Early effects of the COVID-19 pandemic on fertility preferences in the United States: an exploratory study

The COVID-19 pandemic may have motivated racial/ethnic minorities, sexual minorities, and those experiencing mental health issues to change their fertility preferences and try for a child later.

Like Comment
Related Content

VOLUME 116, ISSUE 4, P1128-1138


Christine H. Naya, M.P.H., Darby E. Saxbe, Ph.D., Genevieve F. Dunton, Ph.D.



To explore early disparate impacts of the COVID-19 pandemic on fertility preferences


Cross-sectional study


Online survey questionnaire


A total of 440 female participants who were trying to conceive (TTC) in the past year or currently are TTC.


No interventions administered.

Main Outcome Measure(s)

Change in fertility preference


Approximately 1 in 3 participants reported changing their fertility preferences because of the COVID-19 pandemic. Of those that reported changing their fertility preferences, 23.9% reported TTC earlier and 61.6% reported TTC later. Preliminary findings show the odds of changing fertility preferences in black or African American women were 5.45 (95% confidence interval [CI], 1.50–19.90) times that of white women and in nonheterosexual women were 2.76 (95% CI, 1.41–5.42) times that of heterosexual women. Furthermore, every 1 unit increase in state anxiety and depressive symptoms was associated with a 26% (95% CI, 3%–54%) or 17% (95% CI, 5%–31%) increase in odds of pushing back TTC, respectively.


This exploratory study highlights how the fertility preferences of racial and ethnic minorities, sexual minorities, and those experiencing mental health issues may be disparately influenced by the pandemic. Research is needed to examine further the disparate effect of the COVID-19 pandemic on fertility preferences.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.