Rethinking Reproductive Health: Why What You Do in Your Twenties Matters for Your Future Fertility

What began as a spur-of-the-moment decision during a sleepless night in the middle of the pandemic, when Zoya Ali was just 23, has turned into an important platform for public health education: Uteropedia, an Instagram community now counting almost 100,000 followers, focused on breaking taboos around women's health and making reproductive science easy to understand.

Now in her late twenties, Zoya notices a clear split among her friends. Some are starting to think about having children, while others want to travel or are still unsure. Her advice to everyone is simple: don’t ignore the topic. «My friends had all these basic questions about their bodies, their cycles, STIs, contraception», Ali recalls. «And I'd think about it – it had been five or six years that I was studying reproductive health. That was the only reason I knew. Had I chosen business or arts instead, I wouldn't have had the answers either».

To address these questions, journalist and Why Wait Agenda founder Eleonora Voltolina met with Zoya Ali in Paris during the ESHRE 2025 meeting to record a special podcast episode. With ESHRE 2026 in London coming up soon (5–8 July), we are sharing this and other episodes recorded in Paris.

Don't Play the Ostrich: Keep Your Options Open

Many young adults don’t realize that one in six couples in the UK and worldwide faces infertility. Untreated sexually transmitted infections (STIs) in your early twenties can cause blocked fallopian tubes and serious fertility problems years later. Research also shows that choices like smoking, vaping, and drinking alcohol can harm your fertility by lowering ovarian reserve and disrupting important hormones.

«What you do today, your body will remember. You will forget, but your body will never forget», Zoya warns. Whether through preconception counseling or exploring social egg and sperm freezing – which has seen a staggering 400% increase in the UK – getting assessed early gives you the power of choice before it's too late.

Breaking the Gender Bias in Fertility

For a long time, discussions about fertility and the «fertility gap» have focused mostly on women, putting all the pressure on them. Zoya Ali, who has also been an editor for Eshre’s Journal Club, wants to include young men in these conversations as well.

«We're always telling women it’s too late for them. But no one talks about the men», Zoya says. She sees a growing interest from men who want to learn about sperm health and testosterone. Ali points to a study showing that men with better sperm quality live, on average, three years longer than those with lower quality. Reproductive health isn’t just a «women’s issue»; it affects everyone’s health and lifespan.

Why It Matters to Know Your Menstrual Cycle

As a Senior Scientific Research Associate at the women’s health company Hertility, Zoya strongly supports the use of modern tools, such as health and period-tracking apps, to help people take control of their bodies.

Most workplaces are designed around a 24-hour male hormone cycle and don’t consider women’s natural cycles. Apps can help track symptoms, notice productivity changes during different phases, and give people the information they need to speak up at the doctor’s office.

Tracking is important because it helps break down harmful myths. Schools often say a normal cycle is 28 days, but a large study of over 600,000 cycles found that only 13% of women have a 28-day cycle. Knowing that cycles between 21 and 35 days are normal helps women notice real problems, like signs of PCOS, and get help sooner.

A Call to Action for Policymakers

If Zoya Ali had a magic wand to change the landscape of global reproductive health, her target wouldn't be clinics or IVF public policies – it would be the school curriculum. With declining birth rates and rising global infertility, she argues that governments must urgently implement robust fertility education. «There are guidelines that exist, but people are not following them because they don't have the education to understand how important these things are», she concludes.

Want to know more about how to protect your future choices and navigate reproductive health without the taboo?

Listen to the full episode with Zoya Ali on The Why Wait Agenda Podcast.