Fertility myths and facts

Posted on 29 March 2016

Battling to conceive? We reveal the truth behind some commonly held beliefs about fertility.

MYTH: Only female fertility declines with age

FACT: Declining fertility is a reality for both women and men.

In women fertility starts declining after the age of 30. By their late 30s women have half the fertility rate of women in their early 20s.

While men over 70 can still conceive, sperm quality deteriorates with age. Male fertility decreases most after age 50 but starts to decline at 40.

‘We cannot change our age, but if we reflect on the impact age has on fertility the message to patients having difficulty conceiving is not to shy away from the problem,’ says Dr Dawie Slabbert, a gynaecologist and fertility specialist at Mediclinic Panorama. ‘The best time to conceive is now.’

MYTH: Fertility treatment is seldom successful

FACT: Success rates are in fact very encouraging.

The first port of call when it comes to fertility treatment is usually to prescribe clomiphene citrate, a fertility medication that stimulates your ovaries to release eggs.

If this is unsuccessful, the next step would be assisted reproductive techniques (ART). With intrauterine insemination (IUI) sperm is placed inside a woman’s uterus to increase the chance of fertilisation. With in vitro fertilisation (IVF) – the egg and sperm are manually combined in a laboratory dish to create an embryo which is then transferred to the uterus.

‘Improvements in medication, microsurgery and in ART make pregnancy possible for the majority of couples pursuing treatment,’ says Dr Slabbert.

‘More than two thirds of infertile couples will be able to make their dreams of having a child come true. In particular, success rates have dramatically improved for couples who require ART. The pregnancy rate for an ART cycle now approaches the monthly fertility rate for most couples.’

Success rates vary from patient to patient and from situation to situation, so it’s best to visit a fertility specialist to evaluate your particular case.

MYTH: Women over 40 rarely have healthy pregnancies

FACT: While fertility declines with age and risks increase, having a successful pregnancy in your 40s is certainly possible.

‘Many women well into their 40s will have healthy children,’ says Dr Slabbert. ‘However, the risk of birth defects such as Down’s syndrome does increase as you age, as do the risks of developing complications during pregnancy such as gestational diabetes (diabetes during pregnancy) or hypertension (high blood pressure). Early genetic screening can be used to detect certain defects such as Down’s syndrome. Maintaining a healthy diet and exercise pattern will help reduce possible health complications for the mother. Your physician can help you evaluate your individual risks based on your age and overall health.’

MYTH: Fertility treatments usually result in twins or triplets

FACT: Multiple births as a result of fertility treatments are less frequent than is commonly believed.

‘Most cases of successful treatments with ovulation induction with either IUI or IVF will result in a single birth,’ says Dr Slabbert. ‘Worldwide the rate of twin pregnancy averages approximately 3,5 per 1 000 births and less than 1 per 1 000 births for triplets or more. The rate of twins with the use of clomiphene citrate is approximately 5-10%. The number of embryos or zygotes transferred following ART directly correlates with the risk of multiple pregnancy, increasing from 1,4% with a single IVF embryo transfer to 17,9% following the transfer of two embryos, and 24,1% with the transfer of four embryos.’