Physicians are often reprimanded for neglecting their own health. But when it comes to fertility, studies are finding that the road to becoming a physician may actually be part of the problem. Emily Osman, MD, FACOG, TS (ABB), reproductive endocrinologist at IVI RMA New Jersey, says medical training — spanning medical school, residency, and often fellowship — directly overlaps with peak reproductive years. Performing through sustained levels of elevated stress and little sleep is often seen as a badge of honor, but it could be creating a culture of self-neglect that undermines healthy pregnancy.
Simultaneously, many physicians postpone having children until after training, only to discover that biology has not followed the same timeline. Research has found that female physicians experience infertility at substantially higher rates than women in the general population, yet many report receiving little or no education about reproductive aging or fertility preservation during medical school training. Medical education itself should better prepare future physicians for informed family planning.
Black women physicians occupy a unique intersection. Like many women in medicine, they often delay childbearing because of lengthy training and demanding careers. But research shows that Black women experience infertility twice the rate as white women, and Black communities generally have less fertility knowledge. That combination means discussions about fertility preservation are especially important for Black female physicians, who may find out all too late that their career was in direct competition with their prospects for motherhood.
Margaret M. Quinlan, PhD, Professor of Communication Studies and Director of Health & Medical Humanities at the University of North Carolina at Charlotte, believes the conversation often places too much responsibility on individuals instead of institutions.
“What we often frame as ‘personal family planning decisions’ are actually decisions shaped by institutional structures,” Dr. Quinlan said. “Medical training frequently overlaps with the years when fertility is highest, placing many women in an impossible position.” She added that “medical education is based around the premise: train now, and your life can come later.” However, reproduction does not work that way.
Occupational demands may further increase reproductive risks. Dr. Osman noted that female physicians, particularly surgeons, experience higher rates of miscarriage, preterm birth, and pregnancy complications. It is unclear if prolonged standing, radiation exposure, surgical smoke, anesthetic gases, and other workplace hazards are contributing to those outcomes, but further studies are needed to better understand the risks. Although research on male physicians remains limited, experts agree that far more attention has been paid to women’s experiences because reproductive aging is more time-sensitive and because delayed childbearing has measurable effects on female fertility.
It is worth noting that female doctors aren’t the only group experiencing high rates of infertility. The same is true of women in active-duty military service, according to an Armed Forces Health Surveillance Division study. What both groups have in common is physically and mentally taxing training that often takes place during peak reproductive years, as well as careers built on exposure to high levels of stress for prolonged periods. In both cases, physiological needs may play second fiddle to public service, and the repercussions may show up as a combination of fertility challenges, reproductive disorders, and menstrual interruption.
“Looking back on my training, the emphasis was understandably on contraception, pregnancy prevention, and learning how to care for our patients,” said Josette C. Dawkins, MD, a reproductive endocrinologist at Boston IVF. “We became very good at counseling patients about their reproductive health, but we spent very little time discussing our own.”
She believes reproductive health should become a routine component of physician wellness, alongside discussions of burnout and mental health. “The goal isn’t to tell women when to have children,” Dr. Dawkins said. “It’s to ensure physicians understand their reproductive timeline and available options early enough to make informed decisions.”
The evidence suggests earlier education could make a meaningful difference. Dr. Osman points to U.S.-based research showing that only 8 percent of female physicians reported receiving education about the reproductive risks associated with delaying pregnancy during training. Those who did receive counseling had lower rates of miscarriage and were less likely to require infertility evaluations later in their careers.
Dr. Quinlan argues that medical schools should focus on both the science behind reproductive challenges, as well as the financial and structural barriers physicians face when trying to access fertility care. She says that many are unable to access reproductive endocrinology and infertility (REI) specialists or treatment because of the expense and medical school debt.
In the Rutgers University Press book she co-authored with Bethany L. Johnson, “You’re Doing it Wrong: Mothering, Media, and Medical Expertise,” Dr. Quinlan noted that the “just relax, and you’ll get pregnant” myth is doubly problematic for physicians facing infertility. First, it frames a medical condition as a personal responsibility. For female physicians, the message especially stings by suggesting a failure of self-management or poor judgment.
Thankfully, more information is coming out about the topic, which helps people get ahead of these concerns and not feel so isolated when they arise. The American Medical Association’s Residency Life 2026 article “Should You Freeze Your Eggs During Physician Residency?” is a great start.
On a personal level, egg freezing and embryo cryopreservation allow younger eggs or embryos to be preserved for future family building. Depending on the patient’s circumstances, reproductive counseling, ovarian reserve testing, and discussions with a reproductive endocrinologist can also help physicians make informed decisions earlier in training.
Dr. Osman believes training programs should make these conversations routine and provide the scheduling flexibility necessary for physicians to pursue fertility preservation. “Women who preserve fertility can increase the likelihood of having biological children in the future by freezing eggs or embryos at an age at which oocyte quality is more favorable,” she explained. She also noted that preimplantation genetic testing can reduce the likelihood of transferring embryos with chromosomal abnormalities.
Her perspective is deeply personal. “I myself have experienced infertility during my fellowship, and the ability to cryopreserve genetically normal embryos for the future allowed me to have the family that I have always wanted despite not making compromises in my own career trajectory,” Dr. Osman said.
She also noted that medical students also consider their specialty choice based on perceived family-friendliness, with certain fields such as internal medicine, family medicine, or pediatrics considered more compatible with motherhood. Medical students should read up on the recent research on infertility incidence among female surgeons and other relevant specialties so they can make informed decisions about their career.
Egg and embryo freezing decisions may have more to do with health insurance coverage than ideal timing. For people looking to join medical school relatively young, it may be worthwhile to compare health insurance options under their parents’ coverage before aging out to needing their own —through their educational institution or employer. Dr. Dawkins noted that fertility insurance mandates are not applicable in every state. Accepting residency in a new state or carrying significant amounts of loan debt can be factors that might affect eligibility for health insurance coverage or fertility grants. For grants and support, medical students and physicians can consider organizations like the Tinina Cade Foundation and the CCRM Black Fertility Matters initiative. The American Medical Women’s Association also has a physician fertility working group, which accepts new members hoping to increase support, advocacy, and research on the problem set.
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