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Fertility Questions and Answers

Simply click on the question, and the answer will appear below it.

Q: Is infertility only a problem for women?

A: Approximately 40% of infertility challenges are the result of female-specific factors and 40% is due to male factors. The remaining 20% of cases are either a result of both partners or for unknown reasons. Consequently, when seeking help, both male and female partners should be evaluated.  

Q: What are examples of conditions categorized as "Male Infertility Factors"?

A: Male factors can include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced), malformed sperm cells, and a genetic disease such as cystic fibrosis or a chromosomal abnormality.  Learn more

Q: What are examples of conditions categorized as "Female Infertility Factors"?

A:  Female infertility factors are many and can include ovulation disorders; blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis; and, congenital abnormalities involving the structure of the uterus and uterine fibroids. Learn more 

Q: Is in vitro fertilization (IVF) the only option for reproduction assistance?

A:  No. The majority of infertility conditions (85-90%) can be resolved with conventional therapies such as drug treatment and intrauterine insemination (IUI) or surgical repair of reproductive organs. For women who have blocked or absent fallopian tubes, or for men who have low sperm counts, in vitro fertilization (IVF) offers a chance at parenthood for couples who would otherwise have had no hope of having a "biologically related" child. IVF accounts for less than 5 percent of all infertility treatment in the United States.  

Q: Are multiple gestation pregnancies (twins, triplets and more) caused by in vitro fertilization (IVF)?

A:  Advances in reproductive medicine, such as ultrasound-guided embryo transfer, allow physicians to transfer the smallest number of embryos possible resulting in a lower risk of multiple births.

IVF New England's average singleton birth rate of 84.2% is nearly 15% higher than all other fertility treatment providers in the area, as published by the Society of Assisted Reproductive Technologies (SART). Consequently, IVF New England's IVF results, also reported by SART,  represent the lowest rate of multiple gestation births (twins, triplets, or more) among New England fertility centers.

Multiple embryo transfers not only increases the chance of becoming pregnant with more than one baby, but also dramatically increases the odds of prematurity, low birth weight, disability, and death for the infants, and risks of preeclampsia, diabetes, placental problems, caesarean section and other delivery complications for the mother.

IVF New England has been a leader in the field of single embryo transfers, and Medical Director, Samuel Pang, MD, leads the IVF New England physician team in strongly advocating for patient and offspring safety through single embryo transfer. 

Q: Can infertility be a problem for people under the age of 30?

A:  Ovarian reserve is one of the major causes of infertility in women. Statistics from the Centers for Disease Control (CDC) report the following in relation to age and infertility: 7% of married women are infertile by age 30; 11% have infertility issues by age 35; 33% by age 40; and, 87% at age 45. In addition, recent research indicates that men, too, may experience a decline in fertility with age.

“The drop in natural pregnancy rates is directly correlated to the effects of normal ovarian aging. As women age, their eggs become less fertile and chromosomal abnormalities may begin to appear,” says Dr. Isaac Glatstein, Associate Medical Director at IVF New England. “But the good news is that with the appropriate treatment, up to 80 percent of our patients will conceive.”  

Fertility Screening is recommended for women in their late 20s and 30s to assess ovarian reserves and determine if infertility challenges may exist now or in the future. This involves a simple questionaire, blood tests, and a consultation with one of our physicians to discuss the results.

For women who have particular conditions and a family history of pregancy issues, such as endometriosis, early menopause, trouble getting pregnant or low ovarian reserves, a fertility screening may identify fertility issues early enough to consider methods of fertility preservation, such as egg freezing, which would not be an option after ovarian reserves are too low or depleted. This early knowledge could mean the difference between future pregancy with your eggs or the need to consider donor eggs.

Q: Is egg freezing only useful for women with medical conditions like cancer?

A:  Not at all. Today many women want to delay pregnancy for various reasons such as their career, lack of a long-term partner, and a desire for independence. Egg freezing is an increasingly popular option for women under 37 years of age who want to preserve their future pregnancy potential. Prior to choosing egg freezing, fertility screening is a valuable tool to assess whether a woman may have pregnancy challenges now or in the future.

Q: If a woman or man has already conceived successfully, can they have trouble getting pregnant when they try for more children?

A:  Absolutely. According to the National Survey of Family Growth, more than one million couples experience “secondary infertility.”   A previously fertile partner may be trying to have a child with a new spouse, or one or both partners in an existing relationship may have developed fertility problems since their last child was conceived, such as endometriosis, which is one of the most frequent causes of secondary infertility in women, natural aging, irregular ovulation, or fallopian tube disease. Or, a man might have had a decline in the concentration or mobility of his sperm. Other factors can involve age (even one or two years can make a big difference in a woman's fertility cycle and a man's sperm count), scarring after childbirth, and hormonal changes which can affect ovulation and sperm production.

Q: Does infertility negatively affect marriages?

A: The majority of couples manage infertility challenges effectively. In the process, they can learn new ways of relating to each other, improve their understanding of different coping styles, and deepen their communication, which actually serves to improve their relationship.

At IVF New England, all our patients have free access to our highly qualified psychology team. IVF New England Psychologist comments on couples' communication

Q: How does body fat affect a women's ability to get pregnant?

A:  For women, body fat within normal range -- 20 to 24 BMI-- is very important in making sure that the reproductive system functions normally. If the body mass index (BMI), which is a measure of body fat, is too low or too high, it can adversely affect the ability to conceive. Women at particular risk include those with eating disorders, such as anorexia nervosa or bulimia, and women on a very low-calorie or restrictive diet. Strict vegetarians also may experience infertility problems due to a lack of important nutrients such as vitamin B-12, zinc, iron and folic acid. On the other hand, women with a BMI in the high 30s should consider loosing weight to increase their chances of a safe pregnancy.

Q: Is infertility psychologically based? Maybe people just need to relax and they'll get pregnant.

A: Infertility is a medical condition affecting the reproductive system. Stress can result from struggles with infertility, not cause it.

According to the American Society of Reproductive Medicine (ASRM), women under 34 should seek fertility help after attempting to become pregnant for 1 year, through unprotected sexual intercourse, without success. Women 35 years and older should seek fertility help after attempting to become pregnant for 6  months, And, women 39 years old and over should seek help after 3 months of trying to become pregnant without success.

Q: Do most people get pregnant very easily?

A:  It is estimated that infertility affects between 7 and 8 million people of childbearing age in the United States. This represents about 10% to 15% of the reproductive-age population, according to the Centers for Disease Control (CDC).

Q: Is it true that after a couple adopts a baby they usually get pregnant?

A: No. Studies reveal that the rate for achieving pregnancy after adopting is the same as for those who do not adopt.

Q: Some people believe that adoption is the only ethical solution to infertility: it's a lot cheaper and easier than medical treatment, and there are so many babies who need homes. Is this a valid assumption?

A: The biological urge to have children is quite strong.  Many people challenged by infertility are comforted by seeking treatment because they have options which very often enable them to overcome infertility and have children themselves. However, for some when they have exhausted their options, they are able to  consider adoption wholeheartedly and without any reservations or “what ifs”.  Also, in some instances adoption can be more costly and time-consuming than expected. It is, however, possible to choose to adopt and many former infertility patients go on to pursue this option for becoming parents.

Q: Is one's diet important when trying to conceive

A: Removing sugars from the diet, (e.g., caffeine, white flour, white sugar, white corn, white rice, etc.), may improve ovulation and regularity. Foods that are broken down quickly raise insulin levels too quickly and disrupt delicate hormonal values in the ovaries causing more testosterone to be produced, impairing egg quality and thus possibly lowering the chance of conception. In some women, high insulin levels may cause irregular ovulation, irregular periods, or polycystic ovarian syndrome (PCOS).

Q: Is it OK to exercise during fertility treatments? During pregnancy?

A:  The American College of Obstetricians and Gynecologists encourages pregnant women to engage in regular, moderate intensity physical activity to continue to derive the same associated health benefits during their pregnancies as they did prior to their pregnancies in the absence of pregnancy complications.  

Moderate intensity exercise refers to a level of exertion where the heart rate is raised to a level where one is working and breaking a sweat but is still able to carry on  a conversation. It is recommended to engage in moderate intensity activity for 30 minutes daily.

We recommend moderate activity exercise during fertility treatments with the following caveats:

Activity during fertility treatment cycles: Only low-impact, low to moderate intensity activity is advised to protect the ovaries from excessive movement which can lead to twisting or torsion. 

• Examples of acceptable activities include resistance training, group exercise (low options), swimming, yoga (no inversions), Pilates and spin (cycling) while staying seated.

• Examples of activities to avoid include running, high impact group fitness (kickboxing, high impact aerobics) elliptical and cross-fit. 

Activity following embryo transfer: 
Very little clinical data exist pertaining to the impact of physical activity following an embryo transfer. Nonetheless we recommend only low intensity, low impact exercise following embryo transfer until the pregnancy test is performed. Examples of acceptable activities includes yoga (avoid high-temperature yoga), Pilates, swimming, walking, leisurely cycling.

Activity following the pregnancy test: 
Following the pregnancy test (if negative or positive), slowly work back to the normal exercise routine and decrease activity if dizziness, pain or vaginal bleeding occurs.

Second trimester and beyond: 
We recommend avoiding activities with a risk for trauma or falling. Some examples include: horseback riding, gymnastics, downhill skiing, rollerblading, and ice hockey. SCUBA diving should be avoided throughout pregnancy. Exertion at altitudes >6000 feet may pose risk. 

Q: Can acupuncture be beneficial when dealing with infertility?

A: Studies comparing women who have acupuncture and women who don't, indicate it may enhance fertility. Many acupuncturists now specialize in fertility, and “our patients who have utilized acupuncture and other complementary methods may have benefited,” says Dr. Pang of IVF New England.

Q: Can taking two double-strength aspirin day help fertility?

A: High doses of aspirin can adversely impact ovulation. When in treatment, women who have a history of recurrent miscarriage due to certain conditions may be prescribed "baby "or low dose aspirin to reduce the risk of another miscarriage.

Q: Can Robitussin cough medicine help with conception?

A: For a long time, Robitussin was used by physicians and women alike to improve cervical mucus. However, in a randomized placebo controlled study, there was no difference in either cervical mucus quality or pregnancy rate with the use of Robitussin.

Q: Can sugar substitutes interfere with conception?

A: No data exists that has shown that overall usage of sugar substitutes is better than the possible negative effects of sugar. Natural sweeteners like fructose and stevia, maltitol and xylitol may be used in moderate amounts.

Q: Does the use of Cannabis (marijuana) negatively impact conception or healthy embryo development?

A: Smoking cannabis may lead to miscarriages or ectopic pregnancies, according to University of Nashville research published in the Journal of Clinical Investigation. Vanderbilt University researchers in Nashville, Tennessee, have also found that cannabis can trigger inadequate chemical levels that prevent normal embryo development, transport into the uterus and implantation. “Unquestionably, marijuana use in both men and women should be eliminated if they desire to conceive,” says Dr. Isaac Glatstein of IVF New England.