I do this with my patients all of the time. There’s a lot of truth-telling that goes on in my office, and often myth-busting is necessary to get to the truth.
Perhaps you can relate — there are so many headlines and hearsay stories about fertility. Do you struggle to disseminate between what is evidence-based science and what is not?
I don’t care where you live or who your doctor is. My goal is to share what I know in the event that it’s even the tiniest bit helpful to you and your fertility journey.
FERTILITY MYTH #1: Your Hormone Levels Can Tell If You Need IVF
I have a short response to this: Do the TUSHY Method. I also have a longer response. No way, not ever. Your hormone levels can’t tell if you need IVF. There is no hormone level that can tell you that. I want everyone to get pregnant as naturally as possible without my help. The hormones are diagnostic tools. Things like your age, your fertility hormone levels, your desired family size, if your fallopian tubes are open, if the sperm is normal, and if you share common genetic mutations with your partner. These are the things — often in combination — that for many people lead them down the path to IVF.
What’s the takeaway here?
Get your levels checked — this is always the easiest first step to take. However, use that as a diagnostic tool to start your process of uncovering more information about your ability to get pregnant. Reference the TUSHY method. Work on this with your doctor. Get involved in understanding your body hand-in-hand with a medical professional. One final note related to that last point— as I’ve seen this done. Please don’t place your test result readings on a message board online searching for an expert opinion to weigh-in. That’s an evaluation reserved for your doctor or someone like me. Be mindful of where you’re getting your advice.
FERTILITY MYTH #2: You Need To Be Trying For A Really Long Time Before You Get Sperm Checked
This is something that came up this week in my office. No way is this true! Time is precious. Our fertility decreases with age. Why then would you consider wasting that precious fertility by trying for an extended period of time before getting simple testing done? Sperm testing is simple and affordable. Your guy basically needs a cup…maybe a movie (haha) — I’m trying hard to be funny. At the end of the day, this is serious stuff.
Today we are lucky in that there are really cool do-it-yourself kits. YO sperm kits. I am not paid to support this company, but I think their test is awesome. You can do this test easily, show it to your doctor and then they can tell you if you need a more advanced version of that kit.
There’s really no excuse not to do these sorts of tests. Once you’re clear on the quality then you can understand if there are things you can do to make the sperm even better.
Trust me when I say this. You do not want to be the person that tries for a year and then finds out that there’s no healthy sperm due to a genetic reason. That would be super frustrating — just wasting 12 months. I want to prevent that from happening.
FERTILITY MYTH #3: Menopause Is Really Hard to Pinpoint. There’s No Point Even Checking Levels To Find Out More.
Imagine me shouting, “NO!”. That’s how I feel about this one. Menopause is really simple. It’s something that’s been around forever. It takes about six years to go through it. You usually start around when you’re 40.
I feel sorry for all of my employees in my office because I have the thermostat set to 66 degrees and they’re all in ski jackets walking around me, and that is the truth. At the end of the day, menopause is not a mystery.
There are levels you can check: FSH, AMH — they tell you when your menopause is.
No woman should find out she is menopause when she’s ready to start her family.
Here’s what you need to know:
- Get your levels checked by the time you’re 25. Consider getting your levels checked even earlier if you have a family history of early menopause, if you’ve had one ovary removed, or if you know your mom needed fertility medications to get pregnant.
- If you’re 32 years old and you’re not done with your family and you have one kid, but want a second. You may want to consider preserving embryos, not eggs — if you still like your partner. Wink, wink.
- If you’re 37 and have one kid. Definitely don’t spend too much time trying and get your fertility levels checked and see a doctor. At the end of the day, your fertility is precious.
FERTILITY MYTH #4: It’s Easy To Get Pregnant After 40 — Just Do IVF.
I wish it were that easy. If only it was. You hear me talk about Botox for ovaries. There’s no such thing. I had a patient lament to me about her frustration of not knowing that her fertility was fleeting. That she looked young for her age at 35 and so didn’t even consider in the realm of possibility that her fertility would be declining. She met her husband at 43. Now she’s in menopause. She’s a very educated woman who feels frustrated that nobody told her this could be a possibility.
Readers — this story. This and many, many, many more. This is why I write these posts. I don’t want you to say, “I wish someone had told me…”
I’m channeling all of my patient’s stories and energy into this post. I’m fired up about this. IVF is taking an egg, putting it with a sperm cell, and hoping it’s a genetically normal embryo. Which at 40 there is a 10% chance an embryo is genetically normal. Yes, I have my strategies and my special sauce. However, I do not have the power to change DNA to get you pregnant.
FERTILITY MYTH #5: Egg Freezing Gives You Control and Guarantees You Can “Have It All”.
I get all riled up when I see Instagram ads about control. Like this one:
Egg freezing means taking control of your fertility. It guarantees you a successful pregnancy in the future. You can have it all.
This is harmful vs. helpful messaging. It’s selling a false promise versus exposing the truth. I am here to expose the truth. You want to know the truth — that’s presumably why you’re reading this.
Egg Freezing gives you the chance for pregnancy. It may give you the illusion of control. It may make you feel like you can have it all. But it does not.
It’s very important to freeze an embryo if you can. I have women that come to me with eggs they’ve frozen and we find out that none of them are viable.
Here’s my advice to you:
Understand the viability of the eggs you’ve frozen. Think about all of the things ahead of time. I’m hoping that you realize that egg freezing gives you the illusion of control and no guarantees. Finally, get your levels checked.
FERTILITY MYTH #6: IVF Medications Increase Your Egg Count
They do not. When I see a patient who is 43. She comes to my office and has three eggs. She thinks that when starting fertility medication that she’ll then get 10. She will not. That’s not how it works.
Patients think they don’t need to take medication if they have lots of eggs. You still have to take medication.
Realize what your numbers are. Look at the IVF attrition pyramid from Dr. Ezzati.
Understand what you’ll get from the steps in the cycle.
FERTILITY MYTH #7: Genetic Testing is 100% Guaranteed
I talk about genetic testing all of the time with my patients. I want everyone to know about it and to understand what the limitations are.
I tell my patients:
Did you know that you can test your embryos for chromosomes? You can do genetic testing on them.
My patients typically respond:
Yes — I’ve heard that genetic testing is 100% guaranteed for a healthy pregnancy.
Unfortunately— it is not a guarantee for anything. With the chromosome testing, all you can check are the chromosomes. I can’t check genes and tell you what the baby’s eye color will be. All I can tell you is if the embryo will have an extra chromosome. Watch my show on PGT — this will dive into more detail about this topic. Or read about it here.
FERTILITY MYTH #8: You Can Create A Male Or Female Embryo Through IVF
You can’t do that. You can create an embryo then later find out the gender before transfer. What are you going to do if you have embryos that are the gender that you don’t want? This is a question to think about.
The fact remains: We (as fertility doctors) can’t control the gender of an embryo.
A quick side story: There was a study with a clickbait title about women who are stressed during pregnancy have more girls and less boys. That is so false. It makes me upset even thinking about that headline. My point is this. If you want a male embryo it could take 2–3 cycles for that to happen. It is nature and human biology taking hold.
FERTILITY MYTH #9: You Have To Do 3–6 Cycles of IUI Before Doing IVF
Nobody needs to give you permission for what you need to do to have a baby. You’ve heard me say it before. Get your diagnosis before pursuing any type of treatment. Understand what you need. Determine what’s in your way. Go seek the treatment that will be best for your specific situation.
I’ve seen patients with blocked tubes on a hysterosalpingogram tell me that they knew about the blockage, but still did IUI. This is before they saw me, of course, but they pursued the typical course of treatment for infertility vs. the type of treatment specific to help them. They tell me they knew in their gut it wasn’t right, but they did it anyway.
This is an example of where I would encourage you to speak up for yourself. If something doesn’t feel right then say so. If you know what you need and you’re not getting it then state that. Find a different doctor if you need to.
FERTILITY MYTH #10: IVF Makes A Woman Go Through Menopause Earlier
These are the things I hear from patients. I went through IVF and they retrieved 5 eggs, and so I’m going through menopause sooner.
IVF does not make a woman go through menopause earlier. I rescue eggs as a fertility doctor. We save eggs. We are not causing you to go through menopause sooner than you already would.
FERTILITY MYTH #11: After An IVF Pregnancy, Your Chances Of Having A Natural Pregnancy Increase
This is another myth. Even my patients believe this. Patients that I’ve helped with IVF. Will come to me two years later and tell me that their OB has told them that they are more fertile now that they’ve had IVF. I’m dumbfounded — no, this is not true!
Never spread this rumor. If you get pregnant naturally after IVF that’s wonderful, but your fertility levels do not get better over time.
I hope this was helpful. Please share this with your friends. Help others set the record straight between what is a myth and what is fact. If you’re on your fertility journey please know that whatever stage you’re at, you are not alone. There is a warm, supportive, virtual and physical community to support you wherever you live. Sometimes I’ve found that it takes opening up about our own stories for others to share theirs.
As always, I encourage you to reach out here in the comments or email me directly: firstname.lastname@example.org, if you have any questions. Or if you have a suggested topic for a future show.
You can also catch more of me and topics like this through The Egg Whisperer Show. The episodes are live-streamed on YouTube, Facebook, and Twitter and on Wednesdays at 7 PM PST. Subscribe to the podcast too!