IssueJuly 22Opinion

Is the Fertility Specialist on Instagram

Why it is rewarding to connect with the millennial generation utilising fertility services and the fertility community at large on Instagram. An insight by Alexandra Peyser, Liat Goldstein, Christine Mullin and Randi H Goldman;
Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Northwell Health, North Shore University Hospital, USA

Social media has rapidly become an integral part of our daily routines. Communication via user-generated content enables interaction and collaboration among healthcare communities and patients. Most patients utilise social media to inquire about information about their symptoms, diagnosis, and treatment. Online availability of health-related information has increased significantly in recent years. Social media has changed the way people seek and share information on healthcare despite the potential lack of information quality control. However, little information is available on the use, risks, and benefits of using social media to educate the general public, patients, and healthcare professionals.

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What is Insta

Instagram (Insta) is a free online social networking service that is currently used by 67 per cent of American  young adults aged 18–29 years and 47 per cent of adults aged 30–49. The platform enables users to post pictures and videos to their profiles, add a caption, and use hashtags (# symbol) to describe photos fertility and
categorise posts into searchable topics that other users can find. Users can follow specific hashtags and any
number of accounts to view a steady stream of personalised content. Users can also search by hashtag to view
desired content posted in aggregate and “share”, “like”, or “comment” on posts. A recent poll showed that the average user spends 21.2 minutes on Instagram each day, with the 18–29 age group spending the most time at 30 minutes.

Fertility journey on Instagram

Increasing numbers of patients are now sharing their (in) fertility journeys through Instagram. Using hashtags,
patients can share their experiences or find others going through similar circumstances. Whereas, physicians
utilise Instagram as a platform for sharing evidence-based medical education to inform the public on any health care subject. Despite the rising influence of this particular platform, the literature remains scarce regarding the
use of Instagram within the field of reproductive medicine and infertility. Few peer-reviewed studies quantitatively evaluate fertility-related content on Instagram, and more importantly, limited published reports are indicating who is responsible for these posts.

A recent article by Blakemore and colleagues analysed individual accounts from ‘Fertility Influencers’ on both Twitter and Instagram to determine the topography of fertility-related information on social media. They found that the majority of influential accounts were from patients, with a paucity of a board-certified reproductive endocrinologist and infertility specialists contributing to this space. The authors analysed the five most recent posts by fertility influencers (39 on Twitter and 28 on Instagram) and reported the top 11 hashtags most used by those influencers. While that study focussed on fertility influencers and they are most commonly used hashtags,
this study was designed to determine what a first-time patients desiring fertility treatment may find as they
begin their search on Instagram.

Our study

We tried to look for prevalence, authorship, and types of fertility and related information targeted toward new fertility patients on Instagram and compared the content of posts authored by physicians versus patients.
We made a list of ten hashtags consisting of fertility terms which included: IVF, Infertility, Fertility, IVF Journey, Infertility Awareness, IVF Support, Fertility Awareness, IVF Success, Egg Freezing and Egg Retrieval. These terms were chosen based on what a first-time IVF or planned oocyte cryopreservation patient may search for as they gather information regarding fertility options. Top posts were determined by Instagram via a proprietary algorithm consisting of parameters including the number of likes, comments, and user engagement on the posts.

What we found

Our study demonstrated an abundance of information related to fertility on Instagram with 66 per cent of posts directed toward patient experience and authored by patients. Only 10 per cent of posts were authored by  individual physicians. 10 per cent of posts were advertisements directed at reproductive-aged women.

Physicians be online

Despite the recognised role of social media in providing health-related information, many medical providers and public healthcare institutions are reluctant to use social media platforms. Providers need to be wary of maintaining patient confidentiality online and abiding by HIPAA. Providers must also be aware of workplace  policies surrounding the use of social media, the time commitment of posting content, and the implications of engaging in discussions online. Many medical societies have published guidelines on the appropriate use of social media. The American College of Obstetricians and Gynecologists (ACOG) was one of the first to offer guidance to physicians. Their recently revised committee opinion in 2019 states that social media is “not only acceptable for the modern practising physician but has become a necessary element for relating to patients and practising medicine.” The American Medical Association (AMA) describes six considerations for ethical use of  social media, encouraging the protection of patient privacy, realising permanence, alerting colleagues to suspected inappropriate use, maintaining patient boundaries, realising that actions online may negatively affect their reputation amongst patients and colleagues, and considering creating separate personal and professional accounts.

Conclusion
Social media provides a powerful tool to inform, engage, and communicate with the fertility community. It will
exponentially grow larger as the millennial and Gen Z generations begin to reach their reproductive prime. Physicians have an opportunity to connect with and educate a large number of patients looking for support by authoring evidence-based posts on social media.

Modified from: Peyser, A., Goldstein, L., Mullin, C. et al. Fertility education: what’s trending on Instagram. Fertil Res and Pract 7, 3 (2021). https:// doi.org/10.1186/s40738-021-00095-6

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