Myth Buster
The Top 10 Fertility Myths Millennials Believe, According to Experts
This generation is more educated about their reproductive health than any previous one, but they also may be running into scary and unhelpful misinformation.
Millennials may be the generation of smartphones and social media, but being tech savvy in the information age has its downside. There is so much “information” out there that it can be hard to sort fact from fiction. This is especially true when it comes to fertility. The oldest Millennial babies, born in the early ‘80s are entering their 40s more educated about their reproductive health than any previous generation, but they also may be buying into scary myths about fertility from unreliable sources.
The good news for Millennials trying to conceive is that infertility rates in the U.S. have remained about the same for the past 50 years, while infertility services and fertility treatments have only gotten better over the years. “Reproductive science has grown so much,” says neonatologist and pediatrician Dr. Terri Major-Kincade, M.D, a double board-certified neonatologist and pediatrician. But, because there’s a lot of advice (good and bad) out there, Dr. Major-Kincade says it’s important for parents-to-be — or anyone looking to get pregnant again — to weed through it and understand what it all means.
To help you filter information, Romper talked to reproductive and pregnancy experts to debunk some of the misinformation about fertility that may be floating around on your IG and Facebook feeds.
Myth: Once you hit 35, it’s over.
Despite there being so much health information readily available, a recent study showed that Millennials don’t really understand when fertility begins to decline. We’ve all heard it from our family and friends (and maybe even doctors) more than once: When women turn 35, our fertility nosedives.
On average, it is more difficult to get pregnant after 35 than, say, in your 20s, but that doesn’t mean it will be for you. The vast majority of the medical community agrees that age 35 is a completely arbitrary number based on data from an outdated line of clinical reasoning.
Even if an individual’s fertility does wane, there are many ways to improve your chances of getting pregnant, from calculating when in your cycle you are naturally most fertile, on through medication, intrauterine insemination, surgery to remove polyps, scar tissue, or pelvic adhesions, and assisted reproductive technology, including IVF.
“A lot of women can get pregnant after 35,” says Dr. Robert Kaufmann, M.D., a reproductive endocrinologist at Fort Worth Fertility in Texas. When it comes to assisted reproductive technology, “success rates will vary, of course, and there is a point where we should cut off patients from trying to carry,” he says, noting the American Society for Reproductive Medicine’s (ASRM) guidelines discouraging fertility treatments in women over the age of 55. (However, from age 42 onward, it is very unlikely to have a successful IVF cycle using fresh embryos from non-donor eggs, according to the CDC. While you can carry well into your 50s, doctors will either use your frozen eggs or donor eggs.)
Myth: Birth control has no effect on your fertility
Let’s bust a myth up front: Taking birth control before trying will not affect your chances of getting pregnant. According to a comprehensive literature review from the journal Contraception, pregnancy rates for women who discontinued using contraceptives — including the pill, IUDs, implants, and injections —are pretty much the same as the pregnancy rates for women who have not used birth control at all. (Easy evidence of this is how missing just one pill can make you more vulnerable to unplanned pregnancy.) But that doesn’t mean contraception doesn’t have any effect on your fertility, especially from a nutritional standpoint.
Katie Goldberg, MCN, RDN, LD, a dietician specializing in pregnancy, says that birth control can cause changes to gut health and strip your body of key nutrients for health and fertility. Studies have shown that oral contraceptive use has been associated with a risk for inflammatory bowel disease, like Crohn’s Disease and ulcerative colitis, however, this association has only been linked to women with a history of smoking. But, gut health is also associated with immune function, and a poor immune system causes inflammation, which, as naturopathic doctor Priya Prakash shares on her website, has been associated with recurrent pregnancy loss and decreased progesterone levels. As Prakash notes, studies have shown this “can in turn lead to implantation failure, the development of autoimmune processes impacting fertility, and the development of antisperm antibodies preventing fertilization.”
“If I have a patient who has been on birth control for awhile, I will recommend taking time to replenish healthy bacteria and baby-building nutrients before trying to get pregnant,” says Goldberg. Dietary recommendations include taking prenatal vitamin with folic acid and vitamin B12, eating full fat dairy, consuming foods with antioxidant and anti-inflammatory properties to help replenish the body, and eating enough fiber. It’s also helpful to limit inflammatory foods like refined grains, sugar, soda, and processed and pre-packaged foods.
Myth: Freezing your eggs guarantees that you can have a baby in the future.
This narrative is all over pop culture: If you’re having a hard time finding a partner in your 20s or 30s, you can just freeze your eggs and use them anytime in the future. In reality, it’s not always so straightforward. “If you freeze your eggs, of course, there is no guarantee, but the younger you froze your eggs, the better your chances,” says Dr. Kaufmann.
Generally, eggs retrieved and frozen from women 35 years old and under have better chances of later becoming a successful pregnancy. However, overall success rates aren’t exactly known since there isn’t a lot of data on how many women have actually followed through with thawing their eggs and attempting to get pregnant. According to Yale Medicine Fertility Center, some studies report the rates of frozen egg usage at only 3 to 9 percent, though those rates are increasing.
Myth: Infertility is a female issue.
This is one of the most common fertility myths Dr. Kaufmann hears from his Millennial patients. While women often have to bear the emotional weight of infertility, the reality is that a third of infertility cases are caused by male factors, according to ASRM. Another third can be attributed to female factors, and the last third are caused by a combination of male and female problems, or unexplained. If you are in a heterosexual partnership and have been trying to conceive for about a year without becoming pregnant, a fertility specialist will test both of you to try to determine the cause of the infertility and some possible solutions. You will be evaluated with a blood test to determine if you’re ovulating, ovarian reserve testing to check the amount of eggs in your ovaries, and imaging tests to look for ovarian or uterine abnormalities, for example, while they will look at your male partner’s semen quality, testicular biopsy, and imaging of his vas deferens or scrotum.
Myth: You don’t need a plan for trying to conceive — just get started!
On TV and in movies, couples decide they want to have a family and start trying right away. In real life, however, doctors encourage couples to have a consultation with an OB-GYN or a reproductive specialist before trying to get pregnant in order to account for conditions related to family medical history, medication, or habits that may affect fertility for either parent, and possible structural concerns with a woman’s uterus.
Dr. Major-Kincade gives some advice to help ensure healthy outcomes for both parents and baby: “Plan for the pregnancy a year before. Make sure you are screened for hypertension, diabetes, and obesity the year before getting pregnant. Develop a plan with your doctor to be in your best health prior to becoming pregnant.”
Myth: Weight loss is always good for fertility.
How many times have we heard that a friend is trying to lose weight before trying to get pregnant? “Being a healthy weight is helpful for fertility, but how you get there matters,” says Goldberg. She discourages using fast and extreme approaches to weight loss like intermittent fasting, keto, or excessive exercise. “Weight loss can cause a lot of stress on the body, which is counterproductive to fertility,” she says. In fact, Goldberg says, “Healthy habits matter more than the exact number on the scale.”
Myth: “Older” moms are likely to have children with genetic abnormalities or developmental issues.
Millennial women are a driven and ambitious crowd. Working hard and reaping the rewards has been an important part of identities. As a result, many of us are thinking about family differently or delaying having children as we work to build our careers. But we’ve all heard the myth that “older” mothers — defined by the medical community as those with “advanced” maternal age,” which is understood as a continuum but generally refer to women over 35 years old — may be at risk for having children with genetic abnormalities or developmental issues.
However, this is not always or even often the case, says Dr. Major-Kincade. “Many older mothers have children with no problems at all, and we also see younger moms who may have children with genetic conditions with no risk factors prior to pregnancy.” She says that if couples have concerns for genetic abnormalities due to family histories or other reasons, they can consider genetic testing during the pregnancy to help prepare for potential concerns.
As Dr. Major-Kincade has seen, age might make a difference in having children with genetic abnormalities in an unexpected way. The older you get, the greater chance of genetic abnormalities in the egg, which is why genetic testing is recommended for pregnant women over 35. Thankfully, screening tests like the NIPT can indicate at 10 weeks if there is cause for concern, and a diagnostic test like chorionic villus sampling (CVS) or amniocentesis can tell you definitively whether there is a chromosomal issue. Anatomy scans have advanced so much that developmental issues can also be detected early. For all of these reasons, there are actually greater rates of Down Syndrome in children born to mothers under 35, for whom testing is not as strongly encouraged.
Myth: Fertility has nothing to do with what you eat and drink.
As a nutritionist specializing in pregnancy and fertility, Goldberg, who struggled with unexplained infertility for three years before having her two children, works to debunk this myth a lot. While we may try to do our best to eat healthy food on a daily basis, Goldberg says there are specific nutrients that can improve your fertility, and your male partner’s.
Indeed, as noted in this article published by Harvard Medical School, studies of men have found that healthy diets improve semen quality, while diets high in saturated or trans fats harms it. Further, diet may play a role in IVF. “For couples receiving assisted reproductive technologies, women may be more likely to conceive with folic acid supplements or a diet high in isoflavones (plant-based estrogens with antioxidant activity), while male fertility may be aided by antioxidants,” write Robert H. Shmerling, MD and Alison Shmerling, MD, MPH.
Goldberg recommends foods that are rich in antioxidants and anti-inflammatory properties like dark leafy greens, berries, citrus fruits, avocado, fatty fish, nuts, and seeds. She also encourages switching from skim and low-fat dairy products to full-fat dairy. “Research indicates one to two servings per day of full-fat dairy may support fertility, while skim and low-fat dairy work against it,” says Goldberg.
While alcohol can serve as a good elixir for baby-making, it can actually hinder your chances of getting pregnant. “Alcohol increases stress on the body, can reduce sperm count and quality, and reduce egg quality. Sticking to a few drinks per week is good, and cutting out alcohol altogether is ideal,” she says. Finally, she encourages taking a high-quality prenatal vitamin before even trying to conceive to prepare your body.
Following a vegetarian or vegan diet is ideal for fertility.
It’s super trendy to be vegan and vegetarian, so much so that Meatless Monday has become a staple for meal planning. There is some research that touts the health benefits of eliminating meat and animal products from your diet, like lower BMI, blood pressure, and a reduced risk for heart disease, diabetes, and cancer. So would switching to these diets aid in conception? Not exactly, says Goldberg. “If you are struggling with infertility, I do not recommend following a strictly vegetarian or vegan diet,” she says. “Many nutrients that are key for healthy egg, sperm, and hormone production are found and best absorbed from animal sources.” If you are already vegetarian or vegan, Goldberg says that you need to plan carefully and probably supplement above and beyond a prenatal vitamin.
Myth: Supplements and over-the-counter medications will improve your fertility.
While you may have heard of miraculous supplements that increase your chances of getting pregnant, there isn’t any real medical evidence to support over-the-counter fixes for fertility, says Dr. Kaufmann. While there are a few key practices to good fertility like avoiding cigarettes, moderating marijuana usage, managing stress, and consuming good nutrition, he says, “nothing you really do will improve ... your fertility, medically speaking.” However, he doesn’t discount the emotional side of a fertility journey, saying that sometimes a supplement might make you feel as if you’re doing something. But, in reality, “there is no quick fix.”
This article is the result of a Romper & March of Dimes collaboration. Tune in to Millenials and Motherhood, an insightful discussion featuring the experts here and more guests, covering everything from social media, to fertility and nutrition. The talk is part of MOD’s It Starts With Mom Live series, of which Romper is proud to be the national media partner.
Studies referenced:
Anderson, R.A., Davies, M.C., Lavery, S.A.; Royal College of Obstetricians and Gynaecologists. (2020) Elective Egg Freezing for Non-Medical Reasons: Scientific Impact Paper No. 63., BJOG, https://pubmed.ncbi.nlm.nih.gov/32102111/
Argyle, C.E., Harper, J.C., Davies, M.C. (2016) Oocyte cryopreservation: where are we now? Human Reproduction Update, https://pubmed.ncbi.nlm.nih.gov/27006004/
Chavarro, J.E., Rich-Edwards, J.W., Rosner, B., Willett, W.C. (2007). A prospective study of dairy foods intake and anovulatory infertility, Human Reproduction, https://pubmed.ncbi.nlm.nih.gov/17329264/
Mansour, D., Gemzell-Danielsson, K., Inki, P., Jensen, J.T. (2011) Fertility after discontinuation of contraception: a comprehensive review of the literature. Contraception, https://pubmed.ncbi.nlm.nih.gov/22018120/
Khalili, H., Higuchi, L.M., Ananthakrishnan, A.N., et al. (2013) Oral contraceptives, reproductive factors and risk of inflammatory bowel disease. Gut, https://gut.bmj.com/content/62/8/1153
Andrea Brazdova, Ph.D, Helene Senechal, Ph.D, Gabriel Peltre, Ph.D, and Pascal Poncet (2016) Immune Aspects of Female Infertility, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845518/
Ido Sirota, MD, MHA, Shvetha M. Zarek, MD, and James H. Segars, MD (2014) Potential Influence of the Microbiome on Infertility and Assisted Reproductive Technology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137456/
Tersigni C, D'Ippolito S, Di Nicuolo F, Marana R, Valenza V, Masciullo V, Scaldaferri F, Malatacca F, de Waure C, Gasbarrini A, Scambia G, Di Simone N (2018) Recurrent pregnancy loss is associated to leaky gut: a novel pathogenic model of endometrium inflammation? https://pubmed.ncbi.nlm.nih.gov/29665864/
Experts:
Dr. Terri Major-Kincade, M.D., double board-certified neonatologist and pediatrician
Dr. Robert Kaufmann, M.D., reproductive endocrinologist
Katie Goldberg,, MCN, RDN, LD, a dietician specializing in pregnancy and postpartum
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