Age is one of the factors that strongly influence egg quality and reproductive potential. The American Society for Reproductive Medicine (ASRM) noted that, according to the available evidence, pregnancy and birth rates appear to be higher when eggs are frozen at a younger age. “The period before age 35 is especially important as this is around the time when a turning point occurs in the decline of ovarian reserve,” said Ana Pérez-Alzueta, a gynecologist specializing in fertility preservation at Fertilab Clinic, Barcelona, Spain. “For professional athletes, this issue takes on a unique dimension. Some of their best years from a reproductive standpoint coincide precisely with highly demanding phases of their careers,” she added.

This does not mean that all female soccer players should consider preserving their eggs. The decision must be evaluated on a case-by-case basis and depend on each woman’s circumstances and reproductive plans, according to the expert. “For those who know they do not want to become mothers yet, understanding the possibilities and limitations of fertility preservation can help them make an informed decision,” said Pérez-Alzueta.

Egg freezing can expand future reproductive options, but it does not guarantee a subsequent pregnancy. The ASRM itself considers that there is still limited evidence to predict the chances of childbirth following planned freezing and recommends informing patients of this uncertainty.

Female Athletes and Fertility

Scientific evidence on fertility and assisted reproduction in elite athletes is limited. “Considerations of Fertility in Elite Sportswomen: A Narrative Review,” published in 2026 in BJOG: An International Journal of Obstetrics & Gynaecology, noted that high-intensity training is associated with a higher frequency of menstrual irregularities, particularly in situations of low energy availability. However, the specific effect of elite-level exercise on fertility is much less clear. The authors emphasized that female athletes are underrepresented in reproductive research and that there are limited data on the outcomes of fertility treatments in athletes and their potential impact on training and performance.

A study published in August 2026 in Sports Medicine analyzed a survey of 216 female athletes who had undergone egg freezing or in vitro fertilization. Overall, 79% continued to exercise during treatment, although most reduced the intensity, frequency, or duration of their activity. The researchers did not observe an increase in adverse events among those who continued to exercise compared to those who stopped, but they emphasized that further studies are needed to establish specific recommendations for female athletes.

Egg Freezing and Training

Oocyte vitrification begins with a phase of ovarian stimulation using hormonal medication. The goal is to ensure that several follicles mature at the same time so that more than one oocyte can be retrieved during ovarian puncture.

During the process, physical activity does not necessarily have to be completely discontinued, but it must be adapted to each individual case and the stage of treatment. As the ovaries increase in size, certain high-impact activities or those involving sudden movements may require adjustments due to the risk for complications such as ovarian torsion.

At Fertilab, the gynecologist explained that for a soccer player, this may mean temporarily dialing back certain exercises, especially during the final phase of ovarian stimulation. “Whenever possible, treatment planning can be coordinated around a window in the sports calendar that minimizes disruption to training and competition,” Pérez-Alzueta said.

A recovery period is also necessary following oocyte retrieval. Side effects may include abdominal bloating, pelvic discomfort, or fatigue, although their severity varies among women.

Fertility and Anti-Doping Regulations

There is also a specific issue that particularly affects professional female athletes: anti-doping regulations. Fertility treatments may involve various medications, and not all are treated the same under World Anti-Doping Agency (WADA) regulations.

The 2026 WADA Prohibited List includes, among others, certain hormonal modulators used in female infertility treatments, such as letrozole and clomiphene, which are prohibited at all times. Therefore, an athlete who needs one of these drugs may have to apply for a Therapeutic Use Exemption (TUE), a formal approval that allows the use of a normally prohibited medication or treatment for a legitimate medical reason under anti-doping rules. WADA itself has a specific guideline on female infertility and TUE that explains these situations.

In contrast, other medications commonly used for ovarian stimulation, such as gonadotropins — follicle-stimulating hormone or a combination of follicle-stimulating hormone and luteinizing hormone — are not considered doping substances. The WADA guideline also noted that human chorionic gonadotropin is not prohibited in women, although it is prohibited in men.

A Measure Greeted With Optimism

The Royal Spanish Football Federation’s (RFEF) proposal has garnered support from several international players. Olga Carmona and Patri Guijarro, two Spanish professional soccer players, took part in the presentation of the agreement and welcomed the addition of another option to help guide decisions about their reproductive future. Both said female soccer players should have the freedom to decide when to become mothers, along with the support needed to balance that choice with their professional careers.

“We’re very happy to have reached this agreement. It’s a very important step for us: having one more resource, being able to choose when and how we want to approach our future, make decisions, and stay informed. It’s very important to us and represents another step forward among all the progress being made within the Federation,” said Carmona.

“Being able to choose to become a mother and decide when, but also — if we want to be mothers — having support throughout our careers. I think that, in recent years, thanks to work-life balance measures, we’ve been receiving that support, and efforts are being made to ensure we feel heard,” said Guijarro.

Vanessa Sotelo, a Spanish national futsal player, also stressed the importance of giving female athletes access to resources that address their personal futures, not just their athletic careers. “Measures like these help our sport and the women of our country grow,” she said.

The RFEF Offers a New Resource for Its Athletes

On September 8, the RFEF announced an agreement with the Tambre clinic to facilitate access to assisted reproductive technologies for players on the Spanish women’s national team — including futsal players — as well as for first-division referees and assistant referees. The agreement also extends to individuals employed by the federation. Among the options available are oocyte vitrification, in vitro fertilization, egg donation, and certain genetic tests.

The agreement, in effect until spring 2029, will offer tools and alternatives that allow for making decisions about personal and professional futures with greater freedom and knowledge, according to the RFEF, which presents the measure as a way to expand opportunities for work-life balance and maternity protection.

“If Spain and its national teams are the best in the world on the field, they must also be the best in areas such as work-life balance,” said RFEF President Rafael Louzán. The initiative joins other work-life balance measures the RFEF had already implemented, such as those allowing female players, while pursuing their careers, to spend time with their families during major international tournaments.

Fertility Preservation and Work-Life Balance

The measure has also drawn criticism. Ana Peleteiro, a Spanish Olympic track-and-field athlete and triple jumper, has questioned on her social media why egg freezing is being presented as a feminist measure and has argued that true progress should involve guaranteeing contracts, a return to work after childbirth, and support for child care. Peleteiro has thus raised a fundamental question: whether the measures are intended to make it easier for female athletes to become mothers or whether, indirectly, they make it easier for them to delay motherhood in order to continue competing.

Former soccer player Larraitz Lucas has also called for a broader approach: in statements reported by EL PAÍS, a major Spanish newspaper, she said that female athletes should be able to become mothers during their careers and then continue their professional activities, rather than necessarily having to postpone motherhood.

The Comisiones Obreras union, the largest trade union confederation in Spain, has taken a similar stance, warning that financial assistance for fertility treatments should not replace workplace measures that protect pregnancy and allow women to balance motherhood with competition.

A Debate That Goes Beyond Spanish Soccer

The RFEF’s initiative is not an isolated case. Other sports organizations have begun to develop policies related to fertility and motherhood.

In 2025, the Women’s Tennis Association introduced a specific rule allowing female tennis players to take a leave of absence from competition to undergo fertility preservation procedures, such as egg or embryo freezing, and return with special protection of their ranking. This is important because it not only facilitates treatment but also aims to protect the player’s athletic career.

Similar initiatives exist in soccer as well. The Union of European Football Associations has recommended that fertility treatments, such as egg freezing or in vitro fertilization, be taken into account in soccer’s employment policies. In addition, some clubs, such as Chelsea Football Club, the English professional women’s soccer club based in London, England, have begun offering financial and medical support related to fertility to their female players.

A Medical Decision Cannot Replace a Personal Decision

“Fertility preservation can offer an alternative to female soccer players who decide to postpone motherhood, but it should not become an automatic response to the demands of professional sports,” noted Pérez-Alzueta.

True progress lies in expanding possibilities. “It’s about ensuring that a woman can decide to become a mother during her athletic career without feeling penalized and that, if she prefers to wait, she is aware of the available alternatives,” noted Pérez-Alzueta.

“Because reproductive freedom isn’t about deciding for an athlete when she should become a mother, but rather about providing her with three fundamental elements so she can decide for herself: information, options, and the ability to make that decision,” she concluded.

This story was translated from El Médico Interactivo on Univadis, part of the Medscape Professional Network.