What You Need to Know About Fertility in Your 20s

Learning more about your fertility can be empowering, especially when you’re a career-driven girl boss with her eye on the C-suite.

As women wait longer to have children (and get married), most of us spend our 20s trying to prevent pregnancy (research suggests upwards of 60 percent of women of reproductive age use some form of contraceptive). And while all that energy going toward not getting pregnant can help you reach all of your other goals (you know, like getting ahead at work, traveling the world, and having some serious you time), it also means you likely aren’t super familiar with your fertility. No matter your goals, whether you want to have kids, or what your current relationship status is, your 20s is a prime time to learn about your fertility, docs say. After all, your fertility actually peaks in your mid- to late-20s

Since one in eight people in the U.S. are impacted by infertility, gaining knowledge about your reproductive health can help you take control of your body and its future. Depending on your ambitions—both personal and professional—you may choose to act on your fertility with your future in mind by freezing your eggs or saving for IVF. And on a more personal level, fertility can be a good indicator of overall health (and vice versa).

So what should you know? In honor of National Infertility Awareness Week we spoke with Dr. Brian Levine M.D., founding partner and practice director of CCRM New York and a board-certified reproductive endocrinologist and OB-GYN. Here are seven biggies.

When it comes to fertility, lifestyle matters

Here’s some seriously good news: “Fertility is not a progressive slide like everyone thinks it is with a peak in your 20s and raisin-like ovaries in your 40s,” Dr. Levine tells STYLECASTER. “Fertility is dynamic.”

In fact, the American College of Obstetricians and Gynecologists notes that being underweight, overweight, exercising too much, drinking excess alcohol, and smoking can all hinder fertility. These habits can negatively impact the functioning of your fallopian tubes, which is the where the egg travels from the ovaries to the uterus, explains Dr. Levine. Stress on the body (as in the case of being underweight) can also send your body into protection mode, which could lead to irregular cycles and lead you to stop ovulating.

The good news: “Living a healthy lifestyle is the most positive thing that someone can do to impact their fertility outcome,” Dr. Levine notes. His suggestions: Cut the cigs, don’t overdo it with the drinking, try to get more sleep, keep your stress levels in check (ahem, yoga!), and eat a little bit cleaner. “It’s been demonstrated in numerous studies that having a balanced, normal diet can impact cycle regularity, which is the best predictor of someone being able to get pregnant on their own without assistance,” Dr. Levine says.

Lifestyle can also play a big role in how regular your cycle is — something that, well, plays a big role in fertility. An average cycle is about 28 days, according to the ACOG (though that’s an estimation and every cycle is different). It’s easiest to know when you’re fertile by tracking your cycles with apps such as Flo or Clue. By doing this, you might also uncover your cycle is irregular. Fortunately? One of the best things to do to fix an irregular cycle is living a healthy lifestyle, Dr. Levine says.

Being on the pill doesn’t hurt your fertility

Birth Control Pills


You might have heard this or at the very least worried about it, but allow Dr. Levine to clear things up: “The answer is no. Being on the pill does not hurt your fertility.” After you go off the pill, fertility returns to normal. It usually takes anywhere from weeks to months to ovulate again.

One study out of Boston University that looked at woman who discontinued use of oral contraceptives found that, while there was a temporary delay in return to fertility, long-term use did not hurt a woman’s chance of becoming pregnant and in fact, longer-term use of the pill was linked with a higher likelihood of pregnancy.

The IUD is one of the most effective forms of birth control

iud review 7 Things Women in Their 20s Need to Know About Their Fertility

Image: STYLECASTER/Getty Images.

Looking for a highly effective form of birth control? The IUD might just be your best friend. It’s approximately 99 percent effective, whereas the pill which is about 93 percent effective, according to the CDC.

IUD’s are a popular form of birth control for women and couples who want a long-term contraceptive solution. There are a few different hormonal IUD options available and they are effective for 5 or more years. Many women with a hormonal IUD report less bleeding during their periods (and for some, periods become shorter and less frequent), less cramping and an overall decrease of menstrual symptoms. And they can be removed by your doctor at any time—so if your reproductive plans change or you don’t want to keep your plastic, T-shaped friend in your uterus, simply schedule an appointment with your doctor and change your course. 

But hormonal birth control doesn’t protect against STIs

gettyimages resized horizontal 7 Things Women in Their 20s Need to Know About Their Fertility

Image: Getty Images.

Whether you choose an IUD or the pill, neither protects against sexually transmitted infections (STIs) which are on the rise in the U.S. That’s important to know — and it’s important to get screened — because STIs can negatively impact fertility.

“Things like HPV and chlamydia and gonorrhea can actually have pretty bad outcomes if you’re trying to get pregnant later in life,” says Dr. Levine. “They can, for example, scar your fallopian tubes.”

‘Trying’ might not mean what you think it means

Pregnant Couple


‘Trying’ means monitoring your cycle and having unprotected intercourse a couple of times a week for a number of months sequentially. In order to ‘try’ your best, Dr. Levine says, you also want to make sure you’re having sex during the window of time in your cycle when you can indeed get pregnant, which is right around ovulation. (The U.S. Department of Health & Human Services’ Office on Women’s Health has a good tool for how to find out this timeframe.) “I always try to clarify for people that just because you had sex doesn’t mean you were trying to get pregnant,” says Levine.

Also: Up to the age of 35, the definition of infertility is ‘trying’ for one year for pregnancy with no result.

It takes two to tango

early days sex haze retouch2 7 Things Women in Their 20s Need to Know About Their Fertility

Image: STYLECASTER/Tory Rust.

If you’ve been trying for a year with no luck (meaning, you haven’t gotten pregnant during that time), don’t immediately blame yourself. “Infertility, in general, is 40 percent female causes, 40 percent male causes, and 20 percent either unknown or combined [causes],” says Dr. Levine.

Think your partner could be to blame? A semen analysis measures sperm volume, concentration, motility (how well sperm swim), morphology (sperm shape) — all indicators of fertility — and it’s relatively easy to do. (He just has to provide a semen sample — something he can even do at home.)

And remember: His lifestyle matters, too, says Dr. Levine. Excess booze, smoking, tight underwear, and hot tub use can all increase the temperature of the scrotum, effectively ‘cooking’ the sperm and hindering fertility, Dr. Levine says.

Learning about your fertility is always empowering, acting on at-home data is not

why women freeze eggs


It’s easy to assume that in your 20s your fertility is normal and that no matter what your plans are, you’ll be fine, says Dr. Levine. And for the most part, otherwise healthy people in their 20s do have normal fertility (phew!). But you don’t want to make assumptions on either side of the fertility conversation, he says. “Don’t assume that everything is perfect, but also don’t assume you’re going to have a problem just because fertility’s in the news all the time.”

Curious about your own fertility or think that something could be up your end? There’s nothing wrong with taking an at-home fertility test. But you’ll want to share your results with your doctor if you’re concerned — not act on the information (or freak out unnecessarily on your own), notes Dr. Levine. A reproductive endocrinologist or fertility doctor can do a full work-up and put results in context of your lifestyle. Dr. Levine and the entire team at CCRM is dedicated to shifting the cultural narrative around fertility and family planning since that is critical to understanding and ultimately overcoming infertility. 

“If anytime you get an abnormal value, know that fertility is dynamic,” Dr. Levine advises. In short: You have more control than you think.

CCRM is a global pioneer in fertility science, research and treatment that delivers some of the highest in vitro fertilization (IVF) success rates in the industry. It specializes in the most advanced fertility treatments, with deep expertise with IVF, fertility assessment, fertility preservation, genetic testing, third party reproduction, and egg donation. Since one in eight couples in the U.S. are impacted by infertility and women’s fertility peaks in the mid- to late-20s, CCRM is working to shift the cultural narrative surrounding fertility and family planning.

This post was created by STYLECASTER for CCRM. 

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