Learning about your reproductive health early can give you more information, time, and options — even if you don’t yet know whether you want children.
Congresswoman Alexandria Ocasio-Cortez recently shared that she decided to freeze her eggs at 36. It wasn’t the first time she’d spoken publicly about her reproductive future — back in a 2020 interview, at 31, she was already asking herself whether this was something to consider.
Her story sparked an important conversation. But for me, the question isn’t just why a woman decides to freeze her eggs.
The question is: why do we wait so long to start learning about our fertility? I recently spoke about it on this Instagram video.
You don’t have to be ready to have a baby
Maybe you’ve always known you want to be a mom. Maybe you’re still not sure. Or maybe it’s simply not something you’re thinking about right now. Either way, you deserve to know your body and have clear information about your reproductive health.
From a young age, doctors tend to talk to us about birth control — how to prevent pregnancy. They might also recommend it to manage painful periods or other symptoms. But why does the conversation stop there?
Why don’t we also talk about our cycles, family history, possible signs of endometriosis, and future fertility?
Getting informed doesn’t mean you have to pursue pregnancy, freeze your eggs, or make a decision right now. It means understanding your body better and knowing whether there’s any reason to ask further questions.
Many of us discover the problem once we start trying
Most people don’t begin a fertility evaluation until they’re trying to have a baby and it’s taking longer than expected.
That’s how I discovered my fertility issues and my endometriosis, in my 30s.
A test known as an HSG revealed that both of my fallopian tubes were blocked. A laparoscopy later confirmed I had endometriosis, and over time, we decided to remove one of the tubes.
For years, I had painful periods and other symptoms without fully understanding what was happening in my body.
If I’d had these conversations sooner, I might have better understood my symptoms, asked different questions, and known my options with more time to spare.
I can’t know whether that would have changed the outcome. But I do know I would have been better informed.
In this blog post, I shared data published by The New York Times: nearly half of women at 30 hadn’t yet had children, but by 45, 88 percent were mothers.
The data also showed a rise in birth rates among women 35 and older.
If more and more women are reaching motherhood after 35, we need to start talking about fertility much earlier — not to scare ourselves or rush into anything, but to be informed.
What can a fertility conversation include?
There’s no one-size-fits-all evaluation. Tests should be recommended based on age, symptoms, medical history, and each person’s individual needs.
A conversation can start with:
Your medical and family history. Talk to your doctor about any history of endometriosis, polycystic ovary syndrome, infertility, early menopause, fibroids, pelvic surgeries, or pregnancy loss.
Your periods and other symptoms. Extremely painful periods shouldn’t automatically be dismissed as normal. It’s also worth mentioning irregular cycles, bleeding between periods, pelvic pain, pain during intercourse, or other cycle-related symptoms.
Medical guidelines recommend not delaying an evaluation when symptoms or conditions associated with fertility issues are present — things like irregular cycles, suspected endometriosis, or possible tubal problems.
Hormone testing. Depending on your symptoms and history, your doctor may recommend testing to evaluate ovulation, thyroid function, or other possible causes of cycle changes.
Ovarian reserve. Certain tests, like anti-Müllerian hormone (AMH) and an ultrasound follicle count, can offer information about your estimated egg count and possible response to fertility treatment.
But these results can’t tell you with certainty whether you’ll be able to conceive naturally, or exactly how much time you have to do so. It’s also not recommended to use a single ovarian reserve test as a general screening tool to predict future fertility.
The numbers offer information — not a verdict.
Pelvic ultrasound. An ultrasound can help examine the uterus, ovaries, and certain conditions like fibroids, cysts, or endometriomas.
Fallopian tube evaluation. An HSG can be used to determine whether the tubes are open. This was the test that revealed both of mine were blocked.
Not every woman needs an HSG as part of a routine exam. A doctor may recommend one when there’s difficulty conceiving, symptoms, history, or reason to suspect a tubal issue.
Male fertility evaluation. Fertility isn’t only the woman’s responsibility. When there’s a male partner, his evaluation should be part of the process too. A semen analysis can be an important starting point.
Start with a conversation, not a checklist of tests
Talking about fertility starting in your 20s doesn’t mean you need to immediately undergo hormone testing, an HSG, or every available test.
It can start simply, with a few questions during your appointment:
- Is there anything in my family history that could affect my fertility?
- Do my periods or symptoms need more attention?
- What tests would be appropriate for me?
- What can those tests tell me, and what are their limitations?
- When should I see a specialist?
- If I want children someday, what should I know now?
The answers can’t predict everything that will happen in the future. But they can help you better understand your body, recognize possible warning signs, and make decisions with more information.
We prepare for so many stages of life. We get physicals. We plan our careers, finances, weddings, even future baby showers.
Why don’t we also talk about our reproductive health?
I became a first-time mom at 41, after years of infertility and endometriosis. I created Soy Nueva Mamá to share the conversations I wish I’d had much sooner.
You don’t have to be sure you want a baby to start getting informed.
The earlier you know your reproductive health, the more time you’ll have to understand your body, ask questions, and know your options.
What do you wish you’d known about your fertility in your 20s?
This article is for educational purposes only and is not a substitute for guidance from a medical professional. Evaluations and testing should be recommended based on each person’s history, symptoms, and needs.