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

Jean Marie Place^1*John Horowitz¹Minh Nguyen¹Maya Guinn¹Brennan Peterson²

• ¹Ball State University, Muncie, United States
• ²Chapman University, Orange, California, United States

Infertility affects approximately 8.5% of married women in the United States, yet little is known about how young adults anticipate and prepare for potential barriers to biological parenthood. This study investigates college students' childbearing intentions, openness to non-traditional family-building options, and awareness of the financial costs associated with these alternatives. Participants were undergraduate students (mean age = 20) at a Midwestern public university who had largely not previously attempted to conceive. Using a cross-sectional survey, respondents provided information on fertility awareness, family-building preferences in the context of infertility, and cost estimations for various non-traditional options. Findings indicate that 86% of participants desired 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 in vitro fertilization (42.2%). Surrogacy using donor gametes was the least preferred (9.7%). Cost awareness was limited: only 16.7% of estimates for domestic adoption and 48% for international adoption fell within 75-125% of actual cost ranges. Women demonstrated greater openness to alternative family-building methods and had more accurate cost perceptions than men, though men reported greater confidence in their reproductive planning. These findings highlight the need for education to improve young adults' fertility literacy and financial preparedness for non-traditional family-building options, which may support more informed and realistic family planning decisions.