11 of the Biggest Fertility Myths Busted by 2 Ob-Gyns
Welcome to POPSUGAR Uninhibited: The Fertility Edition, a space where anyone who ovulates can come for information, advice and support. Here, we’ll tackle topics like fertility in your 20s, conception and egg freezing. You can find all of the stories here.
Considering having a baby? Already in the business of trying to conceive? Chances are you’ve come across plenty of fertility myths. While the internet is a great resource that can inform your conversations with health professionals and provide you with a sense of community when navigating an often emotional process, it’s also full of myths and misinformation around hot topics, including fertility. The truth is, whether it’s a Facebook group, or one of the thousands of clinical studies that are available online, sorting facts from opinion, wild speculation and fiction is hard.
Because your fertility is an important topic, spoke to experts Dr Elizabeth Maxwell, Clinical Director of IVF Australia, Wollongong and Dr Kristina King, Gynecologist at Wollongong Private Hospital, to answer some of the biggest fertility myths you’re likely to come across.
Fertility Myth #1: The Reproductive “Cliff”
For women and people who menstruate (PWM), concepts like the “productive cliff’ and “ticking clock” are ones we grow up with. The story goes that we’re most fertile in our late teens and early 20s, then it’s all downhill from there. Unfortunately, this reproductive timeline runs counter to kind of things young women and PWM are likely to be focussing on during this time: education, starting their careers, traveling and having a good time.
For Dr Maxwell and many experts, these concepts — while based in fact — are unnecessarily panic-inducing and in need of a rebrand.
“Unfortunately, we know that after the age of 35 there isn’t much that can be done to halt the decline in egg quality,” Dr Maxwell tells POPSUGAR Australia. However, the concept of a “cliff” isn’t entirely accurate.
“Increasingly, we’re re-naming the ‘fertility cliff’ the ‘slope,’ as in fact instead of ‘falling off a cliff’ at the age of 35, the chance of pregnancy slowly reduces, more like a ‘slope’ between the ages 35-40.”
Dr Maxwell says that the single biggest counter to fertility anxiety is having a fertility plan in place.
“It’s important women and PWM know their fertility options if they are in their late 20s and early 30s, want to have a baby, and aren’t in a position to have one,” she explains.
Dr Maxwell says that one of the most popular “Plan B” options is egg freezing. “Over the last 10 years, egg freezing technology has improved,” she explained. “By freezing your eggs in your late 20s or early 30s, you can preserve their quality, and use them later if you have trouble getting pregnant with a partner at a later stage, or decide to become a solo parent using IVF and donor sperm.”
Fertility Myth #2: You Should Freeze Your Eggs As Early As Possible
If you’re in your early 20s and looking at your options, the “ticking clock” might tell you that freezing your eggs as early as possible is the best idea. If that’s you, Dr Maxwell says there are several points to consider.
“If you freeze your eggs in your 20s you are less likely to use them,” she notes. Given that egg freezing costs thousands of dollars and is a time intensive process, whether you’ll actually use these eggs or not is something to consider.
That said, there are definite benefits. “If you freeze your eggs in your 20s you are more likely to be able to freeze more eggs from the one collection, and they will be of higher quality than if you were in your mid-to-late-30s.”
Ultimately, if egg freezing is something you’re interested in, “it’s best to talk through your individual circumstances with a fertility specialist.”
Fertility Myth #3: Fertility Issues Only Affect Women and People Who Menstruate
While the reproductive clock is typically associated with women and PWM, according to the experts, sperm quality and count contribute to 50 percent of fertility issues. Sperm is also subject to a “ticking clock,” lifestyle factors, and inherited and rare genetic disorders.
“After the age of 50 there is a drop in sperm quality,” says Dr Maxwell. “Studies point to a higher risk of infertility, miscarriage, genetic abnormalities and a higher risk of conditions like autism for the child,” Dr Maxwell explains. Medical conditions associated with age, from the long term impacts of tobacco and alcohol use, to liver and kidney disease and inflammatory conditions and lowered immunity can also impact sperm quality.
As in many areas of reproductive health, the focus areas of studies need to be expanded. Dr Maxwell says that “currently the increased risk is shown to be small, but many larger studies are needed to measure the impact of advanced paternal age on the baby.”
Fertility Myth #4: Smoking Doesn’t Have a Long Term Impact On Your Fertility, You Just Need to Quit While You’re Pregnant
Dr Kristina King says this is “absolutely untrue.”
When thinking about the long term impacts of lifestyle choices on fertility, King tells POPSUGAR Australia it’s important to understand we are born with all the eggs we will ever have.
“[We] have our eggs from the time we are a foetus, and the ovaries store them until they are ready to be released and fertilises,” she explains. A habit like smoking exposes eggs to free radical damage, which King says can have a long term impact on DNA and egg quality which can impair fertility, and lead to pregnancy complications.
Fertility Myth #5: Vaping Does Not Affect Fertility
No matter how motivated you are, quitting smoking is hard. So, is vaping any better? While the long term impacts of vaping are still unknown, King says it’s safe to assume there’s a strong risk of similar harmful effects.
“We don’t yet know the long term effects of vaping on fertility, but we know that vaping solutions contain harmful chemicals, and they’re likely to have similar effects,” King says.
It seems like your best bet is to reach for a nicotine patch.
Fertility Myth #7: Every Cycle Is 28 Days
There is a common belief that 28 days is a standard menstruation cycle, with ovulation falling on day 14, which makes the window for conception very narrow (hello, scheduled sex). Actually, there is a fair bit of variation in what gynaecologists consider a normal cycle, and it’s very common for a cycle to be longer or shorter than the 28 days. In fact, the normal cycle ranges between 24-35 days, and gynaecologists consider your period ‘regular’ if it can be predicted within a four day window.
“A woman will always ovulate 14 days before she gets her period, however, not everyone has a 28 day cycle so not everyone ovulates on day 14,” says Dr Maxwell. This can make working out your ovulation day so that you can calculate your window of fertility tricky.
So when should you be having sex during your cycle? Dr King says that while the egg can only be fertilised within 24 hours of being released, the sperm can survive in the cervix and uterus for three-to-five days.
“You should be having regular unprotected sex — with regular considered every three-to-five days — to give you the best chance of natural conception,” says King.
There are some natural ways to assess when you might be ovulating.
“Signs your body is preparing for ovulation include changes in body temperature and discharge,” says King. However, urine tests found in ovulation kits, blood tests and ultrasounds can also be used to establish your cycle.
Fertility Myth #7: You Only Need to Worry About Being Overweight When It Comes to Fertility
Being underweight or overweight impacts your fertility, and while being overweight is more common, being underweight can pose greater long-term risks.
Dr Maxwell says that the relationship between high body weight and fertility is not all about BMI, it’s about the way body fat stores hormones.
“Body fat stores the hormone oestrogen,” Dr Maxwell explains. When body fat increases, so do oestrogen reserves, and in high amounts they can act as a form of hormonal birth control, inhibiting ovulation and decreasing opportunities for pregnancy. There is also evidence that even with normal ovulation, being overweight can decrease egg quality.
“The good news,” says Dr Maxwell, “is that these changes are reversible and even modest weight loss and an improvement in diet can increase fertility.”
On the flipside, being underweight or over-exercising can have serious impacts on fertility.
“In some instances, the menstrual cycle can stop altogether,” says Dr Maxwell.
When a menstrual cycle stops because of low weight, it can be more difficult to reverse complications than those caused by being overweight. Dr Maxwell says even when weight is gained and a healthy BMI is restored, menstruation can be “very slow” to return. On top of that, dietary deficiencies which frequently impact fertility are common in very underweight individuals and pose their own associated risks.
Fertility Myth #8: Stress Does/Doesn’t Affect Your Fertility
Dr King says the relationship between stress and fertility is complicated.
“Psychological and physical stress can definitely impact fertility,” says Dr King. However, “stress” in this context is chronic (not a looming deadline or a leaky roof).
“Severe trauma or illness can impact hormone loops that control ovulation,” she says. This means that you may notice that your period ‘pauses’ or is delayed during a significant illness.
“This is usually temporary and ovulation will usually return to normal once the period of stress is over,” says King.
Fertility Myth #9: You Cannot Get Pregnant During Your Period
Think trying to get pregnant on your period is a waste? Or that your menstruation window is a natural form of contraception?
“Given that sperm can remain in the cervix/uterus, and shorter cycles and longer periods exist, it’s possible you may be ovulating and fertile just after your period stops. This means with sperm in the reproductive tract, you can fall pregnant,” says Dr Maxwell.
Fertility Myth #10: Couples Should Try for 12 Months Before Seeking Expert Help
Generally, the consensus from experts is that it can take a “healthy” couple up to 12 months to fall pregnant naturally. However, after 12 months it may be time to seek specialist advice. There are a few exceptions to this rule though, according to Dr Maxwell.
“If you don’t have a regular period, are over the age of 35, or one person in the couple has a medical condition that can affect fertility, it’s important to seek a GP referral to a specialist,” says Maxwell. She adds that she is “always happy” to see couples who don’t fit this criterion for a peace of mind “fertility check-up”, too.
Fertility Myth #11: Some Sex Positions Are Better or Worse for Getting Pregnant
Worried that the start of your fertility journey will interrupt your journey through the tantra? You shouldn’t be. Dr Maxwells says that trying for a baby doesn’t mean you’re condemned to the missionary position until you fall pregnant.
“As long as sperm is getting into the vagina and cervix, any position is fine,” says Dr Maxwell. Go nuts.