Why a Fertility Doctor Appointment Should Be a New Year’s Resolution
Planning for the future starts at a younger age than you might expect, says Dr. Jaime Knopman of CCRM New York
January 4, 2025
Written By: Hilary Sheinbaum
A couple of years ago, the wellness chatter among women in my greater social circle slowly, and then seemingly all at once, turned to the topic of fertility. Some were married, some were partnered, and some were single — with and without children of their own.
Although this new discussion topic was riddled with questions, more questions, uncertainty, and stories of both hopes and failures: the subject wasn’t totally out of nowhere. When many women (and men) are future-planning, and thinking about when (or how, or not) to have children— researching fertility, visiting specialists and certainly talking about thoughts and feelings— is warranted.
Research shows that the age that women in the United States having babies has been trending upwards (especially in counties such as San Francisco, Calif. and Manhattan, N.Y.). And many women—whether they live in major metropolitan areas, or not—are visiting fertility doctors for more information, and having children later in life compared to previous generations.
With a new year upon us, the start of 2025 is a great time to make an appointment with a fertility doctor. Yes, your other New Year’s resolutions are important, but this one should be top priority. Here’s why.
Although conceiving sounds simple enough, the fertility journey often isn’t. With that, it’s never too early to start the conversation, says Jaime Knopman, a board-certified reproductive endocrinologist and the director of fertility preservation for CCRM Fertility of New York. (Because, she says age is the No. 1 reason people seek fertility solutions.)
Whether you’re considering having kids right now or in the future, Dr. Knopman’s advice is a must read. She offers her knowledge on topics ranging from when to see a fertility doctor, what to expect in a consultation, and how cancer, DNA and other elements can change someone’s egg freezing timeline.
Hilary Sheinbaum: How long should people wait/try to conceive, before visiting a fertility doctor?
Dr. Jaime Knopman: All depends on your age and your reproductive and family history! A 30 year old can try for a year while a 40 year old should really not try at all. If you are somewhere in the middle, 35 to 40, we recommend no more than 6 months.
With that being said, if your mom or sister had infertility or an early menopause. or you have a known history of ovarian cysts, irregular ovulation or fibroids, come and speak to a fertility doctor before even trying to get pregnant. Do a fertility check-up and make sure everything looks good before starting!
Sheinbaum: What is the ideal age to see a fertility doctor?
Dr. Knopman: You are never too young! I think OB/GYN’s should put egg quantity testing into their annual checkup script. We do pap smears, mammograms and STD testing–why not ovarian reserve testing!
Sheinbaum: Is this the same age for women as it is for men?
Dr. Knopman: Women need to come in earlier! We are born with all of the eggs we will ever have and never make new eggs. Men make new sperm almost their whole lives! There is less of a time crunch for men.
Sheinbaum: Is it ever too early to freeze eggs or embryos?
Dr. Knopman: Did you just read my Oprah article?— [it’s about] why I will freeze my daughters’ eggs at 22. I think early 20s is a perfect time. You have the most and highest quality eggs so take advantage of it! I have frozen for 14 and 15 year olds but this was in case of cancer or transitioning gender.
Sheinbaum: How should individuals go about finding a fertility center or doctor?
Dr. Knopman: Ask around. Speak to your OB, your internist, your trusted friends and do research. Look on reliable websites like SART and CDC.
Sheinbaum: What should people look for in a doctor and fertility center, specifically?
Dr. Knopman: You want a tried and true established fertility clinic that has been around. You want to know that they can freeze eggs and make embryos when the time comes. You want a board certified fertility doctor to be directing your care and a high quality lab.
Sheinbaum: What questions should patients ask when they visit a fertility doctor?
Dr. Knopman: Ask a lot of questions! If you don’t ask, you won’t know. “Who does the procedures? Where are they done? Where are the eggs frozen? Who makes the decisions about the medication dosing? How many eggs have you frozen and thawed? What are the success rates of the freezing? How many babies have you had?”
Sheinbaum: What can people expect during an initial fertility consultation?
Dr. Knopman: Lots and lots of talking! Medical history, reproductive history, genetic history, family history. You should also expect blood work and ultrasounds to check your ovaries and ovarian health.
Sheinbaum: How can people plan in advance and remain proactive when it comes to fertility?
Dr. Knopman: Make it a priority and don’t ignore it. I compare the fertility doctor to the dentist. I have terrible teeth and never want to see the dentist. By the time I go I have six cavities, a root canal and an implant. If I had gone for my regular checkup I would be in much better shape. Go and get information about your fertility rather than waiting until you are experiencing infertility.
Sheinbaum: There are so many reasons why people use IVF or freeze eggs, etc.—what are some reasons that people should be aware of if they need to take action immediately, regardless of age?
Dr. Knopman: Cancer is an ASAP situation. The medications and treatments—chemo, radiation and surgery—will render a woman infertile immediately. Additionally finding out you are a carrier for a dominant condition, BRCA, will result in women coming in to freeze eggs or embryos. Dominant conditions affect 50 percent of the gametes (here eggs) so freezing when you are younger allows you to get more eggs and reduce the chance that eggs will be abnormal when tested as embryos. If you find out that you have a balanced translocation (chromosomal change), you would want to consider freezing eggs at a young age. Same would go for endometriosis or large ovarian cysts (dermoids) that require surgery. Even the best of surgeons will sacrifice some of the good ovarian tissue when they take out the bad tissue. Fragile X premutation carriers would also want to freeze eggs earlier.
Sheinbaum: How many more people are using IVF now vs 5 years ago, and 10 years ago?
Dr. Knopman: It is a dramatic difference. But, more than anything, what I see are more and more people coming in to freeze embryos and eggs. People are not waiting to be infertile they are preserving their fertility. People are coming in younger and therefore getting better and better results. The average woman will live until her mid 80s. This number has gone up every decade. But when our ovaries will tap out: that has stayed the same. We live longer but our ovaries don’t. We need to practice preventative medicine and freeze eggs and embryos early.
Sheinbaum: Why is it best to see a fertility doctor at the top of the year?
Dr. Knopman: When you make your list of things you want to tackle for the year this should be one of them. Don’t let more time pass. Don’t let fear hinder you going for a check up. Bring a plus one—a friend, cousin, parent—if you are anxious about the process. Don’t not come because you don’t want to hear what we might say. And take it one step at a time. I always tell patients, I run marathons but never think about mile 26 and mile 1. I take it in chunks, 5 miles at a time. Same for the fertility process. Do a consultation. Then get the results. Think about retrieval, etc. Don’t think about the negative pregnancy test at the transfer. You will not be able to function if you go too far down the road at once.
Sheinbaum: Anything else you’d like to add?
Dr. Knopman: Everyone should know about their fertility and what happens as they get older. Long gone are the days where we only learn how not to get pregnant. Women will continue to have children later, and therefore they will face more infertility if they don’t know what’s coming down the road. Be proactive, don’t be reactive.
The US healthcare system gets dinged on preventative care. We are good at treating disease but not good at preventing disease. We are getting better—mammograms, colonoscopes, cholesterol screening. Now fertility counseling should be added to that list!
