For women pursuing a career in medicine, the demands of training often overlap with the years when fertility is at its peak. Medical school, residency, and fellowship consume time, energy, and focus, leaving little space for starting a family. While this may feel like just part of the deal, the effects of delay on reproductive outcomes are often more significant than expected.
A recent study of nearly 200 female physicians at a large academic medical center in Massachusetts sheds light on how these choices play out over time. Many reported delaying childbearing for their careers, some faced infertility, and others expressed regret. The findings offer a window into what happens when professional goals and reproductive health collide—and they raise important questions for medical students and early-career physicians.
In this article, we’ll break down what the study found, including how common it is for physicians to postpone parenthood, what kinds of fertility treatments are later required, and why so few pursue egg freezing. You’ll also read about how specialty choice and workplace culture shape these decisions, and what early-career medical professionals might want to keep in mind as they plan ahead.
A closer look at the data
The study, published as a pre-print in Fertility & Sterility, surveyed 194 attending-level female physicians at the University of Massachusetts Chan Medical School. All participants had completed their training and identified as having a uterus. The median age was 42, and most respondents were white, heterosexual, and married. Though the study took place at a single institution, the results echo what smaller and larger studies across the U.S. have also found.
Some of the most surprising findings included:
- 64% intentionally delayed childbearing due to career considerations.
- 28% of those who had attempted conception sought fertility treatment.
- Only one respondent had pursued egg freezing, despite the high rate of delayed childbearing and infertility.
- 41% said their specialty choice influenced their family planning, and 10% would have chosen a different specialty altogether if they could reconsider based on reproductive factors.
- Nearly 60% of those who sought fertility treatment said their colleagues didn’t know about it, indicating stigma or reluctance to share these experiences in the workplace.
Among the group, 64% said they had intentionally delayed childbearing because of their careers. And while some were able to have children later, others struggled. Nearly 30% of those who attempted to conceive required some form of fertility assistance, such as intrauterine insemination (IUI), in vitro fertilization (IVF), or hormonal therapy. These experiences weren’t just clinical—they were emotionally and logistically draining. Respondents described fertility treatment as “a secret second job” and shared how hard it was to manage appointments and recovery while keeping up with demanding work schedules.
Why age matters more than most expect
One of the most consistent themes in the study was delayed family planning. The median age at first pregnancy among respondents was 32, with many stating they waited until after residency or even fellowship to start trying. The average age for American women overall is 27.3. While this may seem like a reasonable timeline, it often pushes conception into an age range where fertility begins to decline. Advanced maternal age—generally defined as 35 and older—is linked to increased risk of miscarriage, pregnancy complications, and infertility.
What’s more, fewer than half of the respondents said they had learned about their own fertility during medical training. Even within a field built on science, many felt unprepared or uninformed about how quickly fertility can decline. Several said they wished they’d received more specific information about fertility timelines and options like egg freezing much earlier.
Specialty choice plays a role
The study also revealed how much specialty selection can affect reproductive planning. Over 40% of respondents said their specialty impacted their ability to build a family. Some specialties—particularly surgical ones—were described as rigid and unforgiving when it came to parental leave or flexible scheduling. Others chose specialties they believed would be more “family friendly,” but still faced institutional obstacles.
About 10% of respondents said they would have chosen a different specialty if they’d considered family planning more carefully at the time. That number may sound small, but it reflects real trade-offs and missed opportunities. Specialty choice isn’t just about interest or aptitude—it also shapes lifestyle, hours, and how easily time off can be managed.
Fertility preservation: rarely used, often too late
Only one (!!!) respondent reported having frozen her eggs. That low number is striking, given how many delayed childbearing or later struggled with infertility. Some of this may be generational—egg freezing only became widely accessible and socially accepted in the past decade—but the responses also point to a lack of institutional support. Many said they didn’t have enough information about egg freezing during training, or that cost and time were major barriers.
Some respondents said they would have considered fertility preservation earlier if it had been encouraged or financially supported. Others described regret that they hadn’t understood how limited their options would become over time. Though the study didn’t focus on medical students, the findings suggest this is an area where awareness and access could make a difference.
The unspoken culture around fertility
One of the clearest messages from the study is that fertility and childbearing remain taboo topics in medicine. Among those who sought fertility treatment, 59% said they kept it from colleagues. Respondents cited fear of judgment, stigma, or simply not wanting to appear “less committed” to their work. Some described returning to work just weeks after giving birth, with little support or flexibility.
The stigma isn’t just about pregnancy—it extends to wanting to have children at all. Several respondents said they felt they had to choose between being seen as serious about their careers or open about their plans to have a family. Until this cultural tension is addressed, many physicians will continue to feel isolated in their family-building experiences.
What medical students and residents can take away
If you’re in medical school, residency, or just beginning to think about your future, this study offers both a warning and an opportunity. The warning: don’t assume you’ll figure it out later! Fertility isn’t something most people think about until they have to, but for women in medicine, waiting too long can close doors.
The good news is that you still have time to learn, ask questions, and make decisions that align with both your career and your personal goals. Talk to mentors who have navigated these issues. Seek out unbiased information about fertility timelines and preservation. Consider how specialty choice, training length, and future lifestyle may intersect with your family plans. Advocate for work environments that honor and respect family building. During your job searches and contract negotiations, prioritize the benefits that will be important to you if you may need to take leave at some point. Most importantly, know that you’re not alone in thinking about this now.
Planning ahead doesn’t mean giving up on your ambitions—it means refusing to let biology, or outdated workplace norms, make the choices for you.
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