Myths and Misconceptions about infertility

What are some of the myths and misconceptions about infertility ?

Myth: Painful periods cause infertility.
Fact: Painful periods do not affect fertility. In fact, for most patients, regular painful periods usually signal ovulatory cycles. However, progressively worsening pain during periods ( especially when this is accompanied by pain during sex) may mean you have endometriosis.

Myth: Infrequent periods cause infertility.
Fact: As long as the periods are regular, this means ovulation in occurring. Some normal women have menstrual cycle lengths of as long as 40 days. Of course, since they have fewer cycles every year, the number of times they are "fertile" in a year is decreased. Also, they need to monitor their fertile period more closely, since this is delayed ( as compared to women with a 30 day cycle).

Myth: Blood group "incompatibility" between husband and wife can cause infertility.
Fact: There is no relation between blood groups and fertility.

Myth: The reason I'm not getting pregnant is because most of the sperm leaks out of the vagina after intercourse.
Fact: Loss of seminal fluid after intercourse is perfectly normal, and most women notice some discharge immediately after sex. Many infertile couples imagine that this is the cause of their problem. If your husband had his climax inside you, then you can be sure that no matter how much fluid you lose afterwards, enough sperm will reach the cervical mucus. This discharge is not a cause of infertility.

Myth: If you work at it and want it enough, you'll get pregnant.
Fact: Unlike many other parts of your lives, infertility may be beyond your control. While newer methods of treatment have improved most couples' chances of having a baby, some problems are still unsolvable.

Myth: Just pray and have faith.
Fact: Believing in God can help you to maintain a positive outlook - but sheer will and blind faith won't overcome a physical problem like blocked tubes or absent sperms.

Myth: A man can judge his fertility by the thickness and volume of his semen.
Fact: Semen consists mainly of seminal fluid, secreted by these minal vesicles and the prostate. The volume and consistency of the semen is not related to its fertility potential, which depends upon the sperm count. This can only be assessed by microscopic examination.

Myth: Infertility is hereditary.
Fact: If your mother , grandmother or sister have had difficulty becoming pregnant, this does not necessarily mean you will have the same problem ! Most infertility problems are not hereditary, and you need a complete evaluation.

Myth: A retroverted ( "tipped") uterus causes infertility because the semen cannot swim into the cervix.
Fact: About one in five women will have a retroverted uterus. If the uterus is freely mobile, this is normal, and is not a cause of infertility. This is not an indication for surgery !

Myth: We should be having intercourse every day to achieve pregnancy.
Fact: Sperm remain alive and active in woman's cervical mucus for 48-72 hours following sexual intercourse; therefore, it isn't necessary to plan your lovemaking on a rigid schedule. Although having sexual intercourse near the time of ovulation is important, no single day is critical. So, don't be concerned if intercourse is not possible or practical on the day of ovulation.

Myth: A woman ovulates from the left ovary one month and the right ovary the next month.
Fact: Only one ovary actually ovulates each month. However, the pattern may not be regular from side to side.

Myth: Pillows under the hips during and after intercourse enhance fertility.
Fact: Sperm are already swimming in cervical mucus as sexual intercourse is completed and will continue to travel up the cervix to the fallopian tube for the next 48 to 72 hours. The position of the hips really doesn't matter.

Myth: If you just relax, you'll get pregnant.
Fact: If pregnancy has not occurred after a year, chances are there is a medical condition causing infertility. There is no evidence that stress causes infertility. Remember, all infertile patients are under stress - it's not the stress which causes infertiliity, it's the infertility which causes the stress !

Myth: Periods that occur less than or greater than 28-day intervals are irregular.
Fact: A woman's period will often vary from month to month. As long as a woman can count on a period at a regular interval every month, this is normal.

Myth: I've never had symptoms of a pelvic infection, so I can't have blocked tubes.
Fact: Many pelvic infections have no symptoms at all, but can cause damage, sometimes irreversible, to tubes.

Myth: My gynecologist has done an internal examination and said I am normal; therefore I should have no problem getting pregnant.
Fact: A routine gynecological examination does not provide information about possible problems which can cause infertility.

Myth: If a woman takes fertility drugs, she'll have a multiple birth.
Fact: Although fertility drugs do increase the chance of having a multiple pregnancy ( because they stimulate the ovaries to produce several eggs) the majority of women taking them have singleton births.

Myth: A man's sperm count will be the same each time it is examined.
Fact: A man's sperm count will vary. Sperm number and motility can be affected by time between ejaculations, illness, and medications.

Myth: I have no problems having sex. Since I am virile, my sperm count must be normal.
Fact: There is no correlation between male fertility and virility. Men with totally normal sex drives may have no sperms at all.

Myth: All physicians are equally interested in the treatment of infertility.
Fact: Not all physicians or even all infertility centers have similar interests. It is important for you to ask your physician about the available treatment he/she can offer you and what are the pregnancy results following such treatment in his/her practice.

Myth: Infertility treatment should not be offered in India, because there are too many babies in this country already . Why exacerbate the population problem by producing more ?
Fact: The right to have children is a fundamental right of every human being and a very basic biologic urge. Just because a neighbour has too many children should not deprive the infertile couple of their right to have their own.

Myth: Azoospermia ( no sperms) is a result of excessive masturbation in childhood.
Fact: Masturbation is a normal activity which most boys and men indulge in. It does not affect the sperm count. You cannot "run" out of sperms, because these are constantly being produced in the testes.

Myth: It must be the couple's fault if they are infertile.
Fact: Infertility carries a major social stigma - and this "victim-blaming" is very common, partly because most people know so little about their own fertility.

Myth: Infertility is not a medical illness and treatment should not be covered by insurance.
Fact: Infertility is a medical problem, which is often amenable to medical treatment. Insurance should cover the treatment costs.

Myth: IVF is too expensive for India to be able to afford.
Fact: IVF and related technologies are undoubtedly expensive - but then, so is heart surgery. Yet, no one objects when over Rs 1 lakh are spent to try to salvage the heart of a 70 year old man (whose life expectancy in any case is only about 5 years and is not extended by the surgery). Why then should medical technology not be used to help couples in their thirties (with their whole lives ahead of them) have their own baby ? In fact, IVF is a much more cost-effective use of medical resources than a number of other accepted surgical procedures (such as joint replacement surgery or kidney transplants).

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.