There are many myths about why infertility occurs, who it affects and what can be done about it. Experts Anna Sane and Dr Evangelia Elenis offer their insights
Tilly co-founder and CEO/CMO Anna Sane, and Tilly's Chief Medical Advisor, Dr Evangelia Elenis, offer their insights on common infertility myths. Tilly (mytilly.co) is the first fertility app offering personalised and evidence-based support across both physical and mental pain points.
1. You are too old to have a baby
There are many misconceptions surrounding fertility, and most taboos are centred around women and their age. Doctors, for example, often show graphs indicating that women’s fertility drastically declines at 35, yet contradictorily, the media is full of stories about women approaching 50 becoming pregnant.
Ultimately, it’s important to understand that the relationship between age and fertility is not black and white. Whilst women’s fertility does decline with age due to changing ovulation patterns, and eggs decreasing in both quality and number, we must acknowledge that every person’s body is different, and a person’s health and lifestyle all play a key role in a person’s ability to conceive.
"The relationship between age and fertility is not black and white"
Also—there are many ways for a person to become pregnant, and while age may not make it impossible, it often requires greater effort and even invasive treatment(s). If you’re over 35 and haven’t become pregnant after trying to conceive for six months, seek out reputable fertility tests and consult your doctor to see if infertility treatments can increase your chance of conception.
2. If your mother got pregnant easily, you will too
Fertility is influenced by a range of factors spanning age, lifestyle, health conditions, injuries and more, all of which are unique to each person and go beyond their familial history.
Asserting that fertility is purely influenced by genetics is thus an extreme oversimplification of an incredibly sensitive and complex topic, and assuming that one person’s journey will be similar to their parents can be both inaccurate and harmful.
On the other hand, some conditions that affect fertility could be hereditary, for example PCOS or POI (premature ovarian insufficiency). So, if you know that your mother had outlying conditions like one of these, it’s important to be proactive about your fertility and get tested for these conditions, as they can complicate your journey to pregnancy and might require additional support from your doctor.
3. IVF can solve all fertility issues
IVF is an amazing option for many struggling with infertility, however it isn’t as simple a solution as we’re often led to believe. In fact, studies show that most patients overestimate the success rates of IVF (in reality the chance of a single IVF cycle leading to a live birth is around 27 per cent), which can unfortunately create unnecessary disappointment.
"If IVF doesn’t work for you, feel empowered to explore alternatives with a specialist"
In reality, IVF isn’t a cure-all treatment for every person experiencing fertility problems. For example, it may improve the odds of finding a healthy egg or sperm, but IVF can't create a healthy egg or sperm if there are none or too few.
Having said that, there are of course many additional treatment options like using donated egg or sperm, so if IVF doesn’t work for you, feel empowered to explore alternatives with a specialist.
4. Men are fertile their entire life
In women, fertility comes to an “abrupt” end with menopause. Among men, on the other hand, fertility declines more gradually. As they age, testicles tend to shrink and soften, which can result in lower sperm production and poorer sperm quality. Additionally, testosterone, which decreases with age, plays a crucial role in sperm production, so it makes sense that lower levels of testosterone (whether due to age or wider health conditions) can directly impact fertility.
While many think that men are equally fertile even into their latest stages of life, it’s important to understand that older age has been found to be linked to a higher proportion of defective sperm, with key issues being poor morphology (shape) and motility (mobility), which can prevent pregnancy or increase risk of miscarriage depending on the severity of the sperm’s deficiencies.
5. Many eggs = high fertility
Many women worry about the number of eggs they have, and AMH-tests (which indicate the amount of eggs a person has) have been sold as “fertility tests”, which is misleading. While a significantly low egg reserve lowers a person’s chance of pregnancy, in reality, egg reserve is just one part of the complex equation that is fertility.
Ovulation issues are a more common cause of female infertility, and egg quality is as important (if not more) than the number of eggs a person has left. There are, in fact, studies indicating that women with a low egg reserve, and those with a normal egg reserve, have the same chances of conception during the first year of trying, if there are no other issues at play.
6. Lying down after sex increases chances of conception
Perhaps one of the most famous images in film and TV of couples trying to become pregnant, there is no scientific proof that lying down or holding your legs up after sex can increase the chance of conception.
After sex, a lot of sperm and semen will leave the vagina regardless of the woman’s physical position, however healthy sperm have the ability to swim upstream and can find their way to the fallopian tubes within minutes, and gravity becomes irrelevant. So, it’s perfectly OK to stand up, or do whatever you’d like to after sex!
"There is no scientific proof that lying down or holding your legs up after sex can increase the chance of conception"
In fact, the same thing is true for embryo transfers after IVF, and while doctors used to recommend a person lays down after treatment, studies now show that it does not make a difference for success rates.
Read more: 5 Ways to boost your fertility
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