Why More Women Are Turning to IVF: An Ob-Gyn Speaks Out

May 29, 2026 - 08:06

Just last Monday, a woman sat across from me in my office and asked a question I have come to dread. Why had no one told her? She is 33, a therapist, married three years, and she has been to her gynecologist every year since high school. She was also on the brink of perimenopause.

She had assumed that when she was ready, her body would be too. No one in two decades of annual visits had ever explained that the most consequential decisions about her capacity to bear children were being made by her ovaries on a calendar she could not see, while her doctor took her blood pressure and refilled her birth control.

She is the patient I see several times a month. She is the most preventable tragedy in American medicine.

I am board certified in both obstetrics and gynecology, and reproductive endocrinology. There is a fertility crisis happening right now in America, and a furious debate about who is to blame. The alleged culprits include housing, smartphones, and capitalism. One group is getting off lightly: ob-gyns.

In July, the Centers for Disease Control and Prevention reported that the U.S. fertility rate had fallen to fewer than 1.6 children per woman, the lowest figure in our history. This comes despite a 2025 survey of American Gen-Z women that found nearly three-quarters intended to become mothers. American women are not opting out of building a family. They are running out of time.

The problem is not that ob-gyns are bad doctors. The problem is that routine gynecological care has become disconnected from fertility awareness. Year after year, women receive Pap smears, breast exams, and prescriptions for birth control without a single conversation about their ovarian reserve or the steep decline in fertility that begins in the early 30s. By the time many women realize they have a problem, they are already knocking on the door of an IVF clinic.

This is not about blame for the sake of blame. It is about a system that treats fertility as an afterthought until it becomes a crisis. Women deserve better. They deserve to know the truth about their own bodies before it is too late.