17 November 2022

Infertility: Myths and truths

Cesar Diaz MEDICAL DIRECTOR IVI
Medical Director
Cesar Diaz-Garcia
MD PhD Assoc Prof
IVI London

 

In the UK, 1 in 7 heterosexual couples struggle to conceive. And the number of cases of infertility – including those that occur for unexplained reasons – is rising. Although declining fertility is a widespread phenomenon and still not fully understood, there are a variety of factors at play. As part of our recent survey on Motherhood and Fertility, we asked women aged 25 – 40 a series of questions about common fertility myths.

Infertility: Myths and Truths

Fact: A woman’s fertility declines significantly after the age of 35.

Women are having children later in life than previous generations, and this seems set to continue. As shown in IVI’s survey results, there are a number of factors behind this shift. Deciding whether to have children is not always straightforward, and it’s not a decision taken lightly by many.

Yet, this shift has had significant implications for UK birth rates: around a third of couples in which the female partner is over 35 struggle to conceive and this is often due to age-related fertility problems. After 35, the quantity and quality of a woman’s eggs start to decline more rapidly which makes getting pregnant naturally become more challenging. For this reason, women who are considering having children at a later stage in life must be informed about the challenges they may face that are intrinsically linked with age.

As part of our survey, respondents were asked when they believed a woman’s fertility starts to decline considerably. In other words, when does the quantity and quality of a woman’s eggs start to decrease significantly. Although the majority of women surveyed (88.2%) believed that age has the biggest impact of female fertility, there was a lack of consensus around the age at which fertility declines.

When asked, a third of women (33.3%) believed fertility started to decline at 40 or over.

“The most important and possibly shocking result of this survey was that 33% of women think fertility declines after 40 – whereas it’s actually 35,” comments Dr Galian. “We must address this lack of information among the general population about the implications of the ageing process on our chances of conceiving. In the same way teenagers are given information about sexually transmitted infections, fertility may need to be part of this discussion, too.”

This lack of awareness about reproductive health can limit family-building options for those who want to start a family later in life, but may not have planned for an alternative to natural conception. Although there are fertility treatments available that can help women and couples aged 40 or over, it is not possible to guarantee a successful outcome. As a priority, the disparity in fertility knowledge and awareness should be addressed first.

Myth: The amount of exercise you do will not affect your fertility.

Nearly half of the women surveyed (44%) said regular exercise had no impact on female fertility levels. While there is a complex relationship between fertility and physical activity, many fertility societies agree that a lack of exercise can be detrimental if you are trying to get pregnant.

Studies show that regular aerobic exercise can help to regulate the menstrual cycle, with one study finding that 30 to 60 minutes of vigorous exercise every day reduced the risk of ovulatory disorders such as anovulation.

Regular exercise can also help to maintain a healthy BMI. Women with a body mass index (BMI) of 30 or over are likely to take longer to conceive compared to women with a healthy BMI, even after factoring in issues such as menstrual irregularity.

Therefore, there are benefits to staying active if you are trying to conceive – including boosting pregnancy health and promoting better mental health. If you are new to aerobic exercise, we recommended at least 150 minutes (2 and a half hours) of moderate activity every week (the equivalent of 30 minutes per day, 5 days a week) or 75 minutes of high intensity exercise every week when combined with strength training. However, it is crucial to keep in mind that too much vigorous exercise – especially if your body is not used to this level of exercise – is not recommended. Finding the right balance is key.

Myth: Stress can cause infertility.

Stress alone is highly unlikely to cause infertility, although it is not surprising many people believe it could. Mantras like, ‘Just relax’ or, ‘Go on holiday and it’ll happen’, all add to one of the most common and pervasive fertility misconceptions. Although infertility is linked to increased levels of stress and anxiety, the impact of stress on a woman’s chances of conceiving remains controversial with very mixed evidence.   

Our survey findings clearly reflected this common misconception: when asked about factors that were detrimental to female fertility, nearly 9 in 10 women (86.4%) believed stress was one of the most damaging – more damaging than sexually transmitted infections (STIs), alcohol and smoking tobacco.

In fact, it is widely agreed by medical societies throughout the world that couples who are trying to conceive should abstain from alcohol completely. While there is mixed evidence showing the direct impact of stress of fertility, drinking alcohol reduces the likelihood of conceiving by almost 20%, according to one Danish study of 6,120 women.

Quitting smoking has a myriad of health benefits with well-established evidence. It is especially important for couples are trying to conceive. While there are several studies showing smoking tobacco damages sperm DNA, meaning the spermatozoa are less capable of fertilising an egg, it also has serious repercussions for female fertility. Several studies found evidence that smoking cigarettes accelerates the decline of the ovarian reserve and contributes to early natural menopause.

Fertility knowledge: Is there a lack of awareness about reproductive disorders?

Female reproductive disorders, such as endometriosis and polycystic ovary syndrome (PCOS), are among the leading reasons why a woman may struggle to conceive. In many cases, sufferers are not aware of their condition, and how this may be affecting their ability to get pregnant. Some of the most common reproductive conditions, like endometriosis, share symptoms with lots of other conditions. This can delay the pathway to diagnosis and treatment by years which, when compounded with increasing maternal age, creates situations that are even more challenging.

PCOS

PCOS is a metabolic disorder caused by a hormonal imbalance that can cause ovulatory problems. Although half of our survey respondents (50.3%) believe they have an adequate amount of information about PCOS, the other 49.7% – equal to 1 in 2 women – say they have little to no information about the condition. This lack of information is a cause for concern when taking into account that PCOS is a leading cause of infertility and commonly persists undetected and undiagnosed. At IVI, we have a full-length medical guide dedicated to PCOS which is available to download for free here. In this guide, you can find detailed information about common PCOS symptoms and treatment options, as well as advice to overcome PCOS-related infertility.

Endometriosis

Like PCOS, endometriosis is a condition with a greater amount of public awareness compared to other female reproductive disorders. This is in part thanks to the continued efforts of charities such as Endometriosis UK. However, when asked about how much information they had about this common condition that affects 1 in 10 women, more than half of our respondents (50.9%) felt there was little to no information available. The symptoms of endometriosis can vary from person to person, and although many women with endometriosis have healthy natural pregnancies, between 30 – 50% of endometriosis sufferers struggle to get pregnant as a result of the condition. Learn about treatment options for endometriosis-related infertility in our dedicated webinar here.

Secondary infertility

According to our survey, nearly three quarters of women (70.6%) say they have little to no information available about secondary infertility. Secondary infertility refers to when someone has had a child previously but is unable to conceive again. This is different to primary infertility, which is diagnosed when someone has never successfully conceived. Secondary infertility is just as common as primary infertility, but it is not often the focus of conversations about fertility struggles. 

Although equally as common as primary fertility, secondary infertility is much less visible. Unfortunately, people suffering with secondary infertility often do not receive the support and attention they need to overcome the underlying causes of their problem, which are often treatable. Misconceptions around secondary infertility leads to a lack of information and guidance for women and couples facing this situation, and many do not seek professional help.

Primary infertility and secondary infertility share many of the same causes. Routine fertility tests, like those offered in our pre-treatment Diagnostic Pack, can help to determine the problem.

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