When most of us enter medical school, we’re stirred with excitement and energy. In our early-to-mid-20s, we dive headfirst into anatomy, physiology, and the daunting task of becoming doctors. A future family? That’s a far-off thought for many.
But looking back, I wish I had started thinking about my fertility much earlier — right after I found my footing in medical school. Here’s why:
1) The Length of Training
Medical training is a marathon, not a sprint. Between medical school and residency, the better part of our 20s is dedicated to rigorous education and training. By the time many of us become attending physicians, we’re often in our early 30s.
There’s never a perfect time to start a family, but balancing 80-hour work weeks with raising a toddler is, to put it simply, difficult. For those with partners also in medicine, this task can feel nearly impossible. Many of my co-residents who started families during training had critical support systems in place, like non-medical partners, full-time childcare, or nearby family help.
Another complicating factor? The uncertainty of residency and fellowship placements. Moving for medical training often delays family planning, pushing it into attending years, when age becomes a significant consideration.
2. Age
Biology plays an undeniable role in fertility. The ideal time to freeze your eggs is before the age of 35, with 20 eggs being a solid benchmark for future pregnancy. Freezing even just eight to 10 eggs can still provide a meaningful safety net. In general, the younger the eggs are when frozen, the better quality they will be and have a higher chance of successfully overcoming the freeze/thaw cycle.
Egg freezing has become more accessible, but it involves a time commitment for hormone injections and egg retrieval, along with financial costs. Ironically, the most feasible time to undergo the procedure may be during medical school, when schedules offer greater flexibility compared to residency or attending life. It’s also when future female physicians are at their youngest. Additionally, as women age, they tend to develop more health conditions such as diabetes and hypertension, which may make future conception more difficult.
While many women have healthy pregnancies after 35, advancing maternal age increases the risk of infertility, chromosomal abnormalities, and pregnancy complications. Freezing eggs earlier can serve as an “insurance plan” against these challenges and, in some cases, mitigate potential future restrictions based on state legislation.
3. The Financial Cost
Egg freezing isn’t cheap. Each cycle can cost between $10,000 and $20,000, not including storage fees or future IVF expenses. However, with the procedure becoming more common, some insurance plans now cover parts of it.
For medical students, it may be worth considering whether loan money could help offset the costs. Additionally, some residency programs are beginning to include fertility preservation in their benefits packages; certainly a consideration as students craft their rank lists. Finally, fertility specialists offer discounted rates for female residents through a specialized program.
4. Taking Control of Your Future
Considering fertility early in medical school allows you to prioritize your future goals, whether they involve starting a family sooner, preserving your options for later, or deciding not to have children at all. Being proactive about fertility planning allows you to navigate the challenges of medical training while securing options that align with your personal aspirations. While many parts of a medical career are out of your control, take charge of your fertility, and do not let the demands of a physician’s career stop your personal goals.
Despite the length of medical school, the ticking biological clock, and the financial concerns of family planning, I encourage all women to consider their future when starting medical training. Thinking about fertility is a deeply personal subject, but starting the conversation early — ideally, as soon as you’re accepted into medical school — can make a world of difference for your future as a mother and partner. Medical training is demanding, but with foresight and planning, you can find out how to navigate the complexities of both your career and your future family. And the good news? You don’t need to sacrifice either one.
What do you think female physicians should consider when it comes to family planning and fertility alongside their careers? Share in the comments!
Dr. Aanika Warner is a medical school admissions expert at Inspira Advantage. She graduated from Johns Hopkins with an MD and MPH in epidemiology/biostatistics before becoming a resident physician at the Johns Hopkins Osler Internal Medicine Training Program. Dr. Warner is currently a Hematology/Oncology fellow at the National Institutes of Health.
Illustration by Jennifer Bogartz
