Fertility can be tricky to understand, especially with all the myths and outdated ideas out there. From old wives' tales to simple misconceptions, it is easy to get confused about what really affects your chances of getting pregnant. In this article, we will clear up some common fertility myths, so you can make better decisions about your reproductive health.

Understanding fertility

Before diving into the myths, it is important to understand what fertility is and how it works. Fertility refers to the ability to conceive and produce offspring.¹ For people assigned female at birth (AFAB), it involves the health and function of the ovaries, fallopian tubes, uterus, and the overall hormonal balance. For people assigned male at birth (AMAB), it involves the production of healthy sperm. Factors affecting fertility can be varied and include age, lifestyle factors, and underlying health conditions.

Myth 1: Fertility declines dramatically after age 35

Many people believe that once you hit 35, your chances of getting pregnant drop sharply. While it is true that fertility can decline with age, the reality is not as severe as often portrayed.

Scientific evidence

Research shows that AFAB people's fertility does decline with age, however the rate of decline can vary. According to studies, while fertility does decrease after 35², many AFAB people in this age group can still conceive naturally. Advances in reproductive technology, such as egg freezing and in-vitro fertilisation (IVF), also offer options for AFAB people who want to delay childbirth.

Practical implications

If you are over 35 and considering pregnancy, it is still possible to conceive naturally. However, it is a good idea to have a preconception check-up to assess your reproductive health and explore your options.

Myth 2: you can't get pregnant during your period

Some people believe that pregnancy is impossible during menstruation, but this is not entirely accurate.

Scientific evidence

The menstrual cycle is complex, and ovulation — the release of an egg from the ovary — typically occurs about two weeks before your next period.³ However, sperm can live in the female reproductive tract for up to five days. If you have a shorter cycle, ovulation might occur close to the end of your period, making pregnancy possible.

Practical implications

If you are trying to conceive or avoid pregnancy, it is important to understand your menstrual cycle and timing of ovulation. While the likelihood is lower, it is still possible to get pregnant if you have sex during your period.

Myth 3: Men’s age does not affect fertility

Many people think that fertility issues are primarily a female concern, but AMAB people’s age can also play a significant role.

Scientific evidence

Studies show that as AMAB people age, the quality of sperm can decline. Older AMAB people may produce fewer sperm, and the sperm that is produced might have genetic abnormalities. AMAB people are solely responsible for about 20% of infertility cases and contribute to another 30% to 40% of cases.⁴ This can lead to lower fertility rates and an increased risk of certain genetic conditions in offspring.

Practical implications

AMAB people who are older and trying to conceive should be aware that their age can affect fertility. Maintaining a healthy lifestyle and discussing concerns with a healthcare provider can be beneficial.

Myth 4: Lifestyle factors does not affect fertility

There is a belief that lifestyle choices have little impact on fertility, but this is far from the truth.

Scientific evidence

Lifestyle factors such as diet, exercise, smoking, alcohol consumption, and stress levels can significantly affect fertility.⁵ For example, smoking can reduce fertility in both AMAB and AFAB people, while excessive alcohol consumption can impact sperm quality and ovulation.

Practical implications

Adopting a healthy lifestyle can improve your chances of conceiving. Eating a balanced diet, exercising regularly, avoiding smoking and excessive alcohol, and managing stress can all contribute to better reproductive health.

Myth 5: Infertility is always a woman’s issue

There is a misconception that if a couple has trouble conceiving, it's automatically the AFAB person’s fault.

Scientific evidence

Infertility affects both AMAB and AFAB people equally. Studies indicate that about one-third of infertility cases are due to AFAB factors, another third due to AMAB factors, and the remaining third due to a combination of factors or unexplained reasons.⁶

Practical implications

Couples struggling to conceive should both undergo fertility evaluations. Identifying issues early can help in choosing the most effective treatment options and avoid unnecessary blame.

Myth 6: IVF guarantees a baby

In-vitro fertilisation (IVF) is often seen as a guaranteed solution to infertility, but this is not entirely accurate.

Scientific evidence

While IVF can be a successful treatment for many, it does not guarantee pregnancy. Success rates vary based on factors like age, the cause of infertility, and the quality of embryos. For instance, younger AFAB people generally have higher success rates with IVF.⁷

Practical implications

If you are considering IVF, it is important to have realistic expectations. Consult with a fertility specialist to understand your chances of success and explore other options if necessary.

Myth 7: Certain sex positions increase chances of conception

There is a popular belief that specific sex positions can enhance the likelihood of conception, but the scientific evidence does not support this claim.

Scientific evidence

There is no substantial evidence that suggests certain positions have a higher chance of leading to pregnancy.⁸ The most important factors for conception are the timing of intercourse relative to ovulation and sperm quality.

Practical implications

Instead of focusing on positions, couples should focus on the timing of intercourse and overall reproductive health. Tracking ovulation and having regular sex can be more effective strategies for conception.

FAQs

Understanding fertility can be a daunting task with the many myths and misconceptions surrounding it. Here’s a guide to answer some of the most common questions about fertility.

What factors can affect my fertility?

Several factors can influence fertility, including:

• Age: Fertility generally declines with age, particularly for AFAB people over 35
• Lifestyle: Smoking, excessive alcohol consumption, poor diet, and high stress can all impact fertility
• Health conditions: Conditions like polycystic ovary syndrome (PCOS), endometriosis, and certain genetic disorders can affect fertility
• Weight: Being overweight or underweight can affect hormonal balance and fertility
• Medications: Some medications can interfere with fertility, so it’s important to discuss any concerns with your doctor

How long should I try to conceive before seeking help?

Generally, it’s recommended to seek help if you’ve been trying to conceive for:

• 12 months if you’re under 35 years old
• 6 months if you’re 35 or older
• If you have irregular periods, known reproductive health issues, or other symptoms that might affect fertility, you may want to consult a specialist sooner

How does age impact fertility for AFAB and AMAB people?

AFAB people: Fertility starts to decline gradually after age 30, with a more significant decrease after 35. The quality and quantity of eggs decrease, making it harder to conceive and increasing the risk of miscarriage and chromosomal abnormalities.

AMAB people: While AMAB people can remain fertile later in life, sperm quality and quantity can decline with age. Older AMAB people may have lower sperm counts and higher chances of genetic mutations, which can affect fertility and increase the risk of certain conditions in offspring.

Can stress affect my ability to conceive?

Yes, chronic stress can impact fertility by affecting hormonal balance and interfering with ovulation. While occasional stress is unlikely to cause infertility, managing stress through healthy lifestyle changes, relaxation techniques, and support can improve your chances of conception.

Are there specific tests to check fertility?

Yes, several tests can evaluate fertility:

• For AFAB people: Hormone tests (to check levels of reproductive hormones), ultrasound (to examine the ovaries and uterus), hysterosalpingography (to check the fallopian tubes), and ovulation tracking
• For AMAB people: Semen analysis (to assess sperm count, motility, and morphology) and hormonal tests

What are the common treatments for infertility?

Infertility treatments vary based on the cause but may include:

• Medications: Hormonal treatments to stimulate ovulation
• Intrauterine Insemination (IUI): Placing sperm directly into the uterus during ovulation
• In-Vitro Fertilization (IVF): Fertilising eggs outside the body and transferring embryos into the uterus
• Surgery: To correct anatomical issues affecting fertility

How does diet affect fertility?

A balanced diet can positively impact fertility. Important nutrients include:

• Folate (vitamin B9): Found in leafy greens, beans, and fortified cereals, folate is crucial for reproductive health
• Antioxidants: Fruits and vegetables rich in antioxidants can improve egg and sperm quality
• Healthy fats: Omega-3 fatty acids, found in fish and flaxseeds, can support hormonal balance

Can I improve my fertility with supplements?

Certain supplements can support fertility:

• Folic acid: This is essential for AFAB people planning to conceive to reduce the risk of neural tube defects. Many everyday foods, such as cereal, are fortified with folic acid
• Prenatal vitamin supplements: These can be purchased from pharmacists or health stores, and provide necessary vitamins and minerals for reproductive health
• Antioxidants: Supplements including vitamin C and E can improve sperm quality. However, it’s best to consult with a healthcare provider before starting to take any new supplements

What lifestyle changes can boost fertility?

Making positive lifestyle changes can enhance fertility:

• Maintain a healthy weight: Aim to maintain a healthy weight through a balanced diet and regular exercise - both overweight and underweight are associated with lower fertility
• Quit smoking and limit alcohol: Both tobacco smoking and alcohol consumption can impair fertility
• Exercise regularly: Moderate exercise supports overall health and fertility
• Manage stress: Practice mindfulness and relaxation techniques and seek support if needed

Are there any natural remedies to improve fertility?

Some natural remedies may support fertility, but they should be used with caution and in consultation with a healthcare provider:

• Acupuncture: Some studies suggest it may improve fertility by balancing hormones
• Herbal supplements: Certain herbs like chaste tree and red clover are believed to support reproductive health, but evidence is mixed and not all are scientifically validated

If you have concerns about your fertility or need tailored advice, it’s always best to consult with a healthcare provider or fertility specialist. They can provide personalised guidance based on your specific situation and help you navigate your path to conception.

Summary

Fertility is a topic surrounded by many myths and misconceptions, but understanding the facts can help you make informed decisions about your reproductive health. Whilst some decline in fertility with age is natural, many people successfully conceive later in life. Lifestyle factors play a significant role in fertility, and both partners should be involved in fertility evaluations if needed. IVF offers hope but is not a guaranteed solution, and there’s no evidence that specific sex positions improve the chances of conception.

By separating fact from fiction, you can approach fertility with a clearer understanding and take proactive steps to enhance your chances of having a baby. For personalised advice and support, consulting with a healthcare provider is always a good step.