Fertility: Fact and Fiction

Birth Control Pills Reduce Fertility (Fiction )

Currently, no evidence shows that the use of birth control pills affects future fertility. In fact, birth control pills are very short acting (that’s why you have to take them every day). Therefore, birth control pills never make much of an impact on the body’s ability to reproduce. In fact, every obstetrician will tell you stories of women who missed just a single pill or two and accidentally conceived. If anything, using the pill or one of its hormonal counterparts such as the patch or the ring may actually help fertility in some women. Birth control pills have been used to treat and reduce symptoms of disorders such as endometriosis and ovarian cysts.

Stress Causes Infertility (Fiction)

The fact is, that while it is possible, although rare, for stress to cause infertility, it is far more common for infertility to cause stress. The role stress plays in a person’s fertility is complicated. Evidence indicating stress as a cause of infertility is minimal. There are rare occasions when extreme stress can interfere with normal ovulation in women and may reduce sperm production in men. Stress can also affect a relationship by keeping a couple from the intimacy of intercourse. Some recent studies in patients undergoing IVF have found that pregnancy rates were either not affected or in one study were actually better when stress was present.

In vitro fertilization is associated with the greatest risk for multiple pregnancy (Fiction)

Use of fertility medications, especially injectable medications, with intercourse or intrauterine insemination carries the greatest risks of multiple pregnancy. Neither the physician nor patient has control over how many developing eggs will become fertilized and implant. With in vitro fertilization, the risk for multiple pregnancy is determined by how many embryos are placed in the uterus and therefore is under greater control. Younger women can maximize pregnancy rates with transfer of one or two embryos. Older women, over 40, may use as many as three or four embryos but still have a very low risk for a multiple pregnancy.

Unfortunately, some IVF programs, will transfer large number of embryos into women in an attempt to increase their programs pregnancy rates. This will definitely increase the risk of multiple pregnancy. These programs are best avoided.

Taking sugar or anything “white” out of your diet can improve ovulation. (Fiction)

Some women, such as obese women or those with polycystic ovarian syndrome or PCOS, have bodies that are resistant to the hormone insulin. Occasionally, they develop high insulin levels. Insulin resistance has been linked to ovulation problems. Weight loss is associated with a reduction in insulin resistance and has been successful at inducing ovulation. Recently, a study of nurses found an association in that women with diets that were high in refined carbohydrates had ovulation problems. There is no data, however, to indicate that changing your diet results in an improvement in ovulation problems. In fact, a recent study in overweight women with PCOS compared a low fat diet to a low carb diet but failed to find a difference.

Obesity plays a role in infertility. (Fact)

Excess weight and obesity can affect fertility in a number of different ways by causing hormonal imbalances that have an impact on ovulation and menstruation. Additionally, obese patients have a poorer chance for success with fertility treatments. They tend to have a worse response to fertility medications and as a result may need higher doses. Pregnancy rates are uniformly lower for obese women. This is true even for high tech treatments such as in vitro fertilization. Some IVF studies show a delivery rate for obese women that is one half what it is for thinner women.

Smoking contributes to infertility. (Fact)

Smoking harms fertility  in a number of ways. Research indicates that smoking is harmful to women’s ovaries and the degree of harm is dependent upon the amount and period of time a woman smokes. Smoking accelerates the loss of eggs and reproductive function and may advance menopause by several years.

Wearing briefs as opposed to boxer shorts lowers sperm counts (Fiction)

It has been believed that briefs increase the scrotal temperature and thus impair sperm production. However, using sophisticated temperature monitoring techniques, doctors have shown there is no significant difference in scrotal temperature regardless of the underwear type. Other studies have failed to find an impact of type of underwear on semen parameters.

Robitussin (guaifenesin) will improve the chances for pregnancy if a woman has “thick” cervical mucus (Fiction)

Around the time of ovulation, a woman’s cervical mucous becomes clear and watery to allow the passage of sperm. Some suspect that insufficient “thinning” of the cervical mucous is a cause for infertility. This is controversial in itself. Use of Robitussin has been rumored for decades to improve the chance for pregnancy. However, there has never been a single study to indicate any positive effect of Robitussin on achieving pregnancy.