Family-Size-First Fertility Planning
Work backward from desired children, current age, and known risks
- Difficulty
- Advanced
- Time to result
- ~weeks to results
- Steps
- 5
- Confidence
- 92%
Crawford starts family planning with two direct questions: how old are you, and how many children do you want? The desired family size changes the timeline because each pregnancy, recovery period, and attempt moves the parent further along the age-related fertility curve. The framework then adds current reproductive information and known conditions such as endometriosis or PCOS. Rather than waiting for a year of unsuccessful attempts in someone already known to be at higher risk, Crawford argues for evaluating relevant variables before trying. The final comparison is between starting sooner, freezing eggs, or banking embryos. She describes embryos as providing more information because fertilization, development, and chromosome testing have already occurred, while eggs remain uncertain opportunities. No option is framed as a guarantee. The aim is an informed, owned decision made before time silently removes options.
Origin
Extracted from The Diary of a CEO
Core principles
- 01Plan for the whole desired family, not only the first pregnancy
- 02Age and egg number jointly affect available options
- 03Known fertility risks justify earlier evaluation
- 04Egg freezing preserves opportunities rather than guarantees
- 05The informed person or couple owns the final choice
How to run it
- 1
Define the full family goal
State how many children are desired and whether that number is firm or flexible. Have the conversation with the partner rather than assuming both people share the same plan.
Pro tip Separate the desire for a child from the preferred genetic or gestational path to parenthood.
Watch out Avoid treating a life goal as a guaranteed schedule.
- 2
Work backward through time
Place the earliest realistic first attempt on a timeline, then account for conception attempts, pregnancy, recovery, and later children. Note the likely age at each stage.
Pro tip Model the last desired child, not only the first.
Watch out Crawford's age-based percentages are population estimates, not personal predictions.
- 3
Add individual risk information
List diagnosed conditions, cycle irregularity, severe period pain, prior losses, and any known sperm issue. Seek individualized testing when the history warrants it.
Pro tip Ask what each proposed test changes about the decision.
Watch out Do not wait a routine 12 months when a known diagnosis or absent ovulation already indicates a problem.
- 4
Compare available paths
Discuss starting sooner, freezing eggs, or creating and freezing embryos. Compare what each path reveals, preserves, costs, and leaves uncertain.
Pro tip Use egg and embryo numbers as probabilities and opportunities, not promises.
Watch out Egg freezing is not an insurance policy.
- 5
Make and document the choice
Choose the path that fits the person's values, relationship, health, finances, and tolerance for uncertainty. Record why the choice was made and when it should be reviewed.
Pro tip A deliberate decision can reduce future regret even when the choice is not to intervene.
Watch out Clinical recommendations must be individualized by a qualified professional.
In the wild
Crawford describes asking a 25-year-old with endometriosis who wants four children when she plans to begin. If the answer is 30, Crawford would assess current ovarian reserve and other variables, then discuss whether egg or embryo preservation now could protect later options.
→ A known diagnosis changes the plan from reactive waiting to earlier evaluation and an informed preservation decision.
Illustrative scenario: a couple wants two children but is not ready to try for several years. They map the likely age of both pregnancies, review current health and fertility information with a clinician, and compare doing nothing now with egg or embryo preservation.
→ They choose with a view of the complete family timeline rather than reacting only when ready for the first child.
Common mistakes
Planning only for child one
The first pregnancy may occur at an age when later pregnancies are materially harder, so the whole desired family belongs on the timeline.
Treating freezing as a guarantee
Crawford describes frozen eggs as opportunities whose fertilization, embryo development, and chromosome status remain unknown.
Waiting despite known risk
A diagnosis associated with infertility changes the case for early testing and planning.
Is it for you?
Best for
It is best for people who want children but expect to delay, want a larger family, or have a diagnosis associated with infertility.
Not ideal for
It is not a universal instruction to pursue IVF or preservation, and it cannot determine an individual's outcome without clinical evaluation.
From the transcript
“for real honest talk about how old they are how many kids they want”
“you can't make make it unless you understand how many eggs do I have are things normal for me”
From the episode
The Pregnancy Doctor: Pregnancy Halves Every Year After 32! If You Want 2+ Children, You Need To Know This! If You Experience This Pain, Go See A Doctor!