U.S. young adults' family-building intentions in the event of infertility and knowledge of associated costs.

Abstract

Introduction: Infertility affects approximately 8.5% of married women in the United States, yet there is limited understanding of how young adults anticipate and prepare for potential barriers to biological parenthood. As reproductive planning increasingly intersects with social, medical, and financial considerations, it is important to examine how emerging adults perceive and approach family-building options. This study aims to explore college students' intentions regarding childbearing, their openness to non-traditional family-building methods, and their awareness of the associated financial costs.

Methods: A cross-sectional survey was administered to undergraduate students (mean age = 20) at a Midwestern public university. Most participants had not previously attempted to conceive. The survey assessed fertility awareness, preferences for family-building in the context of infertility, and cost estimations for various non-traditional options, including adoption, in vitro fertilization (IVF), and surrogacy.

Results: The majority of participants (86%) expressed a desire for biological children, with an average intended family size of 2.3 children. Among non-traditional options, private domestic adoption was the most preferred (58.3%), followed by public adoption (53.0%) and IVF (42.2%). Surrogacy using donor gametes was the least preferred (9.7%). Cost awareness was generally low: only 16.7% of estimates for domestic adoption and 48% for international adoption fell within 75%-125% of actual cost ranges. Gender differences emerged, with women showing greater openness to alternative family-building methods and more accurate cost perceptions, while men reported higher confidence in their reproductive planning.

Discussion: These findings suggest that while college students are generally interested in parenthood, they may lack adequate knowledge about the financial and logistical realities of non-traditional family-building options. The gender differences observed highlight the need for targeted educational interventions. Enhancing fertility literacy and financial preparedness among young adults could support more informed and realistic family planning decisions.