fever and laboratory findings of patients with acute bacterial rhinosinusitis were collected. The bacterial cultures of endoscopic middle meatal swabs were used as a reference.

Results

Serum C-reactive protein level elevation correlated with the bacterial species (p = 0.03), by which was increased in 80.0% of H. influenzae rhinosinusitis and 57.1% of S. pneumoniae rhinosinusitis. The elevated C-reactive protein was the significant predictor for H. influenzae rhinosinusitis with the Odds Ratio of 18.06 (95% CI 2.36–138.20). The sensitivity of serum C-reactive protein level elevation for diagnosing H. influenzae rhinosinusitis was 0.80 (95% CI 0.49–0.94).

Conclusion

Elevation of serum C-reactive protein level was associated with and predicted acute bacterial rhinosinusitis caused by H. influenzae.

Resumo

Introdução

Os médicos se baseiam nas características clínicas para a escolha dos agentes terapêuticos para o tratamento da rinossinusite bacteriana aguda. Streptococcus pneumoniae e Haemophilus influenzae são agentes comuns na rinossinusite bacteriana aguda. Streptococcus pneumoniae e Haemophilus influenzae resistentes a antibióticos requerem medicamentos diferentes.

Objetivo

Este estudo teve como objetivo avaliar as associações entre as características clínicas da rinossinusite bacteriana aguda e bactérias patogênicas.

Método

O estudo incluiu 64 pacientes com rinossinusite bacteriana aguda. Foram coletadas e registradas as características clínicas, incluindo obstrução nasal, secreção com cor alterada, dor facial, distúrbios do olfato, febre e achados laboratoriais de pacientes com rinossinusite bacteriana aguda. As culturas bacterianas obtidas por swab endoscópico do meato médio foram utilizadas como referência.

Resultados

A elevação do nível sérico de proteína C-reativa estava correlacionada com a espécie bacteriana (p = 0,03); ela estava aumentada em 80,0% das rinossinusites por Haemophilus influenzae e em 57,1% das rinossinusites por Streptococcus pneumoniae. A proteína C-reativa elevada foi um significativo fator preditor de rinossinusite por Haemophilus influenzae, com razão de probabilidade de 18,06 (IC 95% 2,36-138,20). A sensibilidade da elevação dos níveis séricos de proteína C-reativa para o diagnóstico de rinossinusite por Haemophilus influenzae foi de 0,80 (IC 95% 0,49 ± 0,94).

Conclusão

A elevação dos níveis séricos de proteína C-reativa é um preditor de rinossinusite bacteriana aguda causada por Haemophilus influenzae.

http://bit.ly/2Rv20mV

Human Reproductive Sciences

http://www.jhrsonline.org/currentissue.asp?sabs=n

From the editors desk Madhuri Patil Journal of Human Reproductive Sciences 2018 11(4):303-305

Preimplantation genetic testing: Its evolution, where are we today? Firuza Rajesh Parikh, Arundhati Sitaram Athalye, Nandkishor Jagannath Naik, Dattatray Jayaram Naik, Rupesh Ramesh Sanap, Prochi Fali Madon Journal of Human Reproductive Sciences 2018 11(4):306-314 Preimplantation genetic testing (PGT) is an early form of prenatal genetic diagnosis where abnormal embryos are identified, thereby allowing transfer of genetically normal embryos. This technology has become an integral part of Assisted Reproductive Technology (ART) procedures. Initial experiments with animals as early as 1890 and those in the mid and later part of the last century paved the forward path of ART and PGT. This review article covers the evolution of PGT and is a pointer toward current and fast-evolving technology, allowing scientists and doctors to better comprehend human reproduction, and ensure healthy pregnancy outcomes.

Psychosocial aspects of therapeutic donor insemination Ansha Patel, P. S. V. N. Sharma, Pratap Kumar Journal of Human Reproductive Sciences 2018 11(4):315-319 The experience of delays in conception or possibility of remaining childless has the potential to create considerable psychological discomfort. In couples with severe male factor infertility, therapeutic intrauterine insemination using donor sperms (TDI) is offered as a treatment, second to in vitro fertilization using donor sperms. TDI is lucrative, less invasive, and a hopeful treatment. However, there are intricacies associated with it. Its immediate outcomes involve limited success rates, nonresponse, and chances of implantation failures, miscarriages, and multifetal pregnancies. Due to this, couples experience distress when they are advised to undergo three to six cycles of TDI in order to meet the expectations of having a baby. TDI has long-term issues on the triad comprising the “recipients,” the “donors,” and the “the children born out of TDI.” Nevertheless, managing psychosocial needs for couples undergoing TDI and other treatments in Indian clinics are grey areas of the conventional treatment pathway. The present review expands on the psychological issues and needs in couples opting for TDI.

"In cycles of dreams, despair, and desperation:" Research perspectives on infertility specific distress in patients undergoing fertility treatments Ansha Patel, P. S. V. N. Sharma, Pratap Kumar Journal of Human Reproductive Sciences 2018 11(4):320-328 “Emotional distress in infertility” is a broad expression that loosely denotes anxiety, depression, grief, crisis, depleting psychological well-being, and all forms of affective and interpersonal disturbances faced by individuals with infertility. The distress is usually associated with involuntary childlessness as it is an unwelcoming event. The developmental crisis associated with childlessness poses a threat to one's sense of self at all levels (individual, family and social). Distress may begin before or during treatments as a person experiences the loss of control over attaining parenthood, anxiety or dejection after the diagnosis, treatments, its complications particularly its limited success rates. This paper reviews the basic concepts, theoretical models related to infertility specific distress (ISD). It elaborates on the effects of individual and treatment-specific variables on ISD with special highlights gathered from the national and international research.

Examination of Y-chromosomal microdeletions and partial microdeletions in idiopathic infertility in East Hungarian patients Attila Mokánszki, Anikó Ujfalusi, Éva Gombos, István Balogh Journal of Human Reproductive Sciences 2018 11(4):329-336 Purpose: The aim of this study was to establish the Y chromosome microdeletion and partial AZFc microdeletion/duplication frequency firstly in East Hungarian population and to gain information about the molecular mechanism of the heterogeneous phenotype identified in males bearing partial AZFc deletions and duplications. Materials and Methods: Exactly determined sequences of azoospermia factor (AZF) region were amplified. Lack of amplification was detected for deletion. To determine the copy number of DAZ and CDY1 genes, we performed a quantitative analysis. The primers flank an insertion/deletion difference, which permitted the polymerase chain reaction products to be separated by polyacrylamide gel electrophoresis. Statistical Analysis Used: Mann–Whitney/Wilcoxon two-sample test, Kruskal–Wallis test, and two-sample t-probe were used for statistical analysis. Results: AZFbc deletion was detected only in the azoospermic cases; AZFc deletion occurred significantly more frequently among azoospermic patients, than among oligozoospermic males. The frequency of gr/gr deletions was significantly higher in the oligozoospermic patients than in the normospermic group. The b2/b3 deletion and partial duplications were not different among our groups, while b1/b3 deletion was found only in the azoospermic group. In infertile males and in normozoospermic controls, similar Y haplogroup distribution was detected with the highest frequency of haplogroup P. The gr/gr deletion with P haplogroup was more frequent in the oligozoospermic group than in the normozoospermic males. The b2/b3 deletion with E haplogroup was the most frequent, found only in the normozoospermic group. Conclusions: Y microdeletion screening has prognostic value and can affect the clinical therapy. In case of Y chromosome molecular genetic aberrations, genetic counseling makes sense also for other males in the family because these types of aberrations are transmittable (from father to son 100% transmission).

A study on balanced chromosomal translocations in couples with recurrent pregnancy loss Pritti K Priya, Vineet V Mishra, Priyankur Roy, Hetvi Patel Journal of Human Reproductive Sciences 2018 11(4):337-342 Background: Recurrent pregnancy loss (RPL) is an obstetric complication that affects couples in their reproductive age. Chromosomal abnormalities, mainly balanced rearrangements, could commonly be present in couples with RPL. Aim: The purpose of this study is to evaluate the contribution of chromosomal abnormalities and balanced reciprocal translocations, in particular occurring in either of the partners, resulting in RPL. Materials and Methods: A retrospective cytogenetic study was carried out on 152 individuals (76 couples) having a history of RPL. The cases were analyzed using G-banding and fluorescence in situ hybridization, wherever necessary. Results: Chromosomal abnormalities were observed in 3.2% of the total RPL cases, of which balanced translocations were observed in 4 (80%) individuals and marker chromosome was detected in 1 (20%) individual. All balanced translocations comprised reciprocal translocations, and no cases of Robertsonian translocations were detected in our study. Among reciprocal translocation carriers, three were male and one was female. Polymorphic variants were noted in 8 (5.3%) individuals. Conclusions: Chromosomal analysis is an important etiological investigation in couples with RPL. Balanced translocations are the most commonly detected chromosomal abnormalities in such couples. Thus, these couples are the best candidates for offering prenatal genetic diagnosis, thereby ensuring a better reproductive outcome.

Circulating levels of vitamin D3 and leptin in lean infertile women with polycystic ovary syndrome Ayman Shehata Dawood, Adel Elgergawy, Ahmed Elhalwagy Journal of Human Reproductive Sciences 2018 11(4):343-347 Objective: The objective of this study is to measure levels of Vitamin D3 and leptin and assess their relation of each to the pathogenesis of polycystic ovary syndrome (PCOS). Design: This was a cohort observational study. Settings: This study was conducted at the Department of Obstetrics and Gynecology, Tanta University. Materials and Methods: Ninety lean women were enrolled in this study and were allocated into two groups with 45 patients in each group: the first group (study group) who are lean women with PCOS and the second group (control group) who are the lean infertile patients without PCOS. Blood samples were collected and tested for study parameters. Results: There were no significant differences regarding demographic characteristics between both groups. The differences were in ovarian volume and hormonal profiles. Serum leptin was found to be significantly increased in lean PCOS than in control groups. Vitamin D3 levels were found to be lower in the lean PCOS group than in control group. Conclusion: Lean PCOS women are a unique group with specific hormonal profiles different from the typical PCOS profiles. Leptin and Vitamin D3 may have a role in the pathogenesis of lean PCOS, but large studies are still required regarding this unique group.

Effect of insulin sensitizers on raised serum anti-mullerian hormone levels in infertile women with polycystic ovarian syndrome Neeti Chhabra, Sonia Malik Journal of Human Reproductive Sciences 2018 11(4):348-352 Context: Increased circulating insulin levels contribute to hyperandrogenism in polycystic ovarian syndrome (PCOS) which causes a derangement in folliculogenesis, thus contributing to polycystic morphogenesis of the ovaries and a higher than normal anti-Mullerian hormone (AMH). A high AMH is an indicator of either stubborn anovulation or a predictor of ovarian hyperstimulation syndrome. Hence, it is postulated that the use of insulin sensitizers will reduce insulin resistance, hyperandrogenism, and subsequently serum AMH levels and will convert anovulatory cycles to ovulatory. Aim: To study the effect of insulin sensitizers on raised serum AMH levels in infertile women with PCOS. Settings and Design: This was a prospective interventional randomized single tertiary center study. Methodology: The study was conducted from August 2015 to April 2016. Infertile patients with PCOS as defined by the Rotterdam criteria with raised AMH (>5 ng/ml) levels were enrolled in the study under strict inclusion and exclusion criteria. The sample size was 105 patients. Cycle regularity, day 2–antral follicle count (AFC), luteinizing hormone, AMH levels, modified Ferriman–Gallwey score (mFGS), and acne score were recorded before starting the intervention. Patients were randomized into three equal groups of 35 each. Group A received metformin alone, Group B metformin plus myoinositol, and Group C only myoinositol. After completion of 3 months of pretreatment, the same parameters were rechecked. Statistical Analysis Used: Univariate analysis and Chi-square test were used for statistical analysis. Results: Of 105 patients, 95 completed treatment and the rest 10 dropped out. There was a reduction in AMH in all groups of insulin sensitizers with significant fall in the metformin only group. Cycle regularity, reduction in AFC, mFGS, and grade of acne were also obtained. Conclusions: Therapy with insulin sensitizers in PCOS women with raised AMH reduces the AMH levels, converts irregular menstrual cycles to regular, and reduces clinical hyperandrogenism.

Window of implantation is significantly displaced in patients with adenomyosis with previous implantation failure as determined by endometrial receptivity assay Nalini Mahajan, Simrandeep Kaur, Maria Ruiz Alonso Journal of Human Reproductive Sciences 2018 11(4):353-358 Background: Adenomyosis is associated with implantation failure and poor reproductive performance in IVF/ICSI cycles. Aims: To compare if window of implantation (WOI) is displaced in patients having adenomyosis compared to controls using endometrial receptivity array (ERA) test. Settings and Design: Retrospective Case control study. 374 patients with previous one or more IVF failures who underwent ERA test between 2013-2016 at our centre were enrolled. Patients were divided into two groups; Group A-36 patients with adenomyosis (study group) and Group B- 338 patients without adenomyosis (controls). Statistical Analysis: Normality assumptions for continuous variables were tested using Kolmogorov Smirnov test. Mean values of two groups were compared using Student's t-independent test. Frequency data by categories were compared using Chi-square/Fisher's exact test. Risk ratio and 95% confidence limits were calculated. P < 0.05 was considered for statistical significance. Results: WOI was displaced (Non Receptive ERA) significantly in adenomyosis 47.2% (17/36) compared to controls 21.6% (73/338) (P < 0.001, CI-8.7%-42.5%) making risk ratio of displaced WOI in adenomyosis versus controls to be 2:1. The incidence of RIF was 66.6% in adenomyosis compared to 34.9% in controls (P < 0.001, CI- 15.5%-47.9%). Pregnancy rate after personalized embryo transfer in adenomyosis group was 62.5%, signifying displaced WOI as a cause of implantation failure in adenomyosis patients with previous implantation failure. Conclusions: Our study suggests it is prudent to evaluate Endometrial receptivity before embryo transfer in patients with adenomyosis to avoid wastage of good embryos.

Knowledge about age-related decline in fertility and oocyte cryopreservation: A national survey Karissa C Hammer, Alyssa N Kahan, Louis F Fogg, Mark A Walker, Jennifer E Hirshfeld-Cytron Journal of Human Reproductive Sciences 2018 11(4):359-364 Context: Women worldwide are delaying childbearing, but are they aware of the age-related decline in fertility? Aims: The aim of this study is to investigate awareness of age-related decline in fertility and oocyte cryopreservation. Settings and Design: A primary analysis of a cross-sectional electronic survey with a nationally representative sample of nulliparous women aged 25–45 years. Subjects and Methods: A national online survey performed March 4–March 9, 2016. Statistical Analysis Used: A linear regression model and ANOVA tests were performed. Results: A total of 1213 women completed the survey. A significant difference was discovered in fecundity knowledge between women who identified as in a partnership compared to those who did not. Partnered women were more likely to respond “know a lot” about the age-related decline in fertility, whereas unpartnered women were more likely to respond “never heard of it” (P < 0.01). Partnered women are also more likely to respond that they would have made different life choices had they been more knowledgeable about fertility at a younger age (P = 0.01). The majority of the survey population had heard of oocyte cryopreservation but did not know much about it. Conclusions: Slightly over half of participants had an understanding of the natural age-related decline in fertility. Having a partner significantly increased the likelihood that a woman reported more knowledge about fertility. More effort is necessary to educate all women on assisted reproductive technologies and the natural age-related decline in fertility, specifically single women of childbearing age.