1. MYTH: Infertility is a woman's problem.
FACT: It surprises most people to learn that infertility is a female problem in 35 percent of the cases, a male problem in 35 percent of the cases, a combined problem of the couple in 20 percent of cases, and unexplained in 10 percent of cases, according to the American Society for Reproductive Medicine. It is essential that both the man and the woman be evaluated during an infertility evaluation.
Common male infertility factors include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality.
Common female infertility factors include ovulation disorders, or blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis (a sometimes painful condition causing adhesions and cysts). Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids are associated with repeated miscarriages.
2. MYTH: The truth is, most people get pregnant at the drop of a hat.
FACT: More than 7.3 million Americans, or 1 in 8 women of childbearing age, had trouble getting pregnant or carrying a baby to term in 2002, the most recent data available from the Centers for Disease Control and Prevention. That's a jump of nearly 20 percent over 1995.
3. MYTH: It's all psychological: Stress is the leading cause of infertility. People just need to relax and they'll get pregnant.
FACT: Infertility is a medical problem; it is a disease or condition of the reproductive system. While relaxation may help with overall quality of life, stress and deep emotions may result from struggles with infertility, not cause it. A recent survey conducted for RESOLVE, The National Infertility Association, revealed that 22% of women mistakenly believe that stress is the number one cause of difficulty conceiving, rather than a medical condition. At least 50 percent of those who complete an infertility evaluation respond to treatment with a successful pregnancy. Those who do not seek help have a "spontaneous cure rate" of about 5 percent after a year of infertility.
Stress is not a cause of infertility, though it can frequently be a side effect of it.. Advising infertile couples that they should "just relax," when what they have is a medical problem, isn't helpful and may be hurtful. A vacation doesn't magically clear up blocked fallopian tubes or raise a low sperm count. Couples do tend to have more sex when they're away from their daily routines and responsibilities, and so if the couple in question is one of the (very rare) few for whom infertility is caused by infrequent intercourse, a vacation can be a boon.
4. MYTH: After people adopt a baby they usually get pregnant.
FACT: Studies reveal that the rate for achieving pregnancy after adopting is the same as for those who do not adopt.
5. MYTH: Adoption is the only ethical and ecological solution to infertility: It’s a lot cheaper and easier than medical treatment and there are so many babies out there who need homes.
FACT: “The biological urge to have children is so strong,” says Dr. Daniel Whitesides of REACH, “the truth is that most people we treat explore medical treatment for infertility prior to considering adoption.” Contemporary adoption options have changed, and adoption can be more costly and time-consuming than expected. It is, however, still possible to adopt a healthy baby.
6. MYTH: Marriages rarely survive infertility struggles.
FACT: The majority of couples manage the infertility crisis, learning in the process new ways of relating to each other, improving their understanding of different coping styles they may have, and deepening their communication, which actually serves to improve their relationship in years to follow and indirectly helps them become better parents.
7. MYTH: Infertility is a personal failing.
FACT: Infertility is a crisis and it is normal for people to feel a sense of inadequacy that affects their self-esteem and self-image. The American Society for Reproductive Medicine highly recommends all those who face infertility issues become more informed about the wide range of options and connect with others facing similar challenges, as well as considering professional counseling.
8. MYTH: Infertility is not problematic for people until they hit their late 30s.
FACT: Most people are not aware that for women, infertility decline begins at 27 or even sooner, although the most significant decline occurs in the mid 30s. According to the American Society for Reproductive Medicine, approximately 10 percent of women under 35 experience infertility and that number more than doubles to 22 percent for women ages 35-39. For women over 40 years old, the number nearly triples to 29 percent. Infertility is defined for patients under the age of 35 as the failure to conceive after one year of intercourse without using contraceptives. For patients older than 35, this time frame is shortened to six months. In addition, recent research indicates that men, too, may experience a decline in fertility with age.
“The drop in natural pregnancy rates is directly correlated to the effects of normal ovarian aging - as women age, their eggs become less fertile and chromosomal abnormalities may begin to appear,” says Dr. Nancy Teaff of REACH. “But the good news is that with the appropriate treatment, the majority of our patients will conceive.”
9. MYTH: People who have successfully conceived before shouldn’t have trouble with fertility later in life.
FACT: According to the National Survey of Family Growth, more than one million couples grapple with “secondary infertility.” A previously fertile partner may be trying to have a child with a new spouse, or one or both partners in an existing relationship have developed fertility problems since their last child was conceived, (e.g., endometriosis – one of the most frequent causes of secondary infertility in women), irregular ovulation, or fallopian tube disease. Or a man might have had a decline in the concentration or motility of his sperm. Other factors can involve age (even five years can make a big difference in a woman's fertility cycle and a man's sperm count), scarring after childbirth, or stress, which can affect ovulation and sperm production.
10. MYTH: Infertility treatment has gotten way too high-tech.
FACT: Most infertility problems -– 85 to 90 percent -- are treated with conventional therapies, such as drug treatment or surgical repair of reproductive organs. For infertile couples where women have blocked or absent fallopian tubes, or where men have low sperm counts,
in vitro fertilization (IVF) offers a chance at parenthood to couples who until recently would have had no hope of having a "biologically related" child.
IVF accounts for less than 5 percent of all infertility treatment in the United States. Since IVF was introduced in the United States, in 1981 through the end of 2002, almost 300,000 babies have been born as a result of reported Assisted Reproductive Technology procedures (ART). About 1 percent of American babies born each year had help from IVF, according to the American Society for Reproductive Medicine. The percentage could be a lot higher. An estimated 50 percent to 80 percent of infertile couples never seek medical care because they can't afford it or their insurance does not cover treatment.
11. MYTH: IVF is still pretty risky.
FACT: The average live delivery rate for IVF in 2000 was 29.9 percent per retrieval -- slightly better than the 20 percent chance that a reproductively healthy couple has of achieving a pregnancy and carrying it to term.
12. MYTH: Using IVF means multiple births.
FACT: In the last five years, doctors have had great success implanting better developed, five-day-old embryos in a mother’s uterus, instead of the older method of transferring three-day-old embryos. The result has been vastly improved pregnancy rates, and the March 16, 2006, issue of the New England Journal of Medicine strongly supported this method for infertile women younger than 36.
With multiple transfers come a heightened chance of multiple births, which dramatically increase the odds of prematurity, low birth weight, disability, and death for the infants, and risks of preeclampsia, diabetes, placental problems, caesarean section and other delivery complications for the mother.
“We are much more aggressive in informing patients about all the things that can go wrong with multiple pregnancies,” says Dr. Richard Wing of REACH, “We’re not comfortable being part of unnecessary risk, and we are letting our patients know that in as plain a language as possible.”
13. MYTH: The “hips up theory” is the best position for conception.
FACT: It doesn't matter what position is used. The sperm has to get into the cervical mucus within five minutes, or they are inactivated by the active PH of the vagina. So having hips rest on a pillow or staying in the position at the time of ejaculation will not enhance fertility.
14. MYTH: Egg freezing is only useful for women with medical conditions like cancer.
FACT: Egg freezing is a great option for single women under 40 who are concerned about their fertility options. Cyropreservation technology is improving daily. “I meet lots of women who feel that the social pressure on women to find a partner by their mid-30s is grossly unfair,” says licensed psychologist Dr. Eugenia Gullick, REACH counseling director. “Some have told me they would be highly interested in this option because it would put them under less stress to find Mr. Right on a timetable.”
15. MYTH: Vitamin B6 can extend the luteal phase.
FACT: The only thing that will extend the luteal phase is to improve ovulation or provide extra progesterone. (The luteal phase is the day after ovulation and runs through the remainder of a woman's cycle when a women produces progesterone increasing her temperature, which acts like an incubator for maturing a fertilized egg if conception has occurred.)
16. MYTH: Taking two double-strength aspirin a day can help fertility.
FACT: There's no data to indicate taking two double-strength aspirin a day can help fertility; some studies suggest that it can adversely affect ovulation and the release of the egg. For women who have problems with miscarriage or have a tendency toward easy blood clotting, one baby aspirin a day can make the difference between a successful and unsuccessful pregnancy.
17. MYTH: Robitussin cough medicine can help with conception.
FACT: For a long time Robitussin was used by physicians and women alike to improve cervical mucus. There was a randomized placebo controlled study done, and there was no difference in either cervical mucus quality or pregnancy rate.
18. MYTH: Herbal fertility supplements are overrated.
FACT: There are many herbal substances, nutritional supplements, and so-called "fertility enhancers" that should be used when prescribed by a physician, health care provider, naturopath, or herbalist -- someone who knows about their properties. While there is no conclusive medical research, there is supportive evidence that they may be helpful.
19. MYTH: Methods like acupuncture don’t help with infertility.
FACT: Studies comparing women who went through acupuncture and women who didn't, indicate it can enhance fertility. In fact, there are acupuncturists now who specialize in fertility, and “our patients who have utilized acupuncture and other complementary methods have unquestionably benefited,” says Dr. Nancy Teaff of REACH.
20. MYTH: Diet is important for pregnancy, not conception.
FACT: Removing sugars from the diet, (e.g., caffeine, white flour, white sugar, white corn, white rice, etc.), will improve ovulation and regularity. Foods that are broken down quickly raise insulin levels too quickly and disrupt delicate hormonal values in the ovaries causing more testosterone to be produced, impairing egg quality and thus possibly lowering the chance of conception. In some women, high insulin levels may cause irregular ovulation, irregular periods, or polycystic ovarian syndrome (PCOS).
21. MYTH: People with lower body fat, like marathon runners and dancers, get pregnant more easily.
FACT: Body fat within normal range, which is between 20 and 24 percent of body weight for women, is very important in making sure that the reproductive system functions normally. If the body mass index or BMI, which is a measure of body fat, is too low or too high, it can adversely affect the ability to conceive. According to RESOLVE, The National Infertility Association, body fat levels 10 percent to 15 percent below normal can completely shut down the reproductive process. Women at risk include those with eating disorders, such as anorexia nervosa or bulimia, and women on a very low-calorie or restrictive diet. Strict vegetarians also may experience infertility problems due to a lack of important nutrients such as vitamin b-12, zinc, iron and folic acid.
22. MYTH: Sugar substitutes interfere with conception less than natural sugar.
FACT: No data exists that has shown that overall usage of sugar substitutes is better than the known bad effects of sugar. Natural sweeteners like fructose and stevia, maltall and xyletol are recommended in moderate amounts.
23. MYTH: Vegetarians and those who limit their protein have no problems with conception.
FACT: Adequate protein intake is essential for conception. About half of all women do not get adequate protein intake, particularly vegans and vegetarians. Vegans and vegetarians also do not get vitamin B12, zinc, iron and folic acid.
24. MYTH: Only women need to be concerned with nutritional supplements to enhance their chances of conception.
FACT: Men who take selenium (200mg/day) and zinc (50mg/day) have improved the number and quality of sperm. In addition, a low-glycemic diet for men has been demonstrated to have beneficial affects on sperm.
25. MYTH: Cannabis (marijuana) has no impact on conception or healthy embryo development.
FACT: Smoking cannabis may lead to miscarriages or ectopic pregnancies, according to University of Nashville research just published in the July Journal of Clinical Investigation. Vanderbilt University researchers in Nashville, Tennessee, have also found that cannabis can trigger inadequate chemical levels that prevent normal embryo development, transport into the womb and implantation. “Unquestionably, marijuana use in both men and women should be eliminated if they desire to conceive,” says Dr. Richard Wing of REACH.
26. Myth: Infertility is the same thing as sterility, and it’s rather rare.
Fact: Sterility is the complete inability to reproduce; infertility is “subfertility,” or impaired fertility. A sterile person cannot reproduce; about 65 percent of those who seek treatment for infertility will eventually go on to have a baby. The World Health Organization (WHO) estimates that infertility affects more than 80 million people worldwide. The American Society for Reproductive Medicine (ASRM) estimates that infertility affects 6.1 million American women and their partners, which adds up to about 12.9 percent of married couples of reproductive age.
27. Myth: Women are having babies well into their forties, so it’s probably safe to delay childbearing.
Fact: Fertility rates are definitely age related. Studies suggest that, on average, female fertility declines slightly starting at age 27, but drops off in a clinically meaningful amount around age 35 and then dramatically at age 40. Thanks to vigorous exercise, a woman who is 35 may have the cardiovascular system of a woman in her twenties, yet her ovarian function is still that of a 35-year-old.
28. Myth: At least infertile couples are “having fun trying.”
Fact: In a study of more than 2,000 Christian women, “lengthy infertility treatment” was listed as one of the four key causes of sexual aversion. (The other three were childhood sex abuse, rape, and painful labor and delivery.) Most couples report a decrease in the frequency of sexual relations after a diagnosis of infertility. What was once a source of emotional intimacy often becomes “love by the calendar,” and infertile couples say they feel a loss of privacy, sometimes even envisioning a doctor in the room during sexual intimacy. Both male and female infertility patients report a decrease in their level of sexual satisfaction, with the women also reporting that they feel less comfortable with their sexuality. More than one infertility counselor has told us, “I’ve never seen a couple going through fertility treatments who felt they had a great sex life.”
#3 is a HUGE issue for me.
I have so many friends telling me that I am too "stressed" and "if I would relax" things would happen. I can say I am a little stressed but not like people think. I worry more about IF/WHEN it does happen again could I handle another ectopic. We don't "try" or "plan" at all. We are just letting life happen and I am hoping. But to have people tell me I am "causing things to not happen because of stress" is so very hurtful. It is just another way to add blame to my already hurting heart for tying my tubes in the first place. It insinuates that *I* am the "cause" of my infertility and that *I* could fix it somehow.
Believe me if *I* could fix it I would have long ago!
Kate over at Busted Plumbing puts it nicely. I think I am still too new (only 1.6 yrs of waiting) to being an Infertile to be so blunt HONEST.
But if I hear "just relax" one more time I will come unglued!
