• Naiké Vorbe, 42, experienced abdominal pain for years and went on multiple diets.
• At 31, she learned she had a genetic predisposition for colon cancer and was diagnosed at stage 3B.
• After learning about the genetic risks, Vorbe's mom was diagnosed early with stage 1 uterine cancer.

For years, Naiké Vorbe tried to ease her abdominal pain. A dietitian advised her to cut gluten and lactose, but nothing worked.

Stomach discomfort wasn't new for her: throughout most of her adult life, she cycled from being constipated to having diarrhea. "I was constantly one or the other," Vorbe, 42, told Business Insider. When she was pregnant with her second child, she saw a gynecologist. Her bowel movements were explained away as common pregnancy symptoms.

Then the pain intensified. After she gave birth to her daughter, "going to the bathroom was more excruciating for me than giving birth," Vorbe said. She kept touching her stomach, knowing that something was wrong. Lying down, she felt a lump.

Shortly after, Vorbe, who lived in Haiti, booked an appointment with a GI. He immediately told her to fly to Miami from Haiti and see a specialist for colon cancer at the Sylvester Comprehensive Cancer Center at the University of Miami.

At 31, two months after giving birth, Vorbe was diagnosed with stage 3B colon cancer.

Fighting for her fertility

In 2014, a few weeks after her colonoscopy revealed a malignant tumor, Vorbe underwent surgery to get part of her colon removed. Months later, the cancer spread to her liver.

Vorbe had no idea what her immediate future would look like. She had a six-year-old daughter and a newborn back in Haiti, along with the rest of her family. Her then-fiancé (now husband), a film director, was traveling a lot for his first movie.

She said she asked her doctor to end her chemotherapy appointments on Thursdays, so she could fly back to Haiti on Friday and stay through Monday to be with her older daughter for the next 10 days. Then, she'd repeat the process.

Zooming out even more, she was concerned about how chemotherapy would affect her fertility. She wanted more kids, so she asked her doctor if she'd be able to have children after treatment.

She said he told her that saving her life was the priority. "But for my life to be worth it, I need the answer to this," Vorbe told him.

He connected her to a gynecologist who administered a gonadotropin-releasing hormone (GnRH) every month, which temporarily suppressed ovary function and reduced the risk of chemotherapy-induced infertility.

Vorbe described him as a "big angel" in her life. "Every ball I threw at him, he worked with me," she said.

She did 12 rounds of chemotherapy. After her 4th, she was scheduled to have part of her liver removed. She took a break from chemo for a few weeks to recover, marrying her husband back in Haiti. When she returned, the tumor on her liver was gone. The part was still removed out of caution, but when it was dissected, no traces of cancer could be found.

Vorbe wanted to quit chemotherapy earlier, now that the tumors were gone. Her doctor insisted on 12 cycles, to give her the best chance of long-term survival. Dr. Daniel Sussman, Vorbe's physician and a gastroenterologist at the University of Miami Health System, told BI that in 2014, when Vorbe was treated, 12 cycles of chemo was "probably considered what was necessary" to increase the likelihood of successful treatment.

An underlying genetic risk

As a child, Vorbe remembers having unexplained stomach pain. Her father would take her to the doctor to be tested for worms and parasites. When she developed the lump in her abdomen as an adult, a gynecologist initially told her to try an enema.

"I was overlooked and pushed to the side because I was so young, I looked healthy," she said.

Additionally, she said discussions around bowel movements are taboo in Haitian culture. "You don't really speak about gastrointestinal issues."

When she was diagnosed with colon cancer, she took a recommended gene panel and learned she had Lynch syndrome, a symptomless genetic condition that raises the risk of developing colon cancer. She wondered if her grandmother, who died at 48, had it, too. "Nobody ever understood that's what happened to her," Vorbe said.

Sussman, who specializes in Lynch syndrome and was involved in diagnosing Vorbe, said that because the field of genetics is so young, entire families may have unknown genetic predispositions for certain cancers. Naiké "ended up being that first person in the family to undergo that genetic evaluation," he said.

Her mom was diagnosed with uterine cancer earlier

Vorbe, now a mom of five, has been in remission for 10 years. As a former colon cancer patient, she gets the recommended yearly colonoscopies. She also gets an endoscopy every two years, as Lynch syndrome puts her at risk of developing other cancers.

She said learning about Lynch syndrome not only helped her understand her diagnosis better. It also helped her mom, who carries the same genetic risk, to get diagnosed with uterine cancer early.

Her mother had a polyp in her uterus that was left alone because it hadn't grown over the years. When she told her gynecologist that Vorbe had Lynch syndrome and was being treated for colon cancer, her doctor immediately scheduled a biopsy. Vorbe's mother was diagnosed with stage 1 uterine cancer and had her uterus removed.

Vorbe said her family is what kept her going through treatments. She remembers thinking "There's no way I can die: I have these two beautiful little girls right in front of me. I want to see them grow up."

Despite being over a two-hour flight away, her family buoyed her throughout her recovery. Her godmother flew with her to her first chemo appointment. Her cousins flew to Miami to be in the house after the appointment, to cheer her up. In Haiti, her sister-in-law would care for Vorbe's baby overnight, then bring her to Vorbe in the morning.

"I had so much love and light around me, it just carried me," Vorbe said.

• Barrett and Shiraine McLeod spent $18,000 on IVF, which they paid for with insurance and an HSA.
• The McLeods said fertility treatments have become more expensive with their second child.
• IVF costs in the US range from $15,000 to $30,000, with insurance coverage varying by state.

Shiraine and Barrett McLeod love being parents. They live in western Connecticut with their toddler, Lejend, who asks them constant questions about spaceships, gravity, and the fish in "Finding Nemo."

"This kid blows our mind every day, and he's only two," Shiraine said.

The couple, who are in their late 30s, experienced an increasingly common path to parenthood: in vitro fertilization. Over 86,000 infants were conceived through assistive reproductive technology like IVF in 2021, the latest data available from the US Department of Health and Human Services shows. The number of Americans using fertility treatments to conceive is rising, but the procedure is costly. One round of IVF without insurance can range from $15,000 to over $30,000.

This comes as reproductive healthcare access is caught in political crosshairs. Barrett said they were undergoing fertility treatments around the time that the Alabama Supreme Court declared that frozen embryos are people, a ruling that threatened IVF access nationwide: "It was scary," he said.

President Donald Trump signed an executive order in February aimed at "aggressively reducing out-of-pocket" IVF costs for Americans, although the White House has not provided additional details on how the policy would work. Separately, the Trump administration has slashed women's and maternal healthcare programs across the US. And, in April, the administration floated policies to encourage people to have more children, including a potential $5,000 baby bonus for every American at the time of delivery.

Even with the federal policy limbo, the McLeods said IVF is an important resource for millions of families like theirs.

"There's a lot of people out there who really, really want kids, and they don't believe that they'll ever get to have them, because IVF is probably the only option and they believe that they can't afford it," Shiraine said.

The McLeods told BI about their experience navigating fertility treatments and their top tips for others. They recently found out that Shiraine is pregnant with their second baby via IVF — a little girl — and they couldn't be more excited.

An HSA and insurance helped the McLeods pay for IVF

The McLeods knew fertility treatments would be expensive. Embryo implantation might not work on the first round, and the cost of doctor's visits, blood screenings, genetic testing, and embryo storage quickly adds up.

Shiraine works for the New York state government and is their household's primary source of health insurance. Barrett works remotely in management and consulting and takes care of Lejend when he isn't at daycare. Together, the couple said they make a comfortable, six-figure income.

"We were just so excited about the possibility of having a child, we didn't really think too long and hard about how much it would cost us at the end of the day after insurance," Shiraine said.

While Shiraine said her insurance covered about 90% of their roughly $18,000 in medical bills to conceive Lejend, the couple had to add regular doctor and testing copays into their monthly budget. She added that some of the procedures she's undergone this year to conceive their daughter have been noticeably more expensive than when she and Barrett first started IVF in 2021: "Initially it was $50 a month to continue freezing the eggs," she said. "Fast forward to today, it's now $75 a month."

Shiraine would tell other Americans thinking about IVF to open a health savings account. Saving $266 a month of pre-tax money in an HSA has helped her cover out-of-pocket costs without stress, she said. She also encouraged others to ask both their insurer and fertility clinic for a potential price breakdown before beginning the IVF process.

"There's certain general things that everyone does with IVF, and there's things that are tailored to your situation," Shiraine said. "If you can get a breakdown from both your insurer and clinic, it helps you plan out what could be covered and what might not be covered."

Dr. Cynthia Murdock, a Connecticut-based reproductive endocrinologist, and the McLeods' provider, added that many of her patients are surprised to learn that they have fertility coverage through their employer or state insurance. In Connecticut and New York, for example, insurers are required to cover some IVF treatments.

"We try to do as much as we can to help people navigate the insurance so they don't have to be stressed about that in addition to being stressed about not getting pregnant," Murdock said.

Beyond finances, Shiraine and Barrett told BI about the emotional impact of fertility treatments. As Caribbean Americans, the couple said they faced some stigma from family members about pursuing IVF because it is outside cultural norms. Shiraine said her mother was skeptical of them publicly talking about their "private" infertility experience. Between the ages 25 and 44, 15% of white women seek infertility treatment, compared to 8% of Black women, per the most recently available National Institute of Health data.

But, after seeing the positive reactions the McLeods were receiving from friends and on social media, Shiraine said her mom praised her for being so open about IVF, adding that it was a "beautiful" moment for their family. The couple said that they continue to share their story to help others experiencing infertility feel less alone, and they're thrilled for Lejend to become a big brother later this year.

"As a woman, in terms of reproducing, I doubted my body a lot," Shiraine said. "I'm so happy to finally have a kid. Going through this process gave me that opportunity."

Do you have a story to share? Reach out to this reporter at [email protected].

• The US birth rate grew by 1% in 2024, according to a new CDC report.
• Moms in their early 40s and late 30s experienced the biggest increases in births.
• Meanwhile, births declined the most among teens and people in their early 20s.

After years of ominous headlines about the world's shrinking birth rates, there's a bright spot. The US birth rate slightly increased in 2024, according to preliminary data from the CDC.

The 1% rise in births was largely driven by moms in their early 40s, who gave birth to 2% more children in 2024 than in 2023. Moms in their 30s and late 20s also experienced slight increases in births.

Brady Hamilton, the lead author of the report, told Business Insider that the stats are a continuation of the trends of the last three decades.

Women in their late 20s to early 40s are having more kids, while those in their teens and early 20s are having fewer. These numbers "support the contention that women are having children at later points in their lives," he said.

Millennial moms are leading the way

While millennials are having fewer kids compared to past generations, they're still having more kids than Gen Zers.

In 2024, the CDC found that women between 30-34 had the most kids, followed by moms in their late 20s (the oldest of Gen Zers).

Emily Oster, the founder of ParentData.org, a bestselling author, and a professor of economics at Brown University, told BI that the CDC's data points to two large trends.

One is that people are choosing to have kids later: fertility peaks in your early 20s, yet women in those age groups have been having fewer kids since the 1990s.

At the same time, medical developments give people more control over when they have kids, if at all, Oster said.

Teenage births continue to decline, dropping 3% since 2023, as birth control access increased. IVF allows women to conceive well into their 40s.

Young people need more time to feel financially ready for kids

Not everyone feels ready to have kids before their 30s and 40s.

"People are just taking longer to get to the place in their life when they think they want to have children," Sarah Hayford, a professor of sociology and director of the Institute for Population Research at The Ohio State University, told BI.

Millennial and Gen Z parents need more time to feel financially secure enough to start families compared to past generations.

Some are staying in school longer to land higher-paying jobs and afford the homes they want.

"What we see is people postponing births early on and then sort of catching up later on," she said.

Trump is on a mission to get more American babies

Despite the uptick in births, the Trump administration is on a mission to boost the birth rate, from "menstrual cycle classes" to giving $5,000 in cash to parents after delivery.

Many Americans want more kids than they have. The challenge is getting parents to actually have more.

Hayford said other wealthy countries, like Japan and South Korea, have introduced policies in the hopes of increasing their birth rates, like four-day work weeks and bonuses for men who reverse their vasectomies.

"None of them have been super successful," she said. While baby bonuses can have some impact, "they have to be really big," and even then, they have a modest influence on birth rates. She said Trump's proposed $5,000 would be under the average cost of delivery in the US, which is around $13,000 before insurance kicks in.

Other policy proposals often mentioned by parents, like lowering childcare costs or lengthening paid parental leave, aren't guaranteed to significantly raise birth rates: Some Scandinavian countries with better childcare support than the US are also experiencing birth declines.

"I don't think we know what it would take to get a bunch of 26-year-olds to want to have three kids," Oster said. "I'm not sure we have the answer to that."

• YouTuber Rebecca Zamolo is launching a fertility brand at Walmart inspired by her own struggles.
• The supplement category has become a playground for influencers.
• Zamolo says Molo's key selling point is in the way it's consumed.

Top YouTuber Rebecca Zamolo went through fertility struggles, including multiple rounds of IVF and miscarriages. She says this was part of the inspiration for her new supplement brand for hopeful mothers, Molo.

The name is both a play on her surname and short for "Mother's Love." Zamolo said its key selling point is a powder delivery system rather than the "horse pills" she took while trying to conceive her daughter, Zadie.

The supplements arrive Wednesday at Walmart stores nationwide as well as online.

"I realized there was definitely a problem when I was taking 14 giant pills a day to get pregnant," Zamolo told Business Insider. "I was like, how can we make this easier?"

In addition to Molo, other players in the fertility supplement market, including Needed and Perelel, offer powder formulas. Other brands like Olly offer gummies.

Influencers including Kourtney Kardashian and Andrew Huberman are active in the supplement category, via Lemme and curations with the brand Momentous, respectively. At the same time, companies like AG1, Bloom Nutrition, and Sugarbear Pro have relied on influencers as a key marketing channel.

All told, the Council for Responsible Nutrition, a lobbying group, pegged the size of the supplement business at $158.6 billion in 2023.

Forty-year-old Zamolo, for her part, has a massive digital footprint, including roughly 18 million followers on both YouTube and TikTok. She creates kid-friendly content with her family, including challenges and games.

Zamolo said that after she struggled for years to get pregnant, her fertility nurse, Christina Westbrook — a Molo cofounder, who also runs an IVF clinic in Los Angeles — recommended a vitamin regimen. Zamolo credits it with helping her conceive.

She is currently expecting her second child, a boy, via surrogate.

The products will be accompanied by a digital hub

While Westbrook developed Molo's formulas, Zamolo's other cofounders include Eyal Baumel — whose company, Flywheel, collaborates with influencers on product launches and other ventures — and Adam Ross at the investment firm Three Leaf Clover, who oversees manufacturing and product development.

Molo will comprise four products at launch: a prenatal mix, a hormone balance mix, a conception mix, and an ovulation and pregnancy test kit. An ovulation mix is coming down the line, and Zamolo said she eventually envisions creating postpartum products and supplements for men.

Molo boxes comprise 30 sachets, which are vegetarian, gluten-free, and non-GMO. All of the products in the line are priced at $29.99 apiece.

The efficacy of different supplements — which aren't regulated by the FDA as drugs — is a topic often debated in the medical community. An evaluation of studies on prenatal supplements in 2023 concluded that they "can play an important role in supporting a healthy pregnancy." The authors, however, noted some concerns surrounding regulation, dosages, and safety, and recommended pregnant women discuss any use of them with their healthcare provider.

In addition to Molo's physical products, a digital hub is in the works where fertility experts, OB-GYNs, and nutritionists will lead discussions, and women — including Zamolo — will be able to share their experiences with the goal of reducing stigma.

"It's giving that opportunity for women all over to take back control of their fertility," she said.

• My wife and I want to be parents, but we need to find a sperm donor.
• The process of finding a sperm donor is strange because we can only look at documents.
• It's also expensive, and we have not yet gotten pregnant.

The calling to have children and be a mother came from deep in my soul — and has remained consistent over the years.

When I came out as queer, I worried about how much more difficult it would be for me to become a parent.

"Modern science is great. You'll be able to have children," a friend said encouragingly. I hoped they were right and now I'm learning the truth.

When my wife and I decided to become parents, we needed a sperm donor. The process has been difficult, strange, and expensive.

We chose our sperm donor based on documents

My wife and I have been in fits of laughter, browsing the sperm banks and seeing some of the photos and descriptions. Each donor provides photos (adult and baby), a personal essay, a voice recording, and a medical profile.

It's weird. Several times, we thought we had found a donor we liked, but then we heard their voice, and it was off-putting — or they'd say their favorite animal is a small bird or ladybug.

We were looking for a donor who was more analytical or mathematical, given that we're both creative and artistic. Physically, we wanted someone tall, with dark brown curly hair — to match the traits of my wife, given that I'd be carrying the baby.

It's hard because the process forces us to emphasize the things that don't matter — looks, career, genetic greatness, and astrological signs. There's no formula. It's all feeling.

When we finally found the donor we wanted, it felt like an instant connection with "the one." It just felt right.

But that connection never goes beyond documents or forms. It's a strange kind of pseudo-relationship and quasi-emotional connection.

We're spending a lot of money

So far, we have spent thousands of dollars on this process, and we've had no pregnancies.

We're also sinking our money into an unregulated industry.

Most of these sperm banks don't adhere to the family limit number, meaning one donor can have anywhere from 10 to 150 children.

Avoiding half-sibling pods can be difficult, but right now, this expensive path seems like our only option.

My wife and I are leaning on each other for support

The process hasn't been easy. Since my wife's DNA won't be involved in the making of our baby, we are navigating a strange territory. We're trying to ensure my wife will leave her park on the child during pregnancy and early life.

"This shift in perspective does not change the facts but gives an optimistic way to see a scenario and gives back some of the control these individuals may feel they lost during the process," Jennifer Teplin, clinical director at Manhattan Wellness, who specializes in maternal mental health and treats LGBTQ+ patients, said told me.

But my wife and I are getting through this together. Luckily, she's always cracking jokes, bringing levity to a strange scenario.

I've also found peace in the fact that no one gets to choose their family. We found a donor my wife and I both felt drawn to, which I'm grateful for. In the end, if we only have one child, they will be born with a much wider support system and family beyond our home.

That's a beautiful gift to give.

• Easier access to mortgages starting in the 1930s spurred the US baby boom, researchers found.
• Two federal programs increased homeownership for eligible Americans, boosting marriage and birth rates.
• Low homeownership rates today may partially explain declining birth rates around the world.

If you want Americans to have more babies, it helps if it's cheap and easy to buy a house.

The advent of mortgages with low down payments in the 1930s facilitated a sharp uptick in the US birth rate that created the baby boom, per a National Bureau of Economic Research February 2025 working paper. The findings might help explain why countries across the globe, including the US, are struggling with tumbling birth rates as housing prices soar and homeownership for younger people stagnates.

The researchers — economists Lisa Dettling at the Federal Reserve Board of Governors and Melissa Schettini Kearney at the University of Maryland — found that two mortgage insurance programs led to 3 million additional births between 1935 and 1957, accounting for about 10% of the spike in births associated with the baby boom. The researchers found that these new mortgages lowered the age when people got married and had their first child and increased the total number of kids they had.

In 1934, the Federal Housing Administration introduced a loan insurance program that offered potential homebuyers 30-year fixed-rate mortgages with much lower down payments than had previously been required. A decade later, the Veteran's Administration began insuring home loans for returning servicemembers with no down payment required.

The FHA and VA-backed loans were a huge hit. The programs helped boost the rate of homeownership among white people of childbearing age from 20% to 50% between 1940 and 1960. And half of this homeownership spike happened before the end of World War II — even as many Americans were still feeling the effects of the Great Depression and few new homes were being constructed.

The researchers analyzed newly hand-digitized data on FHA and VA loans, birth count data from the National Center for Health Statistics, population data from the Census, and personal income data from the Bureau of Economic Analysis to come to their findings.

The analysis finds that these mortgages did not have a discernible effect on births among non-white women because these women were less likely to have access to or benefit from FHA and VA mortgages. Historically, Black Americans were "redlined" out of these mortgages while the bulk of the FHA and VA loans went to white families — the government wouldn't insure homes in areas that they deemed too risky or undesirable, which were often predominantly Black or minority neighborhoods.

How cheaper mortgages led to a baby boom

Finances are key when it comes to the decision to have a kid. When unemployment rises or incomes fall, people have fewer babies. Millennials have been particularly hard-hit by sky-rocketing healthcare and housing costs, and the debt crisis. Their generation controls less than 5% of the nation's wealth, while baby boomers held 21% of the country's wealth at the same age range.

This has all led to a gap between the number of children people say they want and the number they actually have. Some European countries have tried to lift birth rates to subsidize childcare and paid family leave, but have seen mixed results.

"If expenses — especially housing costs — were more reasonable, I'd feel much more financially secure and rich," Madelyn Driver, a millennial earning six figures who was still struggling to afford a home, previously told BI.

Dettling and Kearney's research found that it's actually more about easier access to homeownership rather than lower housing costs.

The type of mortgage that took off in the 1940s didn't bring overall housing costs down; it just reduced the barrier to becoming a homeowner by allowing very low down payments and long-term loans. This meant people could purchase homes at younger ages, often before they made the decision to have kids.

Making it easier for younger people to buy homes now could help boost plummeting birth rates — although, as 2008's housing crisis showed, it's still important to ensure that borrowers are fit to be eligible for mortgages.

One of the key lessons of the mortgage baby boom findings, per Kearney, is that policy that opens the door to accessible credit or lower down payments can make a real impact. "It's not just about, 'Oh, we need housing to be less expensive,'" she said.

Homeownership rates for younger Americans fell after the mid-aughts housing bubble popped and, while they've ticked up over the last decade, still remain relatively low. For Americans under 35 years of age, there's been an even more recent decline in homeownership since late 2020.

"Maybe how easy it is to have kids is less about can they take three months off work versus 'do I have a bedroom to put this kid in for the next 18 years?'" Kearney said.

Do you have a story to share about homeownership and having children? Contact these reporters at [email protected] and [email protected].

• Spain has some of the oldest moms, with 11% of women having kids post-40, compared to 4% in the US.
• Financial insecurity and settling down later in life play a notable role.
• But Spain's accessible fertility treatments and excellent public healthcare are also factors.

Monica Cruz-Lemini, a 46-year-old obstetrician living in Spain, had her first child at 44.

While pregnancies after 35 are considered "advanced maternal age," Cruz-Lemini's experience is far from unusual in Spain, where more than 10% of all births involve mothers 40 or older.

"I think there's a growing pool of women in recent years — and I've seen it both professionally and personally — who are a bit like me," Cruz-Lemini told Business Insider.

Spanish moms are among the oldest

According to Eurostat's latest data, Spain had the second-highest average age of women at childbirth in Europe in 2022, at 32.6 years, as well as the second-oldest average age for first-time mothers, at 31.6 years.

Spain also ranked second for the share of births to women aged 40 or older; 11% of live births in the country were to mothers in their fifth decade or beyond.

In comparison, only about 4% of live births in the US were to women over 40, according to data from the US National Center for Health Statistics, compiled by nonprofit group March of Dimes.

(Comprehensive global data isn't readily available, but Ireland came top in the most recent European stats.)

Financial insecurity

Delaying motherhood is a growing trend across Europe and beyond, not just in Spain.

However, Juan García-Velasco, chief scientific officer for IVIRMA Global, which operates a network of fertility clinics, highlights "a combination of factors" that help explain Spain's particularly high ranking.

One key factor, he said, is financial insecurity.

Spain has the highest unemployment and youth unemployment rates in the EU, and García-Velasco said that this, combined with low wages and financial instability, leads many women to wait until they are more financially secure.

Sarah Richards, a Barcelona-born mother of two who had her second child at 40, said that people want to be financially secure and own their own house before starting a family, "so that's going to happen a lot later here than it would in the UK, where salaries certainly are higher."

Property prices in cities and coastal areas also make it harder for many to afford a home, with Spain having one of the highest average ages in Europe for young people leaving the family home — at just over 30.

"You can't buy there, and the rents are just out of control," Richards said. "You either have a very good job, or you have a rich family that can help you and help with childcare."

Fertility treatments

Waiting longer often leads to a growing reliance on treatments like IVF, and Spain is a leader in Europe in IVF success rates, according to the global fertility agency International Fertility Group.

While a like-for-like comparison between Spain and the US isn't available — as different countries and clinics measure success rates differently — Spain remains a popular destination for Americans exploring international fertility treatment options.

García-Velasco said this may be why it may feel less risky for some women in Spain to leave trying for kids until later in life. "As the outcome is good, this reduces the pressure and the fears," he said

IVF is also widely accessible in Spain and is free for women 40 and under, including those who are single or in same-sex relationships.

In comparison, the estimated average cost per IVF cycle in the US is about $12,000, according to the American Society for Reproductive Medicine.

Spain also has more IVF clinics than any other country in the EU, per the European IVF Monitoring Consortium.

"The more facilities that are offered to become a mother later in life, the easier it's going to be," said Pauline Bronkurst, who had her second child this year at the age of 43.

"In our case," Bronkurst added, "both of our babies were conceived through IVF, so that definitely played a role."

Genetic risks

Having kids later in life does increase the risk of genetic conditions.

But Bronkhurst emphasized the importance of Spain's public healthcare system, which was particularly beneficial after her second child was born with a genetic condition.

While getting pregnant at an older age can increase the likelihood of complications, Bronkhurst said that in countries with universal healthcare and a high standard of medical care, the perceived risk of advanced-age pregnancy is significantly lower.

"I think that plays into the whole thing of waiting longer," she told BI.

Slow to settle down

Another major factor contributing to delayed motherhood in Spain is that people are simply settling down later in life.

The average age of first marriage among men in Spain is 36.8, the highest in Europe, while for women it's 34.7, also the highest, according to the latest Eurostat data.

Stephanie Galavodas, who had her son three years ago aged 41, told BI she waited until her 40s to have a child because she was "saying yes to things in life when I didn't have the partner to build a family."

After years of pursuing degrees, traveling, and establishing her career, she eventually met her partner, with whom she had her child.

"I always knew that I would have kids someday," she said, "and so it felt fine to me to kind of go out in the world and experience things instead of rushing to have a child first."

Going it alone

A growing number of Spanish women are also going it alone.

García-Velasco said the fastest-growing group seeking fertility treatment at his clinics in Spain are single mothers who have decided to raise a child on their own.

This trend is not unique to Spain. A 2020 study published in Fertility and Sterility found a significant rise in the number of single women undergoing IVF in the US over the preceding 12 years.

In Spain, García-Velasco said that many single mothers pursuing fertility treatment cite a "lack of adequate partner" as their primary motivation for going solo.

For Cruz-Lemini, the doctor who had her child at 44, this was the reality. "I'm a single mom by choice," she told BI.

Cruz-Lemini was occupied with studies, training, and then work as a doctor, but, she said, "You get to be around 40 years old and then suddenly you realize that it might be your last chance or chances to have a child."

She found a sperm donor and pursued IVF. A little over two years ago, she gave birth to her daughter.

Sometimes, she said, "you have to do it by yourself because you don't have time to get into a relationship."

For the past decade, Rock Health cofounder and prolific startup investor Halle Tecco has made her name as a voice for the voiceless in fertility care.

She founded fertility e-commerce startup Natalist in 2019 and egg freezing and donation startup Cofertility in 2022. She bet early on several fertility startups like unicorn Kindbody and healthcare provider Tia. She espoused radical transparency about her previous struggles to have a child.

While she raised funding to help other people get pregnant, though, Tecco's battles with infertility continued. She suffered eleven miscarriages, including losing twins at 17 weeks pregnant.

Now, she's taking a huge step back from the industry she helped cement.

"People expect me to continue that narrative. But I've moved on, and I don't want to continue talking about it," she told Business Insider. "I'm not trying to be an infertility influencer."

As she built businesses that aimed to give women control in their fertility journeys, Tecco struggled with a lack of control over her own. Behind closed doors, her dogged optimism clashed with grief and frustration. Her therapist told her, "This is you getting PTSD treatment while still at war."

Today, Tecco is done making new fertility bets. She wants to return to what got her excited about digital health in the first place — encouraging new and exciting ideas in a sluggish industry.

She's writing a book about what to expect when innovating in healthcare. She started teaching a course at Harvard Medical School this year about the complex network of stakeholders involved in healthcare entrepreneurship. She co-hosts the digital health podcast The Heart of Healthcare, and she sits on the boards of healthcare benefits company Collective Health and Cofertility.

She'll continue to support the women's health companies she's invested in. But as far as she's concerned, the fertility-centered chapter of her life is closed.

"I'm a healthcare investor, not a fertility investor. And I want to get back to that," she said.

When Tecco went to Harvard Business School to get her MBA in 2009, she was already interested in healthcare innovation. But it was her time at Apple, where she spent the following summer working on healthcare offerings in the tech giant's app store, that brought her frustrations with the industry to a head.

"There's so much money in healthcare, and such a big opportunity to improve healthcare. Why is nobody building fun, useful things over here?" she recalls thinking.

Returning to business school for her second year, Tecco reconnected with classmate Nate Gross as he was getting his clinician networking startup Doximity, now a publicly traded company, off the ground. Together, they began an independent study about how to get entrepreneurs to bring fresh ideas and technologies to healthcare.

From that study, Rock Health was born — named for the many hours Tecco and Gross spent in front of a whiteboard in Harvard's Rock Center for Entrepreneurship.

Tecco and Gross started Rock Health in 2010 as an accelerator program at a time when few vertical-focused startup accelerators existed. Y Combinator and Techstars both launched about five years earlier to supercharge seed-stage tech startups with venture funding and expert guidance. Rock Health offered founders the chance to do the same in healthcare, with backing from VC firms like Accel Partners and NEA plus companies like Microsoft and Nike.

The firm has made some impressive investments through its venture fund, including in Waystar and Tempus AI, which both went public in 2024; Omada Health, which appears to be eyeing an IPO in 2025; and Lyra Health, which last raised capital at a nearly $5.6 billion valuation in 2022.

Gross and Tecco both attested that they were told "no" many, many times during Rock Health's creation. They faced plenty of pushback from longtime healthcare builders and investors who rejected their vision to bring more tech into the industry.

Those dismissals only strengthened Tecco's resolve.

"I made the promise that I will never be the cranky old guard. There's no use in it," Tecco said. "We need as many smart people helping us solve these problems as possible."

After Tecco moved with her husband Cloudera cofounder Jeff Hammerbacher from San Francisco to New York City in 2016, she stepped away from Rock Health. She'd set her eyes on her next goal: building a family.

Getting pregnant turned out to be "a huge struggle," Tecco said, as she confronted the high costs of fertility treatments, a stunning lack of support and education, and no guarantees of pregnancy. She told Business Insider in 2019 that her own fertility journey was fraught with "a lot of misinformation, a lot of secrecy and shame."

Tecco's son was born through IVF in 2017 after four years of trying. Adamant about improving the fertility care experience for others, Tecco officially launched Natalist two years later to provide products and educational materials to people trying to get pregnant, from at-home ovulation tests to prenatal vitamins.

"It gave me a lot of satisfaction to support others in a way that I hadn't been supported," she said.

Tecco was early in the femtech investment wave, too, founding and backing fertility startups when few others did. She first invested in Kindbody's seed round in 2018; by some estimates, VC funding for women's health increased more than 300% between 2018 and 2023, even as healthcare funding slumped overall last year.

While running Natalist, overseeing women's health strategy at Everly Health after Natalist was acquired, and then cofounding egg donation startup Cofertility, Tecco wanted to have a second child.

Getting pregnant a second time proved even more difficult. Tecco endured multiple unsuccessful rounds of IVF and eleven miscarriages, over nearly five years.

Throwing herself into her work did little to help her escape the heartbreak. Infertility and pregnancy, as she spent her spare time helping thousands of patients trying to conceive, were always on her mind. She wrestled with jealousy over other people's "miracle babies" as she waited desperately for her own.

Secondary infertility, the difficulty of having another child after a previous successful pregnancy, robbed Tecco of countless hours of her life and plenty of happiness. Miscarrying twins at 17 weeks pregnant was "the first time in my years where I didn't have a plan B," she wrote in a 2023 blog post.

She paused fertility treatments in the summer of 2022 to spend time with her family. After much reflection and therapy, she realized that "overcoming" her secondary infertility wouldn't mean having another child. It meant making peace with the idea that she never would.

"It was harder than I can explain to make that decision, especially if you're someone like me, where you're like, I want this thing, I'm going to get this thing," Tecco said.

But, she said, "I wanted to go into my 40s being really clear about my intentions of moving on."

Tecco entered healthcare not solely to invest in startups, or to build her own, but to help other aspiring healthcare entrepreneurs with fresh perspectives and technologies in clearing the industry's many hurdles. Now 41 years old, she wants to get back to that.

This year, she's been focused on writing a book with that very thesis, aiming to pass along her knowledge to the next generation of healthcare builders. She sees it as the natural next step up from her blog, where she's covered topics from the value of an MBA versus a master's degree in public health (both degrees that Tecco holds) to why a startup may not be venture-backable.

But, true to form, Tecco is juggling multiple other ventures as she writes. She's still recording The Heart of Healthcare podcast alongside industry experts including Bessemer Ventures Partners investor Steve Kraus and Fenwick & West startup lawyer Michael Esquivel. In her classes at Columbia University and Harvard Medical School, she's teaching and learning from hopeful healthcare innovators. She's stopped angel investing, choosing instead to focus on the startups she's already backed, but she's also invested her personal wealth in top venture funds, including Oak HC/FT, Seven Seven Six, and Union Square Ventures.

While Tecco's Cofertility cofounder Lauren Makler oversees day-to-day operations at the startup as CEO, Tecco remains deeply involved with the company's strategy and fundraising efforts as a board member. And Rock Health is "still running Halle's game plan," Gross said.

Makler and Gross both called Tecco's ambition "relentless."

"If Halle has conviction in something, she does not look back," Makler said. "And even having gone through what Halle has gone through, her conviction, effort, and enthusiasm for what we're doing has never wavered."

Tecco doesn't regret the many years she spent speaking out about infertility. She still feels strongly about the twisted financial incentives in fertility care and the stigmas associated with assisted reproduction, even though she's not a patient anymore.

"I don't want to add anything, but I wouldn't want to take anything away. It is still such an important part of my story," she said.

Tecco's book, which she hopes to publish in late 2025, will be infused with her personal experiences, which Tecco said she understands people are interested in. But at its core, she hopes it'll be the "welcome guide" she never got for people interested in healthcare innovation, as motivating as it is practical.

"My goal is that readers close the book, and they're like, let's do this," she said.

• Florence Pugh, 28, was diagnosed with PCOS and endometriosis at 27.
• She froze her eggs at 27 because both conditions can impact fertility.
• Pugh said a different doctor dismissed the diagnoses because of her age.

Florence Pugh has opened up about two recent diagnoses that prompted her to freeze her eggs at 27 years old.

Speaking on Dear Media's SHE MD podcast with her Beverly Hills gynecologist, Pugh, now 28, discussed the moment she was diagnosed with polycystic ovarian syndrome (PCOS) and endometriosis — conditions that can impact fertility.

The Oscar-nominated actress said it was a "mind-boggling" experience to find out that having kids may not be a straight-forward process for her, and embarking into the world of fertility preservation.

Pugh also said that another doctor back home in London, whom she did not identify, dismissed her diagnoses.

"She shook her head and she said, 'well, that's just not possible,'" Pugh recalled. She said she told the doctor about her egg count and hormone test results done in LA. Pugh said the doctor responded: "No, you're fine. And even if you do have it, you'll be fine to have kids well into your 30s."

Dr. Thais Aliabadi, the gynecologist who diagnosed Pugh, reacted to her story on the podcast: "That is what women go through every single day."

PCOS and endometriosis — the leading causes of infertility — often go undiagnosed

PCOS and endometriosis are some of the most common causes of infertility. PCOS is a condition where ovaries produce excess male sex hormones, or androgens, creating hormonal imbalances. Endometriosis occurs when the lining of the uterus grows outside of the uterus.

Common symptoms of both include irregular and painful periods, as well as bloating or weight gain. PCOS symptoms also include thinning hair, excess hair growth, acne, and darkened skin.

Pugh said she had some of the symptoms, like weight fluctuations, acne, and "hair that shouldn't be in certain places." She attributed them all to work stress and just "part of being a woman."

Pugh said she went to get a checkup after being hit by a "sudden feeling" that something was off with her body. "I'd had a few weird dreams; I think my body was telling me," Pugh said.

At the appointment, Aliabadi asked Pugh if she'd ever had her eggs counted — something Pugh said she never thought of doing because she was young.

After counting her eggs and giving Pugh a hormone test, Aliabadi diagnosed her with both PCOS and endometriosis, encouraging her to freeze her eggs in her 20s.

Pugh said she had heard of the conditions before, but didn't think they were common. 1 in 10 women have PCOS, and roughly 200 million people worldwide have endometriosis.

She also didn't expect to have fertility problems because of her family history. "My family are baby-making machines," she said. Her mother had babies into her 40s, for example. She said she was grateful to get diagnosed and freeze her eggs because she'd been wanting kids since she was a child.

These conditions are often misdiagnosed or ignored

PCOS and endometriosis are commonly underdiagnosed or misdiagnosed entirely.

Pugh said she understands that she has "privilege in areas where others won't," so if her symptoms were dismissed, other patients might take even longer to get proper treatment.

PCOS disproportionately impacts women of color, who are also more likely to be misdiagnosed due to racial bias around symptoms like weight gain.

Pugh said she believes everyone should be educated on PCOS and endometriosis because "it's something that will be the defining factor of whether you can have children or not."