Why Do Female Physicians Face a Higher Rate of Infertility?

If you’re a female physician in the United States, you may have heard that you’re at a higher risk of infertility than your female friends who took a different career path. It certainly sounds like the kind of “fact’ that gets posted on social media one day and suddenly becomes gospel, whether it’s true or not. 

Unfortunately, we can’t just write this one off as a social media hoax. Researchers have run the numbers, and it turns out almost 25% of female doctors who are trying to conceive are faced with fertility challenges. This is about double the rate of the general public.

“It turns out almost 25% of female doctors who are trying to conceive are faced with fertility challenges. This is about double the rate of the general public. “

So what’s going on? Should you be freezing your eggs now just in case? Is there anything else you can do? Read on for the research into this fertility concern and what American doctors are doing about it. 

Female doctors and fertility

General fertility rates have been trending downward in the US in recent decades with the CDC reporting record low birth rates in 2018 and only minimal increases since. In 2021, the American birth rate was 1,663 births per 1,000 women — not enough to maintain stable population figures in the US. 

And while some of that could be due to personal choice, scientists have found increasing rates of reproductive problems are cropping up in women and men. Miscarriage rates are up about one % every year and so are the rates of gestational surrogacy — an option growing in popularity for intended parents seeking the help of an additional party for conception. 

But the plight of female doctors stands out among all these figures: 

• 1 in 4 — The approximate number of female physicians who were diagnosed with infertility after trying to have a baby, according to a survey published in the Journal of Women’s Health in 2016 
• 11 % — The percentage of American women in the general population have had the same diagnosis. 
• 42 % —The amount of female surgeons who have experienced a pregnancy loss, according to a survey published in JAMA Surgery in July 2021 which reported that 42 % had experienced a pregnancy loss. 

What’s going on?

What makes female doctors so different from the rest of the population? In part, their education. 

There’s no real way to put this nicely: Age matters when it comes to fertility. Extensive medical research on fertility shows that getting older has a major effect on our reproduction system and our ability to conceive.

But many female doctors — surgeons included — delay pregnancy until after the completion of their residency. How long that will take depends on the doctor’s specialty, but this can be another three to eight years after medical school. For surgeons, a residency is a minimum of five years. 

That puts many female doctors into their 30s before they even begin trying to have their first child. In fact, in the 2016 survey, doctors reported they were 31.6 year old on average at completion of medical school and residency and 30.4 years on average at first pregnancy. By comparison, the average age of an American woman giving birth for the first time in the US is 26 years old, according to data compiled for the New York Times in 2018. 

Almost a third — 28% — of the female doctors surveyed in 2016 who experienced fertility challenges said they would have begun trying to conceive earlier if they could have seen what lay ahead. Close to the same number — 29% — said they experienced diminished ovarian reserve, a condition in which their fertility challenge was linked to having fewer eggs in the body. This condition is largely associated with age. 

But delaying reproduction is only part of the puzzle.

Even after adjusting for age, female physicians have higher rates of infertility. Perhaps this is due to female doctors facing high rates of stress at work that put a strain on the body and can affect reproduction as a whole. Those who opt to start a family before residency is complete may face irregular work schedules and long, grueling shifts that can put intense strain on anyone’s body, but prove especially hard for someone who is pregnant.

Together, all of these factors can have a significant impact on the fertility of a female doctor. 

How can female doctors preserve their fertility?

The numbers may seem a little daunting, especially if you’re in medical school or the midst of your residency. So what can women do about it? 

An infertility task force now exists as part of the American Medical Women’s Association to find answers to this problem plaguing women in medicine, and individual doctors around the country have been working to advocate for improved fertility education and fertility insurance coverage for their peers. 

One of the chief criticisms of the current system comes from Dr. Areila Marshall, one of the founders of the AMWA task force, who wrote about the issue in the journal Academic Medicine in 2020 calling for better awareness of egg, embryo, and sperm cryopreservation. 

Marshall echoed a wish expressed by a number of the physicians who took part in the original 2016 survey: 7% of those doctors said they wished they had known to use cryopreservation to extend their fertility. 

For female doctors who don’t know when — or even if — they want to conceive, egg freezing can be a viable option. 

Freezing is not a guarantee that you will have a baby down the line. It simply means that eggs will be there, waiting, if you decide at some point in the future that you wish to explore conception. 

At Freeze by Co, we are committed to giving women the opportunity to have more control over their reproductive choices. Here women have a variety of paths they can choose from when it comes to egg freezing – whether they’re looking to freeze eggs now or have already frozen some of their eggs.  

Members of our Split program even freeze for free when they give half  of their eggs to intended parents who cannot otherwise conceive.

Bottom line

Women should not have to choose between a dream of pursuing a career in medicine and making reproductive decisions on their own timeline. Egg freezing gives women the power to make more choices about her own body.