In Hong Kong, more and more couples start a family later in life, increasing their chances of experiencing fertility issues. According to the Council on Human Reproductive Technology, from 2009 to 2016, the number of couples receiving fertility treatment in Hong Kong doubled, reaching 11,000 couples in 2016.
There are a lot of myths about fertility floating around. We asked obstetrician gynecologist Dr. Alexander K. Doo 杜堅能醫生 to address some of the most common misconceptions.
1. We can’t have fertility problems, we are already parents.
This is a common misconception. Things may have happened in the interim that have caused changes in the couple’s fertility. Even if nothing has changed, the fact that the couple is older reduces the chance of pregnancy. Secondary infertility (i.e. not being able to get pregnant after previous conception) is an often-overlooked issue.
2. I’m in great shape. I exercise, do yoga and eat healthy. I don’t have to worry about my fertility until I am 40!
There is evidence that fertility starts to decrease around age 30. This decrease accelerates by 35, when it is 50% of what it was at peak fertility. After 40, fertility is lowered even further—halved again compared to fertility levels at 35. This is true even for patients undergoing fertility treatment.
3. A man’s fertility does not decline with age.
Although sperm is continuously being made throughout a man’s life, the age of the male partner has a significant impact on reproduction. This reflects the age-related increase in acquired medical conditions, decreases in semen quality and increasing rates of DNA fragmentation in sperm. Integrity of DNA matter in sperm is crucial to reproduction but we now know that as early as 35, the DNA fragmentation of sperm is significantly elevated. Declining testosterone may also cause a decline in libido, erectile dysfunction and difficulty ejaculating.
4. Infertility is generally due to the woman.
This is another common myth. In cases where a cause can be found, 1/3 is female, 1/3 is male and 1/3 is both, hence it is important to investigate both partners before embarking on treatment.
5. Lubricants are safe for conception.
Lubricants differ on their effects on the motility and the integrity of the sperm, some have a severe detrimental effect whilst others have no significant adverse effect. In couples who are hoping to conceive, they should select their lubricants carefully if required.
6. If you learn to relax, you will be able to conceive.
Although stress can contribute to infertility, there may be other reasons. These reasons should be investigated if you are not pregnant after one year of trying. This will prevent time from being wasted should treatment be required.
7. Having sex daily increases the chances of becoming pregnant.
Sperm can generally survive for up to 3-5 days and the egg is fertilizable for 12-24 hours after ovulation. Your theoretical fertile window is 5 days before ovulation and 24 hours afterwards. You can only conceive when you have intercourse on these days.
8. IVF always results in twins or triplets.
In the old days, when IVF was less mature, multiple embryos were transferred back in the hope that “something would stick” and multiple pregnancies were common. But with IVF becoming more mature and with a higher success rate, single or double embryo transfer is the norm, and the risk of multiple pregnancy has decreased. A successful IVF treatment should be one that leads to a successful and single pregnancy.
9. Some sexual positions boost your chances.
Examples of the best positions for getting pregnant are just myths. There is really no scientific evidence saying that the missionary position is better than the woman being on top when it comes to maximizing your chances of making a baby.
10. A man with a high sex drive will have normal sperm count.
The two are not necessarily related. This is why in all fertility cases, a proper semen analysis of the man is essential.