Abstract
BACKGROUND: Prior studies have documented fertility concerns among adolescents and young adult women, but reasons for these perceptions have not been fully elucidated. We explored the origins and dimensions of fertility concerns in a sample of U.S. young adults assigned female sex at birth. METHODS: We conducted focus groups with participants aged 18-25 years recruited from reproductive health centers in Minnesota, United States, from 2021 to 2022. Eligible participants were assigned female sex at birth, had recent penile-vaginal sex, had never been pregnant, were not attempting pregnancy, and self-identified as having ever been worried about their fertility. Transcripts were analyzed qualitatively for themes regarding: (1) reasons for fertility concerns and (2) participants' perceptions of their current fertility. RESULTS: Participants (n = 19) were predominantly cisgender and 47% were Black, Hispanic, or Multiracial. Reasons for fertility concerns emerged under three domains: personal history of unprotected sex without subsequent pregnancy, risk factors (e.g., contraceptive use, environmental exposures), and psychosocial factors such as inflated perceptions of infertility prevalence. Participants who thought they would have difficulty conceiving in their current state cited mostly evidence-based risk factors like irregular menses and comorbidities; participants who thought it would be relatively easy referenced a lack of those same factors. CONCLUSIONS: Young people with fertility concerns cite myriad reasons and do not necessarily believe they are currently infertile. Sexual and reproductive health messaging for adolescents and young adults should broaden beyond pregnancy prevention to proactively dispel misconceptions and alleviate fears related to fertility and infertility.