Infertility Myths & Misconceptions

Fact: It’s common for people to think of infertility as a female problem, but only 35% of infertility cases are caused solely by female factors. Another 35% results from factors in the male reproductive system, 20% come from both, and 10% are undetermined.

Fact: Studies regarding alcohol use while trying to conceive are conflicting. Heavy  alcohol use by men can impair sperm production. Moderate (3-13 drinks per week) and heavy (14 or more drinks per week) alcohol use among women may take longer to conceive and are at increased risk of needing a fertility evaluation. Data are conflicting regarding moderate alcohol use among women and IVF success rates. It is best to limit alcohol use to less than moderate use when trying to conceive.

Alcohol can increase the risk of birth defects once a woman becomes pregnant and can cause a collection of birth defects known as fetal alcohol syndrome (FAS). There is no known “safe” amount of alcohol that can be consumed during pregnancy, so it is generally recommended that women avoid alcohol in pregnancy.

From Up to Date;

Most observational studies have reported moderate and heavy female drinkers tend to take longer to achieve a pregnancy and are at higher risk of undergoing an infertility evaluation [133,134,136-138]. Others have not noted an adverse effect of moderate alcohol intake on fertility [139,140] nor a difference in risk of ovulatory dysfunction between women with high versus low alcohol intake [141]. Heavy alcohol intake is typically defined as ≥14 drinks per week, and moderate intake is usually defined as 3 to 13 drinks per week, but these definitions are arbitrary and vary in different studies. However, alcohol consumption can impact the developing fetus.

Moderate alcohol use may affect success rates of women undergoing IVF, but the supporting data are mixed.

Heavy alcohol use by the male partner is related to abnormalities in gonadal function, including reduced testosterone production, impotence, and decreased spermatogenesis [145-147]. In the IVF study cited above [142], in couples in which both partners consumed at least four drinks per week, the odds of a live birth were diminished by 21 percent compared with couples in which both partners drank less than four or more drinks per week.

Fact: Relaxation alone won’t help anyone become a parent. One or both partners may have a correctable medical condition that stands in the way of conception. If there’s no obvious physical explanation for infertility, a doctor can still suggest lifestyle changes that could boost the odds of conception.

Fact: According to Resolve, more than 5 million Americans of childbearing age have fertility problems. Even under the best circumstances, conception is tricky. It’s not unusual for a perfectly healthy, fertile couple to try for several months or more before achieving a pregnancy. However, if you are 35 years or younger and have been trying to conceive for one year or more (or if you are over 35 and have been trying for 6 months or more) consultation with a fertility doctor is recommended.

Fact: According to a report in the journal Human Reproduction, a woman’s fertility starts to decline at age 27, although this isn’t clinically significant. Most women of this age can still get pregnant, of course, but it might take a few more months of trying. But by the time a woman reaches 35, her chances of getting pregnant during any particular attempt are about half of what they were between the ages of 19 and 26.

Fact: Researchers at the University of New York at Stony Brook put this piece of conventional wisdom to the test and concluded that underwear style is unlikely to significantly affect a man’s fertility.

Fact: Many men who produce little or no sperm have treatable conditions that can be addressed with fertility treatments or the help of a Urologist. Lifestyle changes—such as quitting smoking, losing weight, and staying out of hot tubs—may also help.

Fact: While some men can father children into their 50’s or 60’s, male fertility isn’t age-proof. Men see a decline in fertility in their 40s, and also have been found to be at increased risk of offspring with certain health conditions, like schizophrenia.

Fact: According to a report from the Johns Hopkins Medical Institutes, some patients have a better than 50/50 chance of fathering a child after a vasectomy reversal. The longer a man waits to have a reverse vasectomy, however, the lower the odds.

Fact: Infertility means that you have been unable to have a child naturally after a year of trying (or 6 months if you are over the age of 35). With the proper treatment, the majority of people go on to have children.

Fact: Here at FSMG, we suggest not using CBD products or marijuana of any kind during fertility treatment as it may affect outcome. Marijuana use has been associated with abnormal sperm counts, morphology and motility. Women undergoing fertility treatment who smoke marijuana may be at increased risk of miscarriage. Marijuana use in pregnancy may be associated with neurodevelopmental abnormalities in children.

Cannabis and Male Fertility: A Systematic Review.

AU

Payne KS, Mazur DJ, Hotaling JM, Pastuszak AW 

SO

J Urol. 2019;202(4):674. Epub 2019 Sep 6. 

PURPOSE With cannabis consumption on the rise and use prominent among males of reproductive age it is essential to understand the potential impact of cannabis on male fertility. We reviewed the literature regarding the effects of cannabis on male fertility.

MATERIALS AND METHODS We performed a literature search using PubMed®/MEDLINE® to identify relevant studies of the effects of cannabis on male fertility. Relevant studies were identified and reviewed.

RESULTS The strongest evidence of cannabis induced alterations in male fertility is in the category of semen parameters. Research supports a role for cannabis in reducing sperm count and concentration, inducing abnormalities in sperm morphology, reducing sperm motility and viability, and inhibiting capacitation and fertilizing capacity. Animal models demonstrate a role for cannabis in testicular atrophy, and reduced libido and sexual function but to our knowledge these results have not yet been replicated in human studies. Studies of hormonal changes suggest inconclusive effects on testosterone levels, lowered luteinizing hormone levels and unchanged follicle-stimulating hormone levels.

CONCLUSIONS Current research suggests that cannabis may negatively impact male fertility. Further studies are needed to validate that robust findings in animal models will carry over into human experience. Clinicians should be aware of these potential effects when prescribing medical marijuana therapies to men of reproductive age, and they should consider the degree of cannabis use as a possible component of a complete male infertility workup.

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 There are minimal data on the effects of recreational drug use on fertility [167]. A study of self-reported marijuana use by individuals undergoing fertility treatment reported a higher risk of pregnancy loss in marijuana smokers compared with past or never-users (n = 308, 379 cycles, adjusted probability 54 versus 26 percent) [168]. Unexpectedly, a higher pregnancy rate was reported for couples undergoing IVF when the male partner smoked marijuana while the female partner did not. These drugs should be avoided because of their general health risks.

Fact: Poor nutrition can have an impact on fertility. Women with a Body Mass Index (BMI) over 30 or those who are severely underweight may have difficulties with fertility. Click here to download a BMI reference chart.

Fact: In conception, timing is everything. Women are the most fertile in the middle of their menstrual cycle. Experts recommend intercourse every other day in this period to increase the likelihood of natural conception.

Fact: IVF has been used successfully for over 25 years. The goal of any skilled IVF program is a healthy, single birth. Our doctors encourage an Elective Single Embryo Transfer (eSET) whenever appropriate, and are proud to have one of the highest eSET rates in the country.

Fact: The COVID-19 vaccine does NOT impact fertility, and this is supported by an increasing amount of data.

The COVID-19 vaccine prompts the body to create copies of the spike protein found on the coronavirus’s surface, which directs the body’s immune system to fight the virus that contains the specific spike protein. False claims stated that getting the COVID-19 vaccine would cause a woman’s body to fight different types of spike proteins and cause infertility. The two spike proteins are completely different and distinct and getting the COVID-19 vaccine will NOT alter the fertility of women who are seeking to become pregnant, including through IVF.

Fact: Fertility testing is useful in detecting large problems such as low sperm counts or blocked fallopian tubes. Up to 30% percent of patients with infertility will have normal testing (unexplained infertility). This may be at least partly explained by an age-related decline in fertility. Often, we can obtain further information as to why you have not gotten pregnant and may be able to help overcome this underlying infertility with treatment.

Fact: At FSMG, genetic blood test results are generally available in an average of 2-4 weeks.

Fact: Yes, it is possible to swim during IVF treatment. There are no swimming restrictions.

Fact: Bleeding between periods can be a result of IVF medications. Irregular bleeding can be a sign of a possible hormonal or structural issue such as a polyp or fibroid.

Fact: There are no flight restrictions while waiting for your pregnancy test. However, we do not recommend travel after a positive pregnancy test until we can do an ultrasound to assess for location and viability of the pregnancy, typically 2-3 weeks after a positive result.

Fact: It is important to talk with a FSMG specialist regarding all your medications during the first consultation or before starting treatment. Typically, you can continue most medications. Please let your FSMG team know if there any changes to your medications during treatment, including changes in doses, or stopping or starting a new medication.

Fact: Yes, FSMG requests the person producing the sample abstain for 48 hours but not more than 5 days prior to a semen analysis. There are no restrictions around intercourse after IUI.

Fact: A total motile count of at least 5 million sperm (post-processing) provides an adequate sample for IUI.

Fact: Novocain doesn’t cause infertility. However, if you are pregnant, let the dentist know that they may give you Novocain without epinephrine.

It is important to continue routine and emergent dental care during fertility treatments and pregnancy.

Fact: There is minimal systemic absorption to the chemicals when hair is dyed. For pregnant women and women undergoing fertility treatment, if appears safe to dye your hair.

Most of the studies of hair dye exposure in pregnancy evaluate outcomes in cosmetologists as compared with the general population. Studies are mixed as to whether cosmetology as a profession is associated with pregnancy loss or low-birth-weight neonates and it is also unclear whether any observed associations found were the result of exposure to chemicals or long work hours.^68–70 Data on safety for specific chemicals are limited, but for an individual pregnant woman, exposure to hair dye results in minimal systemic absorption, so they are presumed to be safe in pregnancy.

Fact: Without an immediate embryo transfer (freeze-all cycles, egg freeze cycles, etc.), you will typically get your period 2 weeks after the HCG-based trigger and 1 week after a Lupron trigger.

Fact: Stop CoQ10 once you become pregnant.

Fact: Acupuncture data statistics show varied results on improving IVF success rates. However, some patients may benefit from acupuncture.

Fact: FSMG specialists suggest that you limit alcohol intake to an occasional drink during treatment and avoid drinking alcohol once you are pregnant.

Fact: For an IVF/embryo transfer cycle (including frozen embryo transfers), it is recommended that you abstain from intercourse during your treatment cycle until a pregnancy test to prevent a high-risk multiple gestation pregnancy from a concurrent natural conception.

Fact: Here at FSMG, we suggest not using CBD products of any kind during fertility treatment as it may affect outcome. Marijuana use in pregnancy may be associated with neurodevelopmental abnormalities in children.

Fact: On average, PGT embryo biopsy results are available about three weeks from egg retrieval.

Fact: True. Stress significantly reduces fertility rates. Studies reveal that women who took a stress reduction course had significantly higher success with IVF. A new study finds higher levels of stress are associated with lower odds of conception for women, but not for men. Considering how stress affects our bodies, it is not surprising that it could affect the reproductive cycle. Minimizing stress and using stress reduction practices are useful tools for women on a fertility journey.

Fact: For most women, the oral contraceptive pill is a safe and effective form of reversible birth control. There is no scientific evidence that the pill causes female infertility. In fact, once a woman stops taking the pill, she can ovulate immediately and become pregnant shortly after ending birth control. The pill does not cause a woman to become infertile by permanently suppressing ovulation. Women who experience a delay in fertility and ovulation after stopping are more likely to have had irregular periods before they started taking the pill.

Fact: You don’t need to take a break from hormonal birth control. It is a myth that women need a break from hormonal birth control. Birth control pills are all safe for long-term use and may be used for as long as a woman wants to prevent pregnancy. Birth control pill should be stopped if a woman has a contraindication to pills such a smoking after age 35, a history of blood clots or uncontrolled high blood pressure.

Fact: There is no scientific evidence that laying down after sex increases pregnancy odds. It takes only five minutes for sperm cells to reach the fallopian tube, after which they can survive for several days in the womb.

Fact: The U.S. Department of Health & Human Services states that out of 100 male/female couples, 12 to 13 will struggle with infertility and be unable to become pregnant within 12 months of trying. Over 6 million women in America ages 15-44 have problems becoming and staying pregnant, according to the Center for Disease Control. While age and lifestyle can play a role in fertility, that does not mean infertility only happens to older, unhealthy people. Structural problems with the reproductive system can affect people of all ages. These can include fallopian tube blockage or damage, ovarian cysts, fibroids, undescended testes, or congenital absence of the vas deferens. Women of all ages can have irregular ovulation due to PCOS, low body weight, chronic illnesses, over exercising, stress, and age.