Pregnancy 101

A Top Doc Reveals 8 Fertility Misconceptions

4. It's gotta be me
Multiple historical, cultural, and religious forces have led many women (and, conveniently enough, men) to assume that fertility problems almost always arise from the female side. It's not an illogical assumption. After all, a woman's reproductive system is a lot more complicated than a man's, and therefore has more components that can be broken. Case in point: Most infertility specialists (including myself, for full disclosure's sake) are trained first as ob-gyns, not doctors specialized in male anatomy.

But the reality is that men can have plenty of trouble too. Sperm issues such as low sperm count or abnormal/unhealthy sperm are the primary problem in 25% to 35% of infertile couples, and some reports indicate that worldwide, male infertility is on the rise. The reason why is still unclear, but some theories suggest toxins from environmental exposure could be at work.

Furthermore, even in couples with female-related fertility issues, mild sperm defects often contribute just enough to make achieving a pregnancy difficult, if not impossible, without help. For these reasons, it's crucial that men be involved with the infertility evaluations from the outset, usually starting with a semen analysis. If a serious abnormality is identified, consultation with a urologist or further testing will likely be necessary.

5. All I need to do is relax
There is no question that high stress is associated with infertility, and that infertility is associated with lots of stress. While the exact biology of how stress might come into play is not fully understood, substances such as cortisol, epinephrine, melatonin, opioids, and others are known to affect stress and reproduction. Along these lines, one recent Israeli study of women undergoing in vitro fertilization (IVF) showed higher pregnancy rates in those who saw a 15-minute clown performance after their embryos were transferred.

This so-called mind–body approach to infertility treatment has gained enormous popularity in recent years. But whether stress can actually contribute to infertility—and, more importantly, whether reducing stress can actually help you get pregnant—is still a controversial issue.

Acupuncture is probably the best example of this debate. In 2008, a thorough review combining the results of 13 of the best studies on acupuncture and IVF patients did suggest some benefits, prompting many specialists to incorporate acupuncture into their treatment recommendations. Conversely, in 2010, three new larger studies were published showing no increase in pregnancy rates from acupuncture.

Given this uncertainty, I tell my patients that if they can do things to reduce stress in their lives while trying to conceive, there is no doubt this is, at some level, a good thing, regardless of how much it improves their ability to conceive. But the one thing they should not do (and I have seen this happen many times) is to "stress" over scheduling or making time for treatment; I can pretty much guarantee this will not be helpful at all.

6. Fertility treatment means I'm going to end up like Octomom
Nadya Suleman became the poster child for everything scary and reprehensible about fertility treatment when she gave birth to octuplets in 2009. But pursuing fertility treatment does not mean you need to price the newest double strollers and build an addition to your home.

While multiple pregnancies have always been the biggest risk of fertility treatment, professional fertility organizations have been working to reduce multiple pregnancies since the early 1990s. For example, guidelines for the number of embryos to transfer have helped reduce the IVF "triplet-or-more" rate by more than 70% since the late 1990s, with only less than 2% of IVF pregnancies in that category in 2008.

I see many patients who start their infertility journey extremely wary of any medications or other "unnatural" interventions. A good fertility doctor can, and will, work with you to try and to avoid an aggressive treatment plan, but he will also be honest with you about your chances and when it's time to try something with a bit more oomph.

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Joshua U. Klein, MD
Last Updated: May 02, 2011

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