Our 20s and 30s can feel like a trail run — with lots of paths to take. At times, we reach spots where the routes aren’t so clearly marked. We have decisions to make about our careers, relationships and one of the biggest doozies: whether to have kids and if so, when?
Some women know without a doubt they want children; others are just as convinced they don’t. Either way, it’s a definitive choice most women make at some stage in their lives. And if you’re on the fence about the decision and/or wrestling with the timing of it, that can drag you into a whole new cave of choices about whether to test your fertility, freeze your eggs or just go for it and try. Either way, the decision-making process can be rife with anxiety and confusion. So we asked a slew of fertility experts for their takes on all the ifs and whens.
Making the decision
Although you might have a partner involved in the actual baby-making and/or raising, the decision whether to embark on the parenthood journey should be an individual one before it becomes part of coupledom, if that’s even relevant.
“It is easy to allow a partner to influence your decision,” says Dr. Denise Howard, senior attending physician and assistant professor of clinical obstetrics and gynecology at Weill Cornell Medicine-Qatar. But first and foremost, you need to be “honest with yourself about your own desires,” she explains.
This next piece of advice might sound strange, but hear us out: Try to boil your desires down to what you’re willing to sacrifice for them. So, are you willing to give up your current sense of spontaneity and control (at least in part) in order to become a parent? Or are you willing to sacrifice the reported joys of parenthood in order to achieve different life goals? “No matter what path you choose, there is going to be a loss that you will need to grieve,” says Sarah Kowalski, a fertility doula and author of Motherhood Reimagined: When Becoming a Mother Doesn’t Go As Planned. “Recognizing that either path will involve a loss helps women process what they actually want.”
Kowalski also suggests putting aside logistical concerns like finances or career implications until you have clarity. Yes, those considerations hold great importance — but she recommends tackling them, if necessary, after figuring out your own gut pull. But if you don’t feel a clear or loud internal message, don’t let that be a source of stress. “The truth is that many women feel ambivalence,” Kowalski adds. “As more and more women speak about their mixed feelings, it normalizes it for others.”
Set aside any perceived societal, parental or other pressures to have kids as well. The decision should come from you. Whatever choice you arrive at is valid, and it shouldn’t be weighted with guilt, shame or other people’s wants.
Figuring out the timing
Of course, when it comes to having babies, age is a fertility factor. The earlier you can make the kid decision, the better, especially if you’re leaning toward having children, are unsure or have any fertility concerns. If you aren’t in the right place in life to start trying to conceive after making a decision to become a mom, you can take measures to explore and potentially preserve your fertility.
“Taking the time to get educated, to complete a fertility assessment and look for potential present or future issues is almost always a good, productive thing to do,” says Dr. Joshua U. Klein, chief medical officer of Extend Fertility Medical Practice in New York City and assistant professor of obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai.
So what should you know about this egg-freezing business, anyway? First of all, a low egg supply can impact the results achieved with egg freezing, Klein cautions. If you are a candidate and want to freeze your eggs, you should do so before age 35 or as early as your late 20s to yield more eggs, he says. And although freezing your eggs might buy you a bit more time, making a decision and taking action is still important as we climb through that pivotal fourth decade of our lives. “There is a significant decline in fertility in the late 30s,” Klein says, “and a dramatic decline in fertility, even with treatments like IVF, for women 40 and older.”
And as if we didn’t have enough on our plates already, we’re also tasked with deciding just how many kiddos we’re hoping to crowd into the mom van. It may go without saying, but if you’re set on building a larger family, you should aim to start trying to conceive earlier in life.
A recent study published in the journal Human Reproduction shows that for a 90 percent chance of conceiving three children (without IVF), a woman should start trying as early as age 23; for two children, age 27; and for one child, age 32. The chance drops to 50 percent if a woman aims for three children starting at 35; two children at 38; and one child at 41.
Women who have fertility issues such as endometriosis or polycystic ovary syndrome should also pursue children (if they want to) as soon as it makes sense in their lives. “All fertility issues are only exacerbated by the effects of reproductive aging,” Klein explains. “Some of these are typically known, and some are impossible to know about unless specific testing is done.”
If you’ve got a male partner in the equation, he can test his fertility too. “We really want men to check their sperm sooner rather than later,” says Kenan Omurtag, MD, assistant professor in reproductive endocrinology and infertility at the Washington University St. Louis School of Medicine’s department of obstetrics and gynecology. Omurtag recommends the Yo Home Sperm Test Kit. He says men who want children should try to conceive before 40 and freeze and bank sperm before undergoing any chemotherapy, radiation or radical pelvic surgery.
Fertility factors, preservation options, the timing of when to conceive and deciding whether to have kids — it’s a lot to tackle. That’s because these are major life decision with huge impact, and we don’t always achieve the outcomes we want. “There is a ton of research documenting the psychological and emotional toll of infertility,” Klein says. “It has been demonstrated to be similar to the stress caused by a diagnosis of cancer or a heart attack.” Women who decide not to have children face stressors too, especially when others put them down for or challenge their choice.
As you hoof life’s trails, stepping in rhythm to the tick of your biological clock, remember there’s no right or wrong answer here. “This is a deeply personal and individual decision,” Klein says. “The only mistake women can really make is to not get the appropriate information to help them make an educated choice about egg-freezing and preserving their options or to allow options for the future to close when they might want those options.”