Infertility - the inability to get pregnant after 12 months of regular, unprotected sexual intercourse - affects about 1 in 10 American couples. A diagnosis can alter relationships, lead to depression and anxiety, and threaten lifelong expectations of parenthood. Thankfully, medical advances such as in vitro fertilization (IVF) have made it possible for certain couples to conceive, but these treatments carry risks and are often poorly understood. Here are five common misconceptions.
Myth No. 1: Stress causes infertility.
The headline of a 2010 U.S. News & World Report article promised readers that they would discover "How Stress May Be Causing Your Infertility." An article on WebMD claims that doctors believe "the stress of actually undergoing infertility treatments can be so great it can stop even the most successful procedures from working." Anyone who has personally experienced infertility has heard some variant on the advice : "Relax, you're trying too hard. Just take a break and you'll get pregnant."
The picture is further complicated by studies that find participation in psychological counseling may improve pregnancy rates . However, other studies have found that these effects are evident only in couples not receiving medical treatments. While counseling can help couples reduce stress and cope more effectively with the uncertainty of infertility, couples should not expect counseling to increase their chances of pregnancy. Ultimately, the myth that stress causes infertility unfairly places the responsibility for treatment failure or success on the shoulders of the woman, a conclusion that is not supported by science.
Because women get pregnant and men don't, people often believe that infertility must be related to what's happening in the female body. Historically, biblical writings, Egyptian papyruses and the medical texts of the classical Greeks show that infertility was a common condition and that women were primarily blamed. These convictions formed cultural traditions and misperceptions that have lasted for centuries. While the Centers for Disease Control and Prevention's website correctly notes that infertility is not always a woman's problem, it still incorrectly reports that in just 8 percent of infertile couples, the man is solely responsible.
In fact, men and women are equally responsible for an infertility diagnosis. According to the U.S. Department of Health and Human Services Office on Women's Health and the National Institutes of Health, about one-third of cases are attributable to men, one-third are attributable to women, and the rest are a combination of male and female factors or unexplained problems. Most male infertility is related to low sperm count, poor sperm movement and abnormal sperm shape. Irregular ovulation, endometriosis, polycystic ovary syndrome and diminished ovarian reserve due to age contribute to female infertility. Combined infertility is diagnosed when both partners contribute in some way (for example, if the man has low sperm count and the woman has infrequent ovulation).
Women throughout the world are delaying the age when they have children. In the United States, the mean age of first-time mothers in 2016 was 26.6 , the highest ever recorded. In 2003, a "60 Minutes" report found that educated professional women who intended to delay childbearing to pursue their careers had significant misperceptions about age and fertility, believing that medical treatments and good health could extend the biological clock well into a woman's 40s and even 50s - an attitude that has also been found in undergraduate students. Fertility clinics can also perpetuate this myth with well-intentioned but misleading statements, such as the Fertility Centers of Illinois' assertion that "advanced medical technology . . . allows us to extend the biological clock for many women."
Myth No. 4: In vitro fertilization works for most patients.
The overall success rate for having a child using one round of IVF in the United States is between 25 and 29 percent, according to the CDC. Because an average round costs $10,000 to $15,000, this can be an expensive gamble for couples. IVF is also stressful, emotionally taxing and physically invasive, which can lead patients to postpone the treatment or drop out altogether. Unsurprisingly, IVF success rates are linked to age. Women under 35 have the best chances of ultimately giving birth (43 percent). After age 37, success rates drop dramatically. Women ages 41-42 have a only a 10 percent chance of IVF success, while women over 44 have only a 2 percent chance.
Myth No. 5: My doctor will tell me what I need to know about infertility.
Yet these discussions rarely take place , and research indicates that gynecologists and nurses have gaps in their knowledge about issues such as the management of polycystic ovary syndrome and the impact of smoking and age on fertility. Even when physicians do have the right information, many are reluctant to engage with patients for fear they might increase their patients' emotional distress or be perceived as pushing childbearing. One possible solution is for physicians to practice preconception counseling with patients during their peak fertility years. By doing so in a neutral, nonjudgmental way, they can give patients information that maximizes their reproductive choices.
Peterson is a professor in the Crean College of Health and Behavioral Sciences at Chapman University in Orange, California.
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