Do You Need to Get Your Fertility Tested?

Gabrielle Karol

InfertilityLast month, a shocking study came out: Almost one in five women in America between 18 and 29 believes she is infertile. That’s almost 20%.

In reality, only 6% of women in this age group are actually infertile.

Why do so many women think they can’t have kids?

Young women aren’t any less fertile than they used to be, but more women may be struggling to conceive: Women in the U.S. are waiting longer and longer to have children; the average woman’s age at her first birth has gone up almost four years since 1970. And fertility does generally decrease with age.

There are many reasons women are waiting to have kids, not least because many of us are choosing to achieve success in our careers before starting a family. We have longer lifespans than our ancestors, so putting off childbirth for a little while may not sound so bad. If only our bodies could see where we’re coming from!

Most young women not trying to get pregnant wouldn’t think about getting their fertility tested, but family planning is a big component of our plans—financial, career and emotional plans alike. Knowing at 25 that you’re at risk to become infertile could lead to a host of decisions, from freezing your eggs now (’cause hey, better to take the most youthful eggs possible) to reconciling yourself early to not having biological children and focusing on your career.

Today, we’ll explore the controversial question: Should young, otherwise healthy women get their fertility tested?

Whether you’re already a mom, plan to be one in the future or don’t want kids at all (like this woman), we hope you’ll find something interesting in our exploration of this highly emotional issue. In the process, we’ll discuss the prevalent myths about fertility, and how to overcome them.

The Biggest Myth About Infertility

We spoke to John S. Rinehart, MD, PhD, JD and president of the Reproductive Medicine Institute in Chicago, Illinois for advice on what all women should know about their bodies, their health and their fertility.

According to Dr. Rinehart, one of the most pervasive myths about infertility is that it can be caused by oral contraceptives. 10.7 million women take the Pill in the U.S., so lots of women may worry their fertility has been affected. But Dr. Rinehart is adamant that there is absolutely no connection between the Pill and infertility. In fact, he says, the Pill can help improve fertility, as it may protect against ovarian cancer and polycystic ovarian syndrome, both of which can hurt your chances of getting pregnant.

So, what can affect fertility?

As we mentioned before, age is a biggie. Dr. Rinehart says that 50% of woman will see a decline in fertility by age 31, and by age 41, 50% will be functionally sterile. Aside from age, two other big factors are smoking and being overweight. Smoking actually ages ovaries and can cause premature egg loss; being highly overweight can lead to irregular cycles and polycystic ovarian syndrome, both of which can affect the body’s ability to get pregnant.

Should You Have Your Fertility Tested?

The majority of women between 18 and 30 shouldn’t be worried about their fertility, says Dr. Rinehart. But in some cases, you might want to have your fertility tested … even if you’re not planning to conceive any time soon:

  • You are 30 or older and haven’t had a child–but want to someday. (Of course, if you plan to start trying for a baby in the very near future, you can just start without going through the process of being tested).
  • You’re under 30 but your mother went through menopause at 38 or younger.
  • You have a family history of fragile egg syndrome or have an autoimmune disease like rheumatoid arthritis, which increases the risk of early ovarian failure.
  • You’re overweight or a heavy smoker with no plans to lose weight or give up smoking.

If you’re one of the 20% who fears you may be infertile or have trouble getting pregnant, getting an answer now can help you develop your long-term plan (should you include a baby in your financial roadmap—and when?), and, at the very least, provide you with the peace that comes with knowing.

The best test available, says Dr. Rinehart, is the AMH hormone test, which can help you figure out if you’re running out of good eggs. Because the test is fairly new, your regular gynecologist might refer you to a reproductive specialist to have it done. The test itself costs a couple of hundred dollars (check with your insurance provider to see if this can be covered) and can be done at any point in your cycle.

The average woman in her early 20s would score a two on this test. Anything above two is an excellent indicator of fertility (a “two” indicates that you have many viable eggs remaining), while any score below one indicates a fertility problem.

If Your Score Is Normal (or Better)

Even if you meet some of the qualifications above for potentially compromised fertility, you can probably wait before reviewing other options if you receive a two or higher. Taking the test yearly and comparing results will show you if your fertility begins to falter, at which point you can reevaluate.

If Your Score Is Low

If you receive a score in the abnormal range and are not in a position to begin trying to conceive immediately (say, you’re 24, single and at the beginning of your career), you might want to consider freezing your eggs. This is a big investment, though: Egg freezing generally costs between $13,000 and $20,000, and the success rate is not perfect.

But if you’re certain you want a biological child at some point, freezing your eggs early on preserves them at their healthiest point, and finding out that you have compromised fertility early on can help you make saving for the costs associated with egg freezing and motherhood a priority at an earlier stage in your life. Meanwhile, in-vitro fertilization, a method you might use later on if you were having trouble conceiving, costs even more: about $12,000 per cycle (and up to $30,000 if you need to use a donor egg). That said, these expenses are covered by certain insurance policies, so you should check with your provider about your personal financial costs.

To find out more about the process of freezing your eggs and the financial costs involved, read this. For the costs of other options like adoption, check out this guide.

In contrast, the simple blood test to evaluate your fertility is only a couple hundred dollars–which, for peace of mind, may just be something worth budgeting for.

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  • Crocky

    Ummm…no.  You know what having a kid does to a woman’s earning power?  THAT is why we have the wage gap, NOT because women are women.

  • Krahulec

    Wow, this really pisses me off.  Seriously.  You site one doctor’s opinion’s and stats about fertility and expect women not to get more paranoid about the subject?  And the line “Knowing at 25 that you’re at risk to become infertile could lead to a
    host of decisions, from freezing your eggs now (’cause hey, better to
    take the most youthful eggs possible)” is especially condescending.  I spoke to my OBYGN, my general practice doctor, an acupuncturist who specializes in fertility and women’s health issues and a DNA specialist because I had a family history of having later pregnancies and wanted to know the actual facts behind having children after 35 both for my health and theirs.  In fact I work with several bright, successful women all over the age of 40 who waited to have kids in their late 30s and said it was the best decision for them.  Before you send a panic out there to women who may or may not be able to drop $20,000 for freezing their eggs or 100s for a medical test that may not be covered by insurance, you may want to present all sides of the story and link to medical journals instead of spouting out one person’s opinions as fact.

    • Sharon J

      Thank you so much for posting this… much more positive to read. This article mostly has me worried :/

  • JackieAU5

    I’m not sure how accurate this article is…everyone I know who is pregnant is in their 30s and has had no problems at all. I think it’s best you get more than 1 doctor’s opinion on such a hot-button health issue. But good job creating awareness. 

  • yourname

    Gabrielle Karol’s other articles include “how to loose weight while you sleep” and something else about handbags.  She graduated college in 2011, english major. Just ignore her, everybody.  Hey learnvest, how about getting some finance people up in here?  Thought the point of this place was to do away with the fashion-girl-with-credit-debt-wants-to-marry-banker trope?

  • bri

    Just getting your fertility tested is probably going to be rather expensive. We’ve been trying for nine months (I’m 33) and my insurance won’t cover any testing until we’ve been trying for a year. After a year, they cover 50% for diagnosis and nothing for treatment. 

    • Guest

      Then maybe you should consider adoption?  Lots of children out there lingering in foster care with a fairly decent % of those available for adoption.  

      As far as your quandary, I have no sympathy, sorry.  You want to have kids?  Your responsibility to pay for it.

      • J-me

        Considering the cost of health insurance these days, I think she is paying for it. The point she was trying to make is that while fertility testing is an option, it’s a costly option and cost wasn’t mentioned anywhere in the article. 

      • betsy_betsy

        Ouch. Thanks for sharing.

        She’s not demanding anything. She’s commenting on how poorly her health insurance will cover this procedure (and follow up treatments).
        Fertility Issues = Health Issues. Should be covered as fairly as any other OB/GYN prodecure.

        I’m suprised that the insurers are so quick to prohbit this…considering that more individuals on a family plan means an increase in premiums/deductable.

      • divinepeach

        Adoption is more expensive then fertility diagnosis and treatment.  I have been down both paths. 

  • superscientist

    English major or not, this woman cites science.  She cited one study, there are others like it. I’m a research scientist. I am quite aware of the risks associated with having children at more mature ages.  If you want to plan a family, considering your fertility is a no brainer.   The emotional and financial costs associated with pushing off having children until your fertility declines are real.  You’re in trouble when the oft avoidable worst case scenario (rounds of fertility treatments) is your Plan A.

  • Anon

    I have to agree with the poster below about getting multiple opinions.  I didn’t start thinking about my fertility until I was 34 and at the time I was living in the Southeast and had two or three doctors refer to me as having an “advanced maternal age”.  We moved back to Southern CA before we actually started trying and the doctors out here seemed surprised when I asked them if my age was a factor.  They seemed to think it was not that big a deal.  We did go see a fertility doctor and at the time I was 36 and the doctor said I was young to be having a child.  I think most of the couples they dealt with were in their 40′s. 

    I think if you know you want to have children one day you should have your fertility checked.  I had a cousin who went through early menopause in her 20′s and now can’t have children.  If she had been checked she might have been able to save some eggs.  Even if you are on the fence about whether children are going to be part of your future you should get checked.  If their are issues you might decide in a hurry that you don’t want your options limited and have a chance to do something about it.

    BTW, I have a 2 month old baby now, and I’m 37, so nyah, nyah biological clock.

  • anonymous

    I think that the way this sensitive subject matter was presented was inappropriate. Yes, we should be aware of the health risks associated having children at a later age, however, this is not the forum in which to raise such awareness. The article has an overall focus on the financial aspects which makes it sound like they are putting a price on having children. I agree that some women might want to get their fertility checked (especially when paranoid after reading this article) but to encourage them because their portfolio might take a hit is a cold thing to say to someone who may be worrying about her ability to fulfill her lifelong dream. But maybe the authors lifelong dream was to write an inappropriate article on a website that claims to give you financial freedom yet hardly ever works. I am really disappointed in Learnvest’s decision to send this out as their daily email. It certainly put me in a terrible mood. Thanks.

  • a very complex topic

    having the fertility test is not always a guarantee for a desired outcome down the road.  i had an above excellent fertility score at the age of 37 when i first started trying to conceive.  after 2 years of trying, spending $10s of thousands of dollars (insurance didn’t cover any of it), i was officially labeled infertile with “no explanation” determined from the dozens of tests i endured.  if i’d taken the fertility test in my 20s, it would have been a waste of money.

    it’s also impt to reiterate that freezing eggs isn’t the simple solution that it may seem.  it is a relatively new big business & often times the only person who gains anything is the dr: $$$.  i thought the jury was still out on how long the eggs can be frozen and still remain viable after x amount of years bc eggs don’t freeze as well as embryos or plain sperm due to the high water content in the cell.  there are new techniques to improve the expiration date, but it  is not hard science at this point.

    readers also need to understand that these options come with a personal health risk.  my dr failed to inform me that the fertility drug clomid (hormone used to release eggs) may be linked to ovarian cancer if taken for more than 3 cycles.  it is also linked to multiples- think octo-mom.  least but not worst, i was not told to stay out of the sun when taking clomid so 4 years after taking the drug, i have pregnancy spots (brown marks) all over my face and on my front tooth.  this subject requires a lot of personal responsibility to cover all of the angles on your own b/c no one can do it for you.  i read 8 books and who knows how many articles in the 2 yrs i was trying and it is beyond unsolicited advice for younger women: don’t get caught up in the baby crazy making. it’s not a topic to be feared.  i have a lot of ethical issues with the amount of money women are asked to cough-up when in a desperate state of either infertility or cancer.  we all make our choices.  choosing not to have a baby nor adopt after trying for so long was w/o a doubt the most difficult choice of my life thus far…. but i am at peace, grateful and so lucky to have the life i do have.  at 41, i feel like not getting what i once thought i wanted was one of the best things to ever happen to me.  thanks for the great article.

  • PCOS Veteran

    There’s some good information here, but I’m wary of how true the facts really are after reading Dr. Rhinehart’s inaccurate statements regarding PCOS. Polycystic ovary/ovarian syndrome (PCOS) is not caused by being overweight. It is one of the symptoms–correlation, not causation. (It is true, however, that being overweight can cause cycle irregularity, which makes it difficult to get pregnant.)  Birth control also does not prevent PCOS, though it is used as a treatment for PCOS patients to preserve fertility. 

    If you do think you have PCOS, you should see a doctor (preferably a reproductive endocrinologist). It isn’t just about fertility; left untreated it can impact your overall health and increase your risk of endometrial cancer and heart attack. It’s also surprisingly common in US women (according to, there are approximately 5 million US women with PCOS).

  • Özge

    There is a site about fertility

  • Glen Victoria

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  • Jay Stacey


  • Glen Victoria

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  • Angela Felix

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  • Meka

    I know this is bad to post but I cant have kids and really want them and adoption is way to high I need help I really want a baby

  • Desiree Isaryk

    Ok I know these posts was from 4 years to 4 months ago and its give or take. But what I’m trying to find is where to start. I don’t think I can have kids. Not trying to make this long but me n h.s. sweetheart both was in past relationships for 7 years and they had kids after us and other ex’s same thing and we never had kids. Now me n him got back together and really want kids with each other for longest time but for both of us we don’t know where to go. We both have state insurance. I’m on medicare he on NJ family care and hard for anyone to take our insurance. So if anyone knows a place in Jersey closest to the shore please give me a heads up or a website orain number. Thank you.