In the pivotal time of residency and fellowship training, physicians are often focused on their work and opt to postpone decisions about pregnancy and childbearing.
With women now accounting for half of active graduate medical education trainees in the country, greater awareness of natural fertility decline may prompt physicians in training to consider cryopreservation of oocytes—commonly called “freezing eggs”—to give them more options for building their families later in life.
“We should be supportive of physician reproductive autonomy and making sure that we have time and space for our trainees and our faculty and attendings to be able to family-build when it’s appropriate and, in their life course, when they want that to happen,” said Rachel Whynott, MD, a reproductive endocrinologist and infertility specialist practicing in San Diego. She is also a member of the AMA House of Delegates, representing the American Society for Reproductive Medicine (ASRM).
“Fertility preservation, through either egg freezing or embryo freezing, can allow people to reproduce more on their own time, when they feel like they are ready and not be as constrained by time,” said Dr. Whynott.
The unfortunate reality, she said, is that as physicians are getting the training they need to excel in the practice of medicine, their bodies are undergoing natural changes that may make it harder for them to get pregnant later, regardless of how healthy they are.
“The time in our lives when we have the most eggs is when we are a fetus ourselves,” Dr. Whynott noted. “We start losing eggs even before we are born. We continue to lose eggs even before we reach puberty, and we continue to lose eggs from there as well.”
Delaying pregnancy can affect fertility
Data from the Association of American Medical Colleges (AAMC) for 2025 shows the average age of those entering medical school was 23. With residency training programs taking an additional three to seven years, and fellowship training programs tacking on another one to three years, physicians can be in training well into their 30s.
“For our residents, it’s a busy time,” Dr. Whynott said. “Research shows that one of the biggest reasons people delay childbearing is due to not having the right partner and desiring a partner, so that may not have happened for them yet.”
According to a 2024 report from the Centers for Disease Control and Prevention (CDC), 15.4% of women 25–49 years old had “impaired fecundity,” a broad category of trouble achieving or sustaining a pregnancy. Among married and cohabiting women 15–49 years old, 7.8% had infertility, defined as a problem achieving a pregnancy. As many as one in four women physicians are estimated to struggle with infertility, which is thought to be due mostly to the age at which they begin trying to have children.
A study in the journal Reproductive Biology and Endocrinology found that 71.8% of the female residents and fellows who responded to a survey said that they had delayed pregnancy due to residency training. At the same time, though, some residents and fellows may not fully appreciate the tradeoff that comes with waiting.
“We do see a little bit of a fertility decline starting around 32, a little more at 35, and then definitely after 37–39, typically egg numbers and quality experience quite a decline,” Dr. Whynott said, noting that men also experience a decline in fertility with age.
“Especially with what we call advanced paternal age—which in many studies is defined over the age of 45 or sometimes over the age of 40—those individuals also are more likely to have genetic abnormalities and increased risk of neurodevelopmental abnormalities in their offspring.” These can include autism spectrum disorders and higher risk of schizophrenia.
By logging in to read the rest of this article, physician residents and fellows will learn more about:
- The detailed steps of oocyte cryopreservation and its outcomes.
- The potential side effects of medication and procedures in the freezing of eggs.
- The possible impact of the egg-freezing and -retrieval process on physicians in training.
- How the AMA advocates for more benefits and accommodations for physicians’ reproduction.
