Background: Fertility-related values have changed considerably in recent years, with increasing individualism contributing to declining fertility rates. This study investigated attitudes, motivations, and reproductive preferences among faculty members at selected Iranian medical universities.

Methods: A descriptive cross-sectional study was conducted among 600 faculty members from 12 medical universities in Iran, including 300 women and 300 men. Data were collected online using a demographic questionnaire, the Attitudes toward Fertility and Childbearing Scale (AFCS), and Miller’s Childbearing Motivation and Preference Questionnaire. Data were analyzed using SPSS version 23.

Results: Significant gender differences were observed in attitudes toward childbearing, fertility motivations, and reproductive preferences (p < 0.001). Male faculty members demonstrated more positive attitudes toward childbearing, whereas female faculty members were more likely to delay childbearing and perceive children as a burden. Although both groups reported relatively high positive fertility motivations, negative motivations were more prevalent among women. Most participants preferred having two children, and the intention to have children was higher among men than women. No significant gender difference was found in the interval between marriage and the birth of the first child (p = 0.148).

Conclusion: Gender-related differences in attitudes and motivations toward childbearing may influence fertility intentions among university faculty members. To address barriers to childbearing, particularly among women, university administrators and health policymakers should implement supportive measures, including work–family balance policies, occupational support, and accessible childcare services. Such interventions may help create a more favorable environment for family formation and childbearing among faculty members