Pre-Pregnancy

Dispelling fertility myths and half-truths

  1. Birth control pills reduce fertility. (Fiction)

Dr. Randy Morris, a Chicago-based board-certified reproductive endocrinologist, says there is no evidence that the use of birth control pills affects future fertility. “In fact, birth control pills are very short-acting,” Dr. Morris says. “Therefore, birth control pills never make much of an impact on the body’s ability to reproduce. 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.”

Wearing briefs vs. boxer shorts lowers sperm counts. (Fiction)

  1. Stress causes infertility. (Undecided)

For this one our doctors actually disagreed. According to Dr. Morris, it is much more likely that the infertility is causing the stress instead of the other way around. “The role stress plays in a person’s fertility is complicated,” Dr. Morris says. “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.” Dr. Morris feels that while stress can affect fertility, it is fairly uncommon and not a major player.

Dr. Paul Miller, an OB-GYN specializing in reproductive endocrinology in the Greenville Hospital System’s Department of Obstetrics and Gynecology, believes that stress can be a major factor, though not the sole cause of infertility. “Both human and animal studies have demonstrated a negative effect of both acute and chronic stress on hormone production and fertility,” he says. “Animal studies are much more convincing, given our ability to perform experiments in a very controlled environment. The difficulty with interpreting such studies is that stress is difficult to measure and what may be stressful to some is just a mere annoyance to others.”

For this one our doctors actually disagreed. According to Dr. Morris, it is much more likely that the infertility is causing the stress instead of the other way around! “The role stress plays in a person’s fertility is complicated,” Dr. Morris says. “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.” Dr. Morris feels that while stress can affect fertility, it is fairly uncommon and not a major player.

Dr. Paul Miller, an OB/GYN specializing in reproductive endocrinology in the Greenville Hospital System’s Department of Obstetrics and Gynecology, believes that stress can be a major factor, though not the sole cause of infertility. “Both human and animal studies have demonstrated a negative effect of both acute and chronic stress on hormone production and fertility,” he says. “Animal studies are much more convincing, given our ability to perform experiments in a very controlled environment. The difficulty with interpreting such studies is that stress is difficult to measure and what may be stressful to some is just a mere annoyance to others.”

According to Dr. Miller, removing the stress, or learning to better cope with it, has a positive impact on fertility. “Is stress typically the sole cause of infertility?” he says. “No. But it is an irrefutable contributor to fertility problems in many cases.”

At any rate, decreasing stress can only be a good thing for parents wanting to conceive and carry a healthy baby.

  1. Taking sugar or anything “white” out of your diet can improve ovulation. (Fact – sort of)

“White foods, like potatoes, rice and white bread, are loaded with carbohydrates and have a high glycemic index,” Dr. Miller says. “This means that they cause a significant rise in blood sugar after they have been eaten, in turn, leading to spikes in the levels of circulating insulin. Insulin helps the body absorb sugar for fuel but also influences hormone production. In the ovary, insulin increases production of testosterone and other androgens (male-type hormones) that are released into the bloodstream.”

It is important to remember that not all women will experience these effects when they eat white food, so therefore, cutting out these types of foods will only affect a few women. Individuals who are most prone to benefit from such changes in diet are those who are overweight or obese, have a family history of diabetes or have been diagnosed with polycystic ovaries. And keep in mind that most doctors believe the positive impact is due more to the weight loss that comes from such a change in diet than to cutting out those specific foods.

  1. IVF is associated with the greatest risk for multiple pregnancies. (Fiction)

According to Dr. Bruce A. Lessey, medical director of the Division of Reproductive Endocrinology & Infertility for the Greenville Hospital System, the number of multiple births in the United States has gone up significantly in recent years. “Many of these come from assisted reproductive techniques, including in vitro fertilization (IVF),” he says. “Most of these are twins, but triplets or higher numbers do occur. The risk to both the mother as well as the babies is real, and is something reproductive endocrinologists are trying hard to avoid. But is IVF the culprit? Probably not. Actually, in vitro fertilization provides one of the safest ways to avoid multiple gestations when women undergo ovarian hyperstimulation for infertility. Aside from the rare cases where an embryo will split and form identical twins, IVF offers the chance to limit the number of potential embryos that will implant and eventually be born.”

With in vitro fertilization, the risk for a multiple pregnancy is determined by how many embryos are placed in the uterus. Obviously, this is much more easily controlled than other types of assisted reproductive techniques, especially as doctors are moving toward a single embryo implantation.

  1. Wearing briefs vs. boxer shorts lowers sperm counts. (Fiction)

Dr. David A. Forstein is also from the Greenville Hospital System’s Department of Obstetrics and Gynecology. He says that many couples believe that the type of underwear a man wears can play a role in their ability to conceive by changing a man’s sperm count. This is a notion that seems to have caught the public’s curiosity and continues to be an area of discussion.

“We do know that sperm production is a complicated process that takes about 72 days from start to finish,” he says. “Any insult during that time frame, such as significant illness, toxic exposures or injury to the testicles, can cause a decrease in sperm count. Chronic or long-lasting reductions in sperm production can be seen in men who are heavy drinkers or smokers, are obese, have varicoceles (varicose veins of the scrotum) or who are exposed to high heat on a regular basis. It is this finding about heat exposure that leads to the boxer shorts myth.”

One of the reasons that the testicles hang outside the body cavity is that they function better for sperm production if they remain below core body temperature. This might lead one to believe that boxers would be better than briefs. “Overall, there is no direct scientific evidence that boxers are any different than briefs in changing sperm counts or promoting fertility,” Dr. Forstein says. “That is to say, men should wear whatever type of underwear they feel is most comfortable.”

  1. Smoking contributes to infertility. (Fact)

This one commanded a resounding, unequivocal yes, from all doctors polled. Smoking can be detrimental to fertility on many levels. Dr. Sharon Jaffe, a board-certified reproductive endocrinologist at the Center for Reproductive Medicine in Orlando, Fla., gives the following facts on smoking and fertility.

The nicotine adversely affects the quality of the cervical mucous and can potentially impair sperm transport.

Smokers go through menopause an average of two years earlier. The metabolites of the nicotine adversely affect egg quality and gradually decrease egg quantity, causing a decrease in ovarian reserve.

The metabolites of nicotine, such as continine, can be found in the follicular fluid (fluid surrounding and “bathing” the egg as it matures or develops) decreasing the quality of the egg and embryo.

Smoking by the male partner can adversely affect the DNA sperm chromatin, causing decrease in fertilization potential, decrease in embryo quality and increase in miscarriages.

Smoking is associated with recurrent pregnancy loss – possibly due to decreased embryo quality or microvascular problem in the uterus.