As a reproductive endocrinologist, I help people who are having trouble getting pregnant every day. Basically, that means figuring how to make sperm meet egg in the best way, and then growing a baby in the most optimal environment. Sometimes the solutions are simple. For example, one of my patients was using KY lubricant during sex, which is known to kill sperm. As soon as she and her husband stopped the KY, they got pregnant with their son. Other cases are more complicated and end up with my patients having to do IVF, use donor eggs or a gestational surrogate. I always tell my patients that even if your route to pregnancy isn’t your romantic ideal, the minute you hold your baby, it makes all the extra steps worth it.
I love to help people avoid fertility challenges by sharing my fertility advice, especially when it comes to busting the myths that I hear all day from patients.
I also love to help people avoid fertility challenges by sharing my fertility advice, especially when it comes to busting the myths that I hear all day from patients. So the week of August 29th, I devoted The Egg Whisperer show to the nine myths about fertility that you should stop believing. If you hear these myths at social gatherings, you can now be a fertility myth buster too?—?it will help everyone.
1. Birth Control Pills Have Ruined My Fertility
Birth control pills mask your infertility because they trick your body into thinking that you’re fertile by hormonally inducing regular menstrual cycles. Because of this, I recommend that if you’re on the pill, you should get your fertility levels checked at least once a year. There’s a simple test that you can do called an AMH test, which measures your Anti-mullerian hormone that helps to drive your reproductive system. The test can’t definitively tell you whether you can get pregnant, but it can give your doctor an idea of how many eggs you have left in your egg bank. I think it’s an important test, especially if you’ve been on birth control pills for an extended period of time. Let’s say you started taking the pill at 16 and then stopped at 32 to find out that your egg count was low. If you had tracked your fertility levels during that period by measuring your AMH, then you would have had an opportunity to decide to have a baby earlier?—?or frozen your eggs?—?depending on the information the test provided. Birth control pills don’t harm your fertility, so don’t blame the pills if you’re facing a fertility challenge. Even if your periods are irregular or absent after you stop the pill, it’s most likely because of an underlying issue.
2. Previous Paternity Equals Current Fertility
It takes two to tango. Remember that an embryo is both an egg cell and a sperm cell. In fertility medicine, it’s essential to study both egg health and sperm health. My patients tend to be women, and only sometimes do they bring in their male partner from the start. It should be all the time. Just because your partner has children or you’ve had a baby together doesn’t mean his sperm is optimally healthy now. No woman should go through expensive fertility hormone tests, ultrasounds, or even IVF, only to find out that the problem was with the sperm. Make sure to test your partner’s or donor’s sperm from the beginning. Knowledge is power. Unlike eggs, which don’t regenerate, sperm does every two to three months. So there are steps that your partner can take to improve his sperm health by changing his diet or avoiding hot tubs and steam rooms. (See my article, Does Your Man Have a Biological Clock?)
3. Baby Number Two Will be Just As Easy As Baby Number One
People share stories with me all the time about how they got pregnant very quickly on their honeymoon with their first baby. Because of this, they assume that years later getting pregnant will be just as easy. It’s a huge myth. Your fertility declines with age because your egg quality decreases, so it’s super important, especially if you’re over 35, to get your fertility levels tested regularly. My Egg Awareness test checks all the critical hormones for reproduction, and by tracking them, you can get a sense of your chances to have a baby. At your postpartum visit for baby number one, ask about a fertility screening and also think about your future family. Based on your age, think about how many more kids you want. There may be steps you can take such as freezing eggs or embryos that will give you a chance to achieve the family size that you want. I see a lot of patients who are over 40 when they start thinking about their first baby, and I can tell you that a hundred percent of them wish they had frozen their eggs earlier.
4. You Can Control the Gender of Your Baby
I get emails all the time from people asking me to help them get pregnant with a boy or girl. They say things like “I heard if you hold your right nostril and sniff out of your left during sex, it will give you a boy.” Or “I’ve heard if I do a headstand after sex, it will give me a girl.” I’m kinda exaggerating, but it’s all to say everything you hear is a myth. With regular sex, it’s always a 50–50 chance of having a boy or a girl. The only way to choose the sex of your baby is through IVF with Preimplantation Genetic Screening. Every egg cell is an X, and every sperm cell is an X or Y. If you go through an IVF cycle, your fertility doctor can show you which embryos are male and which are female. Then you can choose the one that you want to be implanted.
5. Unexplained Infertility is Real
There’s no such thing as “unexplained” infertility. Period. There’s always an answer and a diagnosis. I have patients who come to me who are 42-years-old. They say “I just don’t understand why I’m not getting pregnant. I’ve been told that it’s unexplained infertility.” Well, I think that’s unfair to a 42-year-old woman. At that age, it’s important to know that each egg has a 10% or less chance of being genetically viable, which is why it’s hard to get pregnant. It’s normal human biology. There are five simple fertility screening tests that you can take to get to an answer (See article, Introducing The TUSHY Method: A Novel Approach to Personalized Fertility Care). You can get your tubes checked, do an ultrasound to make sure there aren’t any fibroids, polyps or anything obstructing them. You can do a semen analysis, check your hormones and look at your genetics. I assure you that if you get a TUSHY check, we’ll be able to take all the puzzle pieces and give you an accurate diagnosis that can guide your treatment.
6. Getting Pregnant Should Be Easy
I know all your friends tell you that they just looked at their husbands, or took a shot of tequila, and got pregnant. They’re what I call fertility braggers. Just let them brag, but know that the truth for the majority of human beings is that it actually takes at least six months to get pregnant. For some people, it can take up to a year, including having biochemical pregnancies and multiple miscarriages, which is just part of the human experience. I wish there was a way to cure miscarriages and ovarian aging, but right now there isn’t. That’s why it’s so important to understand your fertility and learn about what you can do to give yourself the best chance for pregnancy.
7. Your Fertility is a Carbon Copy of Your Mom’s Fertility
We inherit genes from both our mom and our dad. Definitely ask your mom when she started menopause, but it won’t be a definitive answer for you. Just because she got pregnancy easily at 19 or 22 doesn’t mean you’ll have the same story, especially if you’re 36, 39 or 42. There are now tests that look at your reproductive genes so that you can understand the full picture of yourself. Also, get your fertility hormone levels checked, but don’t make assumptions based on how good you look on the outside. It’s nice to be super fit, but that doesn’t mean your egg health is good on the inside.
8. Egg Freezing is an Insurance Policy
If your house burns down, we know if you have fire insurance that you’ll be able to get it rebuilt. Egg freezing is improving, and more and more babies are now born from frozen eggs. But there are no guarantees with human biology, so egg freezing is not insurance. It’s a chance for pregnancy, but also remember other factors go into having a healthy pregnancy such as sperm health, the health of your uterus and the ability of an embryo to implant. I don’t want women who are leaning on his choice to get too excited by claims they read online or in magazines about egg freezing. It’s a chance for a future pregnancy and might be a higher chance if you froze your eggs before 35, but nothing is 100% so make sure, and sorry for the bad joke, you’re not putting all your eggs in one basket.
9. You Can’t Have a Healthy Pregnancy without a Regular Menstrual Cycle
Not true. It’s harder, but more and more women these days are having babies in their 40s, even when they’ve stopped having regular periods thanks to reproductive medicine. Because of this, you don’t need ovaries to have a pregnancy. You do need a uterus, even it means borrowing one from a gestational surrogate. The way it works is that fertility doctors like me give patients hormones (estrogen and progesterone) to mimic ovulation and pregnancy. This makes it possible for women who don’t have ovaries or regular cycles to have healthy pregnancies. If you have an irregular menstrual cycle, it could also be a sign of a condition called PCOS or Hypothalamic Amenorrhea. That’s why I always recommend that you get a fertility check-up to figure out what’s happening in your body so you can choose the appropriate treatment to reach your family size goals.
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