Conceptive risk-taking: Personal uncertainty, flexible fertility intentions, and twins from medically assisted reproduction

Extant research shows that uncertain conditions produce patterned changes to reproductive behavior. More specifically, individuals who are uncertain about their ability to get pregnant are more likely to engage in contraceptive risk-taking resulting in unintended pregnancies. This article extends this literature by considering how personal uncertainty influences fertility intentions and risk-taking behavior among people attempting to conceive. Through 86 interviews with individuals who recently or were currently attempting to conceive via medically assisted reproduction (MAR) in the United States, this article finds that personal uncertainty results in a greater degree of risk-taking. Specifically, as individuals became more uncertain about their ability to conceive due to previous failed attempts, a perception that treatments are unlikely to result in pregnancy, and difficulty in paying for treatment, they describe themselves as becoming more flexible in their preference for the number and spacing of children from a prospective pregnancy, and more willing to pursue treatments that risk a pregnancy to twins or higher-order multiples. These findings prompt us to pair the established term and concept of contraceptive risk-taking with the novel ‘conceptive risk-taking’ to more fully encompass the multidimensionality of fertility intentions and the breadth of reproductive risk-taking practices.