Every decade is marked by different milestones and transitions. Your 20s may include several firsts — first full-time job, first time living on your own, and first serious relationship. This may also be the first time you stop to think seriously about your health, including your fertility.
Fertility is based on many factors including age, sex, genetics, and overall health. At birth, ovaries start with all the eggs they’ll ever have, and the quantity and quality of these eggs decline over time. Testes, on the other hand, can produce as many as a million sperm a day starting at puberty. While a person’s sperm production and quality gradually decline with age, it generally doesn’t cause any fertility issues until after the age of 40. Despite these differences, one thing is the same — your overall health can have a significant impact on your fertility health. Building healthy habits in your 20s can help promote optimal fertility for the future.
Personal health choices can directly impact fertility. Fertility can be positively affected by:
Harmful substances can negatively affect fertility, and it’s best to avoid or limit:
Tracking menstrual cycles is a simple way to evaluate reproductive hormonal health. There are many ways to track your cycle, from marking a calendar to app-based trackers. In most cases, when menstrual cycles are regular and consistent (occurring approximately every 21-35 days), it suggests that your hormones are in balance and that you’re ovulating every month. Other symptoms of ovulation include changes in basal body temperature and mild cramps in the middle of your cycle which can also be useful information to help you understand your fertility. If your menstrual cycles are irregular, there may be underlying health issues that can affect your fertility. Your menstrual cycle is an important part of your health that you should discuss with your healthcare provider.
Some worry that long-term use of hormonal contraception can impact their ability to get pregnant in the future, but while contraceptives like birth control pills help prevent pregnancy while you’re using them, they don’t affect future fertility.
Hormonal contraception works by either regulating or stopping your menstrual cycle altogether. It essentially masks your body’s natural menstrual cycle, so stopping hormonal contraception, in some instances, can reveal underlying health conditions. Some of these may impact ovulation and future fertility. Common health conditions that can affect ovulation include:
If you’re ready to stop using hormonal contraception, tracking your menstrual cycle can be an empowering way to understand your body, hormones, and fertility when trying to get pregnant.
You have the best chances of getting pregnant in a given month in your 20s, when you have the highest number of quality eggs. A study found that between the ages of 19 and 26, there is a 79% chance of pregnancy within one year of having unprotected sex. If you aren’t ready to grow your family in your 20s but want to extend your fertility, you may consider egg freezing. Egg freezing has become increasingly common, with many deciding to freeze their eggs for personal or medical reasons, allowing them the opportunity to use them in the future.
While less common, people in their 20s can still experience fertility difficulties. Any of the following may indicate fertility problems:
If you have been trying to get pregnant for 12 months without success, speak with your healthcare provider.
Sperm production is similar throughout your 20s and 30s. However, you may still think about freezing your sperm in your 20s for personal or medical reasons. For example, some may consider freezing their sperm if they work at hazardous worksites or are deployed in the military, where they could be exposed to toxins and chemicals.
People in their 20s can still experience fertility challenges though. Signs of sperm health or delivery issues in your 20s may include:
Generally, your fertility in your 20s is at its peak. So at this point, it may be more helpful to assess and understand your overall health. Through bloodwork, you can measure markers like:
These markers provide a whole-body perspective of your health as well as insight into conditions that could impact your fertility in the future. However, if you have been trying to get pregnant and have shown signs of fertility difficulties or are interested in freezing your eggs or sperm, your healthcare provider may recommend additional tests to evaluate your fertility.
If you’re pursuing egg freezing or have experienced some fertility challenges, your provider may work with you to understand your ovarian reserve — the approximate number of eggs in your ovaries. While it’s not possible to count the exact number of eggs in your ovaries, there are ways to estimate how well your ovaries are functioning. Measuring hormones like anti-müllerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol (E2) can help evaluate your ovarian reserve. Additionally, a provider may also look at your antral follicle count, or the resting follicles before an egg is released This is a simple test completed through a high-quality ultrasound.
A semen analysis is useful to evaluate sperm for those who have experienced fertility difficulties or want to freeze their sperm. This provides information on whether or not there’s sperm in your sample as well as information about semen volume and sperm parameters like concentration, count, motility, and shape.
Your 20s may be the first time that you stop to think about your health and fertility. It can be overwhelming at first, but Carrot can break down what you need to know and support you every step of the way. No matter where you are in your journey, we have resources to help.
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Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical advice, diagnosis, or treatment. Carrot Fertility makes no representations or warranties and expressly disclaims any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app.
