Chapter 37
Myths and Misconceptions
from the book How to Have a Baby:
Overcoming Infertility
by Dr. Aniruddha Malpani, MD and Dr. Anjali Malpani, MD.
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Myth: Painful periods cause infertility.
Fact: Painful periods do not affect fertility. In fact, for most
patients, regular painful periods usually signal ovulatory cycles. However,
progressively worsening pain during periods ( especially when this is
accompanied by pain during sex) may mean you have endometriosis.
Myth: Infrequent periods cause infertility.
Fact: As long as the periods are regular, this means ovulation in
occurring. Some normal women have menstrual cycle lengths of as long as 40 days.
Of course, since they have fewer cycles every year, the number of times they are
"fertile" in a year is decreased. Also, they need to monitor their
fertile period more closely, since this is delayed ( as compared to women with a
30 day cycle).
Myth: Blood group "incompatibility" between husband and wife
can cause infertility.
Fact: There is no relation between blood groups and fertility.
Myth: The reason I'm not getting pregnant is because most of the sperm
leaks out of the vagina after intercourse .
Fact: Loss of seminal fluid after intercourse is perfectly normal, and
most women notice some discharge immediately after sex. Many infertile couples
imagine that this is the cause of their problem. If your husband had his climax
inside you, then you can be sure that no matter how much fluid you lose
afterwards, enough sperm will reach the cervical mucus. This discharge is not a
cause of infertility.
Myth: If you work at it and want it enough, you'll get pregnant.
Fact: Unlike many other parts of your lives, infertility may be beyond
your control. While newer methods of treatment have improved most couples'
chances of having a baby, some problems are still unsolvable.
Myth: Just pray and have faith.
Fact: Believing in God can help you to maintain a positive outlook -
but sheer will and blind faith won't overcome a physical problem like blocked
tubes or absent sperms.
Myth: A man can judge his fertility by the thickness and volume of his
semen.
Fact: Semen consists mainly of seminal fluid, secreted by these minal
vesicles and the prostate. The volume and consistency of the semen is not
related to its fertility potential, which depends upon the sperm count. This can
only be assessed by microscopic examination.
Myth: Infertility is hereditary.
Fact: If your mother , grandmother or sister have had difficulty
becoming pregnant, this does not necessarily mean you will have the same problem
! Most infertility problems are not hereditary, and you need a complete
evaluation.
Myth: A retroverted ( "tipped") uterus causes infertility
because the semen cannot swim into the cervix.
Fact: About one in five women will have a retroverted uterus. If the
uterus is freely mobile, this is normal, and is not a cause of infertility. This
is not an indication for surgery !
Myth: We should be having intercourse every day to achieve pregnancy.
Fact: Sperm remain alive and active in woman's cervical mucus for
48-72 hours following sexual intercourse; therefore, it isn't necessary to plan
your lovemaking on a rigid schedule. Although having sexual intercourse near the
time of ovulation is important, no single day is critical. So, don't be
concerned if intercourse is not possible or practical on the day of ovulation.
Myth: A woman ovulates from the left ovary one month and the right
ovary the next month.
Fact: Only one ovary actually ovulates each month. However, the
pattern may not be regular from side to side.
Myth: Pillows under the hips during and after intercourse enhance
fertility.
Fact: Sperm are already swimming in cervical mucus as sexual
intercourse is completed and will continue to travel up the cervix to the
fallopian tube for the next 48 to 72 hours. The position of the hips really
doesn't matter.
Myth: If you just relax, you'll get pregnant.
Fact: If pregnancy has not occurred after a year, chances are there is
a medical condition causing infertility. There is no evidence that stress causes
infertility. Remember, all infertile patients are under stress - it's not the
stress which causes infertiliity, it's the infertility which causes the stress !
Myth: Periods that occur less than or greater than 28-day intervals
are irregular.
Fact: A woman's period will often vary from month to month. As long as
a woman can count on a period at a regular interval every month, this is normal.
Myth: I've never had symptoms of a pelvic infection, so I can't have
blocked tubes.
Fact: Many pelvic infections have no symptoms at all, but can cause
damage, sometimes irreversible, to tubes.
Myth: My gynecologist has done an internal examination and said I am
normal; therefore I should have no problem getting pregnant.
Fact: A routine gynecological examination does not provide information
about possible problems which can cause infertility.
Myth: If a woman takes fertility drugs, she'll have a multiple birth.
Fact: Although fertility drugs do increase the chance of having a
multiple pregnancy ( because they stimulate the ovaries to produce several eggs)
the majority of women taking them have singleton births.
Myth: A man's sperm count will be the same each time it is examined.
Fact: A man's sperm count will vary. Sperm number and motility can be
affected by time between ejaculations, illness, and medications.
Myth: I have no problems having sex. Since I am virile, my sperm count
must be normal.
Fact: There is no correlation between male fertility and virility. Men
with totally normal sex drives may have no sperms at all.
Myth: All physicians are equally interested in the treatment of
infertility.
Fact: Not all physicians or even all infertility centers have similar
interests. It is important for you to ask your physician about the available
treatment he/she can offer you and what are the pregnancy results following such
treatment in his/her practice.
Myth: Infertility treatment should not be offered in India, because
there are too many babies in this country already . Why exacerbate the
population problem by producing more ?
Fact: The right to have children is a fundamental right of every human
being and a very basic biologic urge. Just because a neighbour has too many
children should not deprive the infertile couple of their right to have their
own.
Myth: Azoospermia ( no sperms) is a result of excessive masturbation
in childhood.
Fact: Masturbation is a normal activity which most boys and men
indulge in. It does not affect the sperm count. You cannot "run" out
of sperms, because these are constantly being produced in the testes.
Myth: It must be the couple's fault if they are infertile.
Fact: Infertility carries a major social stigma - and this
"victim-blaming" is very common, partly because most people know so
little about their own fertility.
Myth: Infertility is not a medical illness and treatment should not be
covered by insurance.
Fact Infertility is a medical problem, which is often amenable to medical
treatment. Insurance should cover the treatment costs.
Myth: IVF is too expensive for India to be able to afford.
Fact: IVF and related technologies are undoubtedly expensive - but
then, so is heart surgery. Yet, no one objects when over Rs 1 lakh are spent to
try to salvage the heart of a 70 year old man (whose life expectancy in any case
is only about 5 years and is not extended by the surgery). Why then should
medical technology not be used to help couples in their thirties (with their
whole lives ahead of them) have their own baby ? In fact, IVF is a much more
cost-effective use of medical resources than a number of other accepted surgical
procedures (such as joint replacement surgery or kidney transplants).
by Dr. Aniruddha Malpani, MD and Dr. Anjali Malpani, MD.
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