Fertility: 8 Myths and Truths
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Fitness

Fertility: 8 Myths and Truths

FITNESS sets the record straight on eight common fertility misconceptions.

The Real Fertility Facts

When it comes to babymaking, it seems as though everyone -- including your mother-in-law's best friend's sister -- has some insight to share. But chances are, a lot of what you hear is nonsense. "Fertility is a major part of our lives that we don't have a lot of control over," says Alice Domar, PhD, an assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School. "When things don't happen the way we want, we look for explanations -- preferably something we can take direct action on -- and that's where the myths start to circulate."

You've heard that...

...diet and exercise will preserve your fertility.

The truth: The quality of a woman's eggs declines with age regardless of how healthy she is, says Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology at Yale University.

Some experts estimate that in 35-year-old women, approximately 1 in 2 eggs are likely to have chromosomal abnormalities; and about 90 percent of eggs are abnormal in women aged 42 or older. And with fewer viable eggs, your fertility rate declines.

Research does show, however, that women who exercise regularly during pregnancy may have fewer pregnancy-related aches and pains. Also, eating a low-fat diet full of fruits, vegetables, and whole grains will help you stay at a healthy weight, which can improve your chances of getting pregnant at any age. "Overweight or obese women often have more trouble conceiving, and they're prone to developing complications such as gestational diabetes and high blood pressure," says Randy Morris, MD, an associate clinical professor for the division for reproductive endocrinology at the University of Illinois Medical School in Chicago.

You've heard that...

...taking birth control pills will make it harder to get pregnant.

The truth: The pill doesn't affect your fertility. And menstrual-suppression pills (the kind you're on for months straight with no "weeks off") won't hamper your fertility either. Research shows that once you stop these pills, you'll start ovulating within three months and probably even sooner, just like with regular birth control pills. "You can start trying to get pregnant as soon as you stop taking them," says Dr. Morris. "They're so low-dose that the hormones are out of your system within a few days." In fact, the pill may have a protective effect. "It can help slow or even prevent the development of ovarian cysts and endometriosis, a condition in which uterine tissue grows outside the uterus in other organs like the fallopian tubes and ovaries," says Dr. Morris. Both cysts and endometriosis are conditions that can interfere with ovulation.

If you do have trouble getting pregnant once you stop taking the pill, it may be due to changes that have naturally occurred over time in your menstrual cycle. "Many women are on the pill for years, then go off it and find that their cycles are irregular," says Dr. Morris. "But the pill didn't cause those irregularities, it simply masked them."

You've heard that...

...to get pregnant quickly, you should have sex every day.

The truth: Sperm live for about 38 to 72 hours in your reproductive tract, so there's no need to, um, overload it. "I see so many people who are making their lives miserable by trying to have sex all the time," says Mark Leondires, MD, a reproductive endocrinologist and medical director of Reproductive Associates of Connecticut. Plus, having sex more than once a day for a few days in a row may reduce sperm count. "Figure out when you ovulate, and have sex every other day two to three days before and after that," he says. You ovulate approximately 14 days before you get your period: So if your cycle is 28 days, you ovulate on or around day 14. To learn more about how to tell when you're ovulating, check out resolve.org, the Web site of the National Infertility Association. And relax: On average, it takes healthy couples about four to six months to get pregnant.

 

More Fertility Facts

You've heard that...

...stress is the most common reason that women have trouble getting pregnant.

The truth: Stress may play a role, but it's not the most common culprit (ovarian dysfunction, which means you're not ovulating regularly, is). "The data showing that stress affects fertility is very weak," says Dr. Morris. "Part of the problem is that stress is difficult to measure. There are plenty of examples in which women under immense amounts of tension conceive and deliver babies -- in wartime and after 9/11, for example." Not only that, many of the studies that examine stress and a woman's ability to get pregnant look only at patients who are undergoing fertility treatments -- which means they may have other issues affecting their fertility as well.

Here's where the stress-conception link has some validity: Stress can alter hormonal balance, which may stop some women from ovulating. Research done by Sarah Berga, MD, chair of the department of gynecology and obstetrics at the Emory University School of Medicine in Atlanta, showed that in women who were suffering from amenorrhea (not getting your period), ovulation resumed when they underwent cognitive behavioral therapy.

Domar's advice to clients she treats at the Domar Center for Complementary Healthcare at Boston IVF: "Don't put too much pressure on yourself. When you're ready to start trying for a baby, stop using birth control and have sex when you feel like it. Don't start in right away with the ovulation-predictor kits, and don't get regimented about when you do it. This will just cause more stress."

You've heard that...

...if you have regular periods, you should have no problem getting pregnant.

The truth: "Getting your period around the same day every month indicates that you're ovulating regularly, but it doesn't ensure that the eggs are good quality," explains Dr. Morris. Many things factor into fertility, including the health of your reproductive system. "Your fallopian tubes [through which the egg travels to get fertilized] could be blocked, and you'll still get regular monthly periods," says Dr. Leondires. Again, that means not just eating right and exercising but keeping your sexual health in top form. Be sure to visit your ob-gyn yearly for a Pap smear, STD screening, and cervical exam -- all of which screen for irregularities and infections so you can get treated for them before they affect your fertility.

You've heard that...

...having an abortion affects your ability to get pregnant.

The truth: An abortion affects fertility only if you had a complication during or after the procedure. An infection, for example, can leave scar tissue on the uterus that could then interfere with egg implantation, says Dr. Morris.

You've heard that...

...if you've already conceived once and had a healthy baby, getting pregnant again will be a cinch.

The truth: "This is one of the biggest misconceptions my patients have," says Dr. Morris. "You're older the second time, and your reproductive system changes over the years," he says. New research shows that a guy's sperm quality also declines with age: A study of about 2,000 couples undergoing in vitro fertilization (IVF) found that pregnancy attempts were 70 percent more likely to fail if the man was 40 or older. So if you do plan on having more children, don't wait too long. If you're approaching age 35 -- or you're older -- consider getting started on baby number two sooner rather than later.

You've heard that...

...having a miscarriage makes it harder to conceive.

The truth: Miscarriage, which occurs in 20 percent of all pregnancies -- doesn't affect a woman's ability to get pregnant, says Henry Lerner, MD, author of Miscarriage: Why It Happens and How Best to Reduce Your Risks. In fact, experts say that in many cases, you can start trying to conceive again as soon as one month after the miscarriage. If you have three miscarriages in a row, however, it may be a sign of an underlying medical problem and your doctor should do tests to figure out if something's wrong.

When to See a Fertility Specialist

It's worth repeating: Don't panic if you don't get pregnant in the first two months. It takes the average woman about four to six months to conceive. Experts say that if you're under 35 and don't have any preexisting medical conditions, try to get pregnant for one year before consulting a specialist. If you're over 35, seek help after six months. Ask your ob-gyn for a referral or go to the Society for Reproductive Endocrinology and Infertility (socrei.org) for recommendations on specialists in your area.

Fertility Factsheet

Number of women ages 15 to 44 who experience infertility:
7.3 million(or about 12 percent of the reproductive-age population)

Number of women who've ever used infertility services:
9.2 million

Average cost of an IVF cycle in the United States:
$12,400

Originally published in FITNESS magazine, November 2006.

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