Egg freezing, at-home tests, and employee benefits — how do millennials think about fertility?
In the last few decades, fertility trends in the U.S. have undergone a massive shift. The average U.S. woman has her first child at age 28 (a five-year increase from the 1980s) and the number of children she has over her lifetime has dropped to a record low of 1.8. As of 2016, women in their thirties now have a higher birth rate than women in their twenties.
These changes reflect positive trends — including more women in the workforce and increased access to contraceptives — but couples who wait longer to have children are more likely to struggle with infertility. IVF use has reached new highs and as many as one in six couples face infertility. According to CDC data, 12% of women of reproductive age (15–44) have sought fertility treatment services. And this is not just an issue affecting women — we’re in the midst of what experts call a “male fertility crisis,” too.
In response to this trend, we’ve seen a wave of startups tackling fertility-related issues. This ranges from measuring hormone levels (Modern Fertility, EverlyWell) to finding a doctor and building a treatment plan (FertilityIQ, Prelude, Future Family, Tia) to enabling employers to offer fertility-related healthcare benefits (Stork Club, Carrot, Progyny).
We were curious to see how startup activity in this sector maps to changing consumer views and spending patterns related to fertility. We surveyed 201 millennials to get their thoughts on family planning, fertility testing, and fertility services as an employee benefit.
Who were the people that we surveyed? Of the 201, 160 (80%) are women and 41 (20%) are men. The median respondent is between the ages of 26 and 29 and does not yet have kids. Only 55 (27%) of our respondents are single, while 63 (31%) are in a relationship and 82 (41%) are engaged, married, or living with a domestic partner.
When do you plan to have kids?
Most of our respondents (52%) plan to start a family when they are between 30 and 33 years old — 22% plan to have kids later, and 12% plan to have kids earlier. The remainder of our respondents are either not yet sure (11%) or aren’t planning for kids at all (3.5%).
Of respondents who are already over the age of 30, most hope to have kids in the next three years (56% for respondents 30-33 years old and 83% for respondents 34–37 years old). Our 30-33 year old respondents are most likely to be unsure of when they will have children (19%), though only 3% said they plan to never have kids.
How concerned are you about your fertility?
The majority of female respondents under the age of 25 (60%) said they are not concerned about their fertility status, while 40% are somewhat concerned. Unsurprisingly, we found that women become increasingly concerned with their fertility status as they age — 70% of 26–29 year olds identify as somewhat or very concerned, compared to 74% of 30–33 year olds and 92% of 34–37 year olds.
We saw a similar trend among male respondents. Almost 75% of those under the age of 25 are unconcerned about fertility, while 67% of the 26–29 year old group identifies as at least somewhat concerned. No male in any age group in our sample is very concerned about fertility.
Do you plan to freeze your eggs?
95% of our respondents have not yet frozen their eggs, and of those who have, 89% are over the age of 30. Almost half of our respondents never intend to freeze their eggs, and 36% are still undecided. Only 1% of our respondents plan to freeze their eggs within the next six months, and another 9% intend to do so at some point in the future but haven’t picked a time.
Women under 30 are more likely to be unsure about whether or not they will ever freeze their eggs (50% of 18–21 and 76% of 22–25 year old respondents). Most of our respondents over the age of 30 have already made a decision either way — only 18% of women age 30–33, and 17% of women age 34–37, said they are still unsure of whether or not they will freeze their eggs.
We found that married women are much more likely than their unmarried counterparts to rule out the possibility of freezing their eggs, a trend that held true across all age groups. 66% of married women age 26–29 do not intend to freeze their eggs (versus 34% of unmarried women in this age group), and 72% of married women age 30–33 do not intend to freeze their eggs (versus 31% of unmarried women in this age group).
Have you taken a fertility test?
Only 10% of our respondents have taken a fertility test. Testing behavior rose for the women in our sample as they approached their early thirties, and then fell after age 33 — none of our female respondents aged 18–25 have taken one, compared to 18% of women aged 26–29, 41% of women aged 30–33, and 29% of women aged 34–37.
Among those who have taken a fertility test, younger respondents are more likely to have taken an at-home test or have gone to a local lab (33% of those under 30 vs. 14% of those over 30 for each of these two options). None of our respondents over 33 had taken an at-home test — 57% were tested at an OB/GYN or other doctor’s office, and 29% were tested at a fertility clinic.
If you did take a fertility test, where would you like to have it done?
Among our female respondents, an at-home test is the most popular option (preferred by 52%), followed by a test at an OB/GYN or other doctor’s office (40%). Fertility clinics (6.5%) and local labs (1.5%) are much less popular.
Testing preferences don’t seem to be correlated with age — our youngest group (age 18–21) is actually most likely to want a test in a doctor’s office (75%), and least likely to want an at-home test (25%). Women aged 22–25 and 34–37 have the strongest preferences for at-home tests (59% and 83%, respectively), while women aged 26–33 are fairly evenly split between at-home tests and tests in a doctor’s office.
Level of concern around fertility is also not predictive of preferences around testing. Women who are not concerned, somewhat concerned, and very concerned about their fertility have essentially equal preferences around testing locations, though women who are very concerned are slightly more likely to want to take a test at a fertility clinic.
Would the presence or absence of fertility benefits impact your decision to accept a job offer?
Female respondents are more likely than male respondents to think about fertility benefits when taking a job offer — 66% of women say that it might or would impact their decision, compared to 51% of men. None of our male respondents say that fertility benefits would be a “big factor” in their decision, compared to 11% of our female respondents.
Of the women who say fertility benefits wouldn’t impact their decision, 53% say this was because these benefits didn’t matter to them, while the other 47% say they just don’t expect these benefits from an employer.
By age, women over 38 are most likely to say fertility benefits would be a “big factor” in their decision (33%), while women aged 18–21 are most likely to say it wouldn’t impact their decision at all (50%). Desire for fertility benefits does not scale linearly with age, however — women in the 26–29 year-old age group are actually most likely to say these benefits might or would impact their decision on a job (71%).
Which of the following fertility companies do you recognize?
For respondents who indicated that they were “very concerned” about their fertility status, we asked what brands they recognized in the fertility space. In particular, we asked whether or not they had heard of EverlyWell, Carrot, Prelude, Modern Fertility, Future Family, Progyny, and FertilityIQ, and also requested they write in names of other brands not listed.
Recognition was highest for Modern Fertility and Progyny (4.5% each), followed by Carrot Fertility (3%) and then EverlyWell, Prelude, and Stork Club (2.5% each). Among respondents who had already taken a fertility test, brand recognition was highest for Progyny (20%), followed by FertilityIQ (10%), and then EverlyWell, Carrot Fertility, Prelude, Modern Fertility, and Stork Club (5% each).
Thanks for reading! We’d love to get your thoughts on fertility trends and hear about anything you are building in this space. You can reach Lisa at email@example.com, and Justine and Olivia at firstname.lastname@example.org and email@example.com.