7 myths about infertility
There is so much information available on infertility, yet much of it is patently false or misleading. Deciphering infertility truths from old wives’ tales can be tricky with so much conflicting information. Here are seven common myths to be aware of.
1. Frequent ejaculations decrease male fertility.
In men with normal semen quality, sperm concentrations and motility remain normal, even with daily ejaculations. In fact, in men with significantly reduced sperm counts, sperm concentrations and motility may be highest with daily ejaculations. Longer intervals of abstinence are actually associated with poorer semen parameters.
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2. Exact timing of ovulation is critical to getting pregnant.
The chance of getting pregnant is related to the frequency of intercourse, with the highest success through daily intercourse during the time between the end of the period and the middle of the cycle when ovulation occurs. Timing of ovulation using high tech devices does not appear to increase success when compared to the use of a menstrual calendar or monitoring cervical mucus that becomes clear and slippery just prior to ovulation. There could be a benefit to using ovulation prediction devices if the frequency of intercourse is very limited (once or twice a month).
3. Lying in bed with your legs up helps you conceive.
There is no evidence that the coital position affects the chances of conceiving. Sperm can be found in the cervical canal seconds after ejaculation, regardless of position. (Coital position also has no relationship to the sex of the baby). Post-coital routines, like lying in bed with legs up to prevent leakage of sperm from the vagina, in order to increase the likelihood of pregnancy have no scientific foundation.
4. Long-term use of oral contraceptive pills causes infertility.
Although there may be a delay in the return to ovulatory cycles for a month or two after stopping birth control pills, there is no evidence that this causes infertility. If there is an underlying ovulation problem, the pills may mask this by artificially creating regular periods, but once they are discontinued, the ovulation defect is exposed and periods will become irregular.
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5. Use of fertility medications will result in earlier menopause.
Egg loss is a constant process occurring throughout a woman’s life and most of the egg loss is not related to ovulation. Taking fertility drugs allows for some of the eggs that otherwise would have been lost to be ovulated or retrieved during IVF. Conversely, suppressing ovulation with long-term oral contraceptive use does not delay the age of menopause. The rate of egg loss is probably at least partially genetically determined so early menopause in a mother can be associated with early menopause in her daughter. The rate of egg loss can be hastened by environmental factors including cigarette smoking, which increases the rate of loss and results in earlier menopause by several years.
6. You should try to conceive for one year before seeking medical advice and assistance for infertility.
While the definition of infertility is one year of unprotected intercourse that doesn’t result in conception, there are situations where waiting a year doesn’t make sense. If you are over 35, it is generally accepted that 6 months is an adequate time to try, and waiting longer may reduce the chances that medical help will be effective. Also, if you have irregular menses, with cycle lengths over 35 days, then you may not be ovulating or may be ovulating infrequently. Conception is difficult with infrequent ovulation as timing is not possible, and will not occur in the absence of ovulation. Women with ovulation problems need to be evaluated right away as medical treatments to induce ovulation are very successful and there is no reason to wait to seek help.
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7. Skyrocketing fertility costs make having a baby unattainable for most people.
There are many employers that now offer fertility benefits to employees. Some employers even work with a fertility benefit management company, like WINFertility, which uses clinical experts to guide patients through their fertility journey. However, if fertility benefits are not covered through a patient’s employer or insurance, IVF patients do have options. In addition to employer and payer solutions, some benefit management companies offer programs for self-pay patients. These direct-to-consumer programs include physician and specialty pharmacy networks to give you access to highly trained and credentialed reproductive endocrinologists and discounted prices on fertility medications. They can also help fertility patients navigate what is often a complex journey with fertility nurse care managers that provide information and support along the way. RESOLVE has a useful tool for finding resources that help make infertility affordable.
Barry Witt, M.D. is the Medical Director of WINFertility and Greenwich Fertility. He is a board-certified reproductive endocrinologist who has been offering reproductive care for more than 25 years.