Fertility Fact vs. Fiction

There’s a vast array of information out there about why you may be struggling to get pregnant, but do you know what’s true and what’s false? From old wives’ tales to scientific research, we share the evidence behind some of the most commonly held fertility beliefs to keep you informed.




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#1 It’s common for it to take 12+
months to get pregnant.




When it comes to the length of time it traditionally takes to get pregnant, age plays an important role. According to Dr. Jessica Scotchie, a reproductive endocrinologist and infertility specialist at Tennessee Reproductive Medicine, the chances of a couple conceiving in any given month if the female is younger than 35 is about 20-25%. “This is assuming the woman is ovulating (having regular predictable cycles), the tubes are open, and there is ample sperm production,” she explains. In this scenario, 60% of couples will be pregnant after six months, and 85% will be pregnant within 12 months. If you have been trying for 12 months or longer and have not conceived, an evaluation can prove beneficial.

For women looking to get pregnant who are 35 or older, the pregnancy rate drops to about 10-15% in any given month, and it’s wise to seek evaluation if conception hasn’t occurred within six months. “Pregnancy rates plateau after about six months in women 35 and older, which is why we recommend earlier evaluation for these couples,” says Dr. Scotchie.

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#2 Infertility affects 15% of
couples at any point in their
reproductive lives.




It’s true that 15% of couples struggle with infertility at some point. A couple is defined as infertile if a pregnancy hasn’t been achieved within 12 months of unprotected intercourse. Fortunately, treatment is possible. Depending on your situation, your doctor may recommend a number of evaluations. Dr. Scotchie explains, “Treatment options are highly specific to each couple, their age, and their history.” Options may include medication to induce ovulation; insemination, which involves placing the sperm in the uterus; in vitro fertilization, which involves stimulating the ovaries, removing eggs, and fertilizing them before returning an embryo to the uterus; sperm, egg, or embryo donation; and gestational carriership, when a surrogate carries the child. Preimplantation genetic testing may also be recommended if it is deemed relevant given a patient’s history, age, or other factors. “This is the process of testing for conditions that can cause miscarriage and health problems in the child before an embryo is transferred,” says Dr. Scotchie.

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#3 You’re more likely to experience fertility challenges if you’re trying to conceive for the first time.




Surprisingly enough, secondary infertility, which is when a couple has trouble conceiving a child after they have already had one or more children, is more common than primary infertility, when first-time parents struggle. In fact, up to 60% of infertility cases are experienced by couples who have already achieved at least one successful pregnancy. There can be a number of different reasons for this, ranging from bodily changes experienced the first time you were pregnant to advancing age.

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#4 If you experience one miscarriage, you’re more likely to experience another.




Miscarriage, which is the term for the loss of a pregnancy before 20 weeks, affects as many as 1 in 4 women. A miscarriage can be caused by underlying hormonal imbalances, anatomy issues, or chronic illnesses like unmanaged diabetes, but most commonly it’s caused by a chance abnormality in chromosomes.

While a miscarriage can be devastating, there’s still hope. “Having more than one miscarriage is uncommon,” Dr. Scotchie explains. “It only affects 2-3% of couples.” This means that even if you have suffered a miscarriage, your chance of having a successful pregnancy is pretty much the same as anybody else’s.

If a woman experiences multiple recurrent miscarriages, fertility testing can help identify a cause and treatment plan.

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#5 You can get pregnant immediately after going off birth control.




This one’s a bit more involved and really depends on the type of birth control you use. For women who use birth control pills, the patch, or the vaginal ring, fertility returns to normal as soon as usage is ceased. The same can be said for an implantation rod or an IUD – once removed, fertility should return to normal. While both the implantation rod and the IUD are designed to prevent pregnancy for multiple years, they can be removed early if you desire to start a family.

If Depo-Provera, a four-times-per-year injection, is your birth control of choice, getting pregnant may take longer. In some women, the effects of this method can take more than a year and a half to wear off entirely. When selecting your birth control method, it’s important to keep this information in mind.

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#6 It’s not always possible to
pinpoint the cause
of infertility.




Both male and female factors can affect fertility, and there are tests designed to help determine what might be leading to issues. Dr. Scotchie explains, “Ovulation disorders are incredibly common, endometriosis is very common, and many couples have a combination of factors.”

However, not all cases are clear-cut. Unexplained infertility, which means ovulation is occurring, the fallopian tubes are open, and there is an ample amount of sperm but conception is still not occurring, affects 10-20% of couples. “This doesn’t mean there’s no cause,” says Dr. Scotchie. “It means there are many factors in fertility that are difficult to test, like fertilization ability, embryo quality, and implantation ability, among others.” Even in the case of unexplained infertility, though, treatment is available and highly effective.

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#7 You are only fertile
on the day of ovulation.




Ovulation occurs approximately once a month when a mature egg is released from a woman’s ovary, enters the fallopian tube, and becomes available for fertilization by a sperm. When it comes to conception, there is a fertility window. Dr. Scotchie explains, “A woman is most fertile the three days leading up to and including the day of ovulation. For a woman with a 28-day cycle, this would typically be days 11-14. For a woman with a 35-day cycle, the fertile window will be a bit later, usually days 18-22.” For conception to occur, an egg and sperm need to come together at the right time. Sperm can live for approximately five days once released, while an egg must be fertilized within 24 hours to create an embryo.


Dr. Jessica Scotchie Reproductive Endocrinologist & Infertility Specialist, Tennessee Reproductive Medicine
Dr. Jessica Scotchie Reproductive Endocrinologist & Infertility Specialist, Tennessee Reproductive Medicine


A final piece of fiction:


You should wait until you’ve been unsuccessful in achieving pregnancy before visiting a fertility specialist.


If you have a history of irregular cycles, endometriosis, fibroids, family history of premature menopause, or a husband with medical problems that may affect sperm production, a consultation before attempting conception can be a positive and proactive step. Not only can a specialist help you identify potential problems early, they can also provide support and understanding. With incredible advancements in education and technology, the dream of becoming a parent is within reach. HS

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