Guest Post by Alison Zimon, M.D.
Like everything we care about, figuring out how to tackle a problem like infertility leads us to educate and empower ourselves. We read books, search the web, and talk with friends and family. Unfortunately, there is a lot of misinformation about the causes and treatment of fertility issues, and this can send you in the wrong direction! Understanding fact from fiction can allow you to focus your energies in the right way, as you seek to understand and optimize your fertility potential.
Here are some of the most prevalent fertility myths I hear from our patients with the facts set straight:
Myth 1: Only older women have to worry about their fertility.
Reproductive awareness is important throughout the reproductive years, and these begin in the early 20s. Unfortunately, many young women believe they won’t have any issues with fertility associated with age. An interesting study out of Melbourne, Australia found that fewer than half young women understand that fertility declines significantly after age 35 years and that most overestimated how successful in vitro fertilization (IVF) could be over 40.
In truth, a woman’s fertility potential declines throughout her reproductive years. This becomes significant in her early 30s caused by factors: the decline in egg count and a decline in egg quality. At age 30, approximately 70% of embryos derived from her eggs will be chromosomally normal. This declines to 60% by age 35, 50% by age 38, and 37% by age 40. Thus, fertility treatment, including IVF, declines over these reproductive ages and becomes significantly less successful after age 40. It’s important to think about your fertility future early, and you might consider fertility preservation via egg freezing or embryo freezing.
Myth 2: We’ve already had one child, so there shouldn’t be any problem having another.
Many people are lulled into complacency once they’ve had a baby and assume they are unlikely to have any difficulty with conceiving a second time and that secondary infertility is very unlikely. Actually, secondary infertility is nearly as common as primary infertility and affects up to 10-15 % of couples who already have a baby. Therefore, if you are trying to get pregnant after a baby, our practice makes the same recommendations as we would for couples that are not yet parenting. We recommend seeking a fertility evaluation after six months trying to conceive if over 35 years of age and after 12 months if under age 35 years.
Myth 3: Women with PCOS can only get pregnant via IVF.
Women with polycystic ovary syndrome (PCOS) are often led to believe that the only way they can get pregnant is with fertility treatment such as IVF. Fertility treatment may be needed for women with PCOS; however, it is not an absolute! While women who have PCOS have irregular cycles and infrequent ovulation, many of them do ovulate so there is an opportunity for pregnancy at the time of these natural ovulations. A first-line treatment is usually an ovulation pill, such as letrozole or clomiphene citrate, that helps PCOS women ovulate more regularly. Only after the ovulation pill approach is unsuccessful after several attempts do we begin considering IVF.
Myth 4: If you eat well, exercise, and keep a healthy lifestyle, you should have no problems getting pregnant.
While eating well, exercising and staying healthy can only be positive factors in your journey to pregnancy, this may not be all that is necessary to help pregnancy occur. There are many causes of infertility, including problems with ovulation, egg reserve, fallopian tubes, uterus or sperm, and thus it is important to have these evaluated. Although a fertility assessment will include an intake and opportunity to improve health and wellness, we wouldn’t want to exclusively focus on this and miss underlying medical fertility problems. While you work on your general health, I recommend that you simultaneously seek a fertility evaluation.
Myth 5: Taking birth controls pills for too long can lead to infertility.
Women often believe that long-term birth control pill/oral contraceptive (BCP, OCP) use will lead to infertility. Fortunately, this is not true. While there is a possibility that return of normal menses may be somewhat delayed after stopping BCPs, even this is uncommon. Loss of menstrual cycles for longer than six months after stopping the pill is extremely rare and occurs at rates of 0.5 – 2.5 % and even in these cases it is believed that an underlying condition is causing this, not the OCP use. Thus, BCPs are safe to use if you plan future pregnancy.
Myth 6: Stress causes infertility and if you just relax, then you will get pregnant.
We hear this myth all the time, and it is not accurate at all. This can actually lead to ignoring underlying medical issues that may cause infertility and shift the burden of the problem to blaming themselves. Infertility in itself causes stress, so we do encourage stress management strategies whenever possible when dealing with infertility to make it more manageable.
The list of fertility myths goes on and on. The first step in embracing any challenge is to understand the issue. The hope is that we can debunk more fertility myths, provide facts straight from a trusted fertility specialist, and empower you to do what’s best for you in your fertility journey.
Dr. Alison Zimon is the Co-Founder and Co-Medical Director of CCRM Boston. She is Board Certified in Reproductive Endocrinology and Infertility and in Obstetrics and Gynecology. In addition to her role at CCRM Boston, Dr. Zimon is a Clinical Instructor in the Department of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School and is a Staff Physician in OB/GYN at Beth Israel Deaconess Medical Center and Newton Wellesley Hospital.