TRYING TO GET PREGNANT: 14 FERTILITY MYTHS DEBUNKED

Posted in Health by woman2womenblog

We live in the era of informatics. Knowledge is easily accessible to us: we can learn virtually anything by just googling it. But paradoxically too much information many times leads to misinformation.

When it comes to fertility issues, there is a lot of disinformation going around. Therefore, it is no surprising what a recent survey showed: knowledge regarding ovulation, fertility, and conception issues is limited among women, and many tend to believe certain myths and misconceptions.

These are 14 fertility myths most people believe, but that science has debunked:

MYTH #1. Maternity wise, 40s is the new 30s

Our life expectancy is longer, and we tend to postpone maternity due to career or study purposes. From that aspect, the 40s can be easily regarded as the new 30s. Unfortunately, this is not true for our ovaries: by the age of 30, a healthy woman has about a 20% chance of conceiving each month, by the time she reaches 40 her odds drop to about 5%.

This is one of the most commonly believed misconceptions: unaware of the age-related fertility decline, many women start seeking help to conceive in their 40s, when they may have already missed the opportunity to become parents.

You should be aware that there is a biological clock, and it’s ticking! If for personal reasons you cannot have a child right now, you may freeze your eggs to use them in the future.

MYTH #2. Certain sex positions increase the chances of getting pregnant

You will find plenty of (mis)information on this topic! In general, it is said that the best positions for getting pregnant are the missionary position (the woman lying on her back, her partner on top) and the “doggy position” (rear vaginal penetration, with the woman on her hands and knees) because they provide the deepest penetration, allowing the man to ejaculate closer to the opening of the cervix.

In fact, there’s no scientific evidence to prove that. This belief is largely based on a single study that looked at the position of the penis in relation to these two sex positions, but it didn’t address pregnancy chances at all.

Therefore, no position seems to be better when it comes to maximizing your chances of making a baby. Sperm can be found in the cervical canal just a few seconds after ejaculation, and within 5 minutes in the tube, regardless of the coital position.

MYTH #3. Lifting your legs in the air for 20 minutes after having sex will help you get pregnant

You have probably heard this one: “lie in bed with your feet in the air after having sex to increase your chances of getting pregnant”. In fact, this is not (totally) true. You may lay in bed for 10-15 minutes after intercourse, as by this time the sperm have largely reached the cervix, and many may even be inside the tube.

In fact, a new study challenged both beliefs: women having artificial insemination were split into two groups – one that rested on their back with their knees raised for 15 minutes after the procedure and one that got up immediately. It turned out that, after several courses of treatment, 32% of the immobile group fell pregnant, compared with 40% per cent in the active group.

Therefore, there is no need to put pillows under your bottom during intercourse to get an advantageous tilt, or to perform cycling motions with your feet in the air.

MYTH #4. If we have sex every day the sperm becomes too weak, reducing our chances of getting pregnant

How often should we make love to boost our chances of pregnancy? You will find all sorts of advice on the web: every other day, 3 times a week, every single day! Which one is correct?

One thing is clear: abstinence intervals greater than 5 days impair the sperm number and quality. Nevertheless, there is not much difference whether men ejaculate every day or every other day. Most fertility specialists used to recommend intercourse every other day, as this would increase sperm quality, particularly in men with lower sperm counts (oligozoospermia). However, recent studies show exactly the opposite: oligozoospermic men had better semen quality with daily ejaculation!

Recent scientific evidence suggests that making love every day confers a slight advantage: the highest chances of pregnancy (37% per cycle) were associated with daily intercourse, although sex on alternate days had comparable pregnancy rates (33%). On the other hand, we should keep in mind that the “obligation” to have sex every day may induce unnecessary stress to the couple, resulting in lack of sexual desire, low self esteem, and ultimately reduced frequency of intercourse.

Therefore, reproductive efficiency is highest when you have sex every day or every other day. The optimal frequency, though, is best defined by each couple’s own preference.

MYTH # 5. We only have sex when I ovulate, on day 14 of my cycle

Ovulation (when the egg drops from the ovary into the tubes) occurs once a month, usually between day 11 and day 21 of the cycle (measured from the first day of your period).

Each woman ovulates on her own schedule. While it is usually said that a woman with a 28-day cycle ovulates on cycle day 14, that’s not necessarily true: a study found that fewer than 10 percent of women with regular, 28-day cycles were ovulating on day 14.

We know that sperm cells are able to survive in the reproductive tract of a woman for about 5 days, and that once the egg is released, it will die in about 12-24 hours. Therefore, the fertile period -or “fertile window”- is a 6-day interval ending on the day of ovulation.

To boost your odds to become pregnant, have sex before and during ovulation, every day or every other day. If your cycles are irregular and you cannot figure out your fertile days, you may use an ovulation predictor kit, or otherwise visit a specialist, who can help you find your fertile window.

MYTH # 6. Smoking doesn’t affect our chances of getting pregnant. I will quit smoking as soon as I get pregnant

You are most likely aware that smoking during pregnancy is dangerous, as it can lead to miscarriage, premature birth, low-birthweight babies and -according to recent studies– congenital malformations.

But you should also know that smoking is harmful for your fertility: smoking as few as five cigarettes per day is associated with reduced fertility, both in women and men, and this seems to be true even for secondhand smoking. It has been estimated that smokers may have a 10-40% lower monthly fecundity (fertility) rate, and that up to 13% of infertility is due to smoking.

Smoking can affect ovulation, as well as the ability of the fertilized egg to implant in the uterus. The effect of tobacco is so harmful for the ovaries that menopause occurs, on average, one to four years earlier in smoking women than in nonsmoking ones.

Men are also affected by tobacco: decreases in sperm density, motility, and abnormalities in sperm morphology have been observed in men who smoke, which impact a man’s ability to fertilize an egg.

Therefore, before trying for a baby, do yourself a favor … and put out the cigarette for good!

MYTH # 7. You don’t need to worry about your age. There’s always IVF

Another common misconception! Many women believe that, if age-related infertility strikes, they can overcome their problem by getting treated with in vitro fertilization (IVF). In fact, just as natural fertility declines with age, success rates with IVF also decline as a woman gets older.

According to the USA Center for Disease Control and Prevention (CDC), women younger than 35 years old have 33% chances of having a baby after IVF; for women ages 38 to 40 the success rate drops to 17%, while those 43 to 44 years old have only 3% chances of giving birth after IVF (using their own eggs).

IVF is not a guarantee to have a baby, and does not extend a woman’s reproductive life. Despite the number of celebrities having babies in their mid-40s and beyond, they may have not necessarily used their own eggs. While every woman has the right to keep her privacy, there is a wrong perception left that fertility treatments can extend a woman’s fertility span. There is a very low probability of improving success of conceiving after age 43 by using assisted reproduction using your own eggs. Nevertheless, you may opt to use oocyte donation (eggs of a younger woman) if age-related infertility stands in the way of parenthood.

MYTH # 8. A woman can’t get pregnant if she doesn’t have an orgasm

For men, things are clear: no orgasm, no pregnancy, as ejaculation occurs during orgasm. Well, that’s not entirely true: semen can be released during intercourse prior to orgasm in the so-called pre-ejaculation fluid, or pre-come (read more here).

For women though, getting pregnant has nothing to do with an orgasm. But could female orgasm improve the chances for conception? The answer is not clear.

Researchers have wondered for years about the purpose of female orgasm, and many theories have been proposed:

Just the pleasure it provokes, so that women want to reproduce and preserve the species!
The “poleaxe” hypothesis: orgasms make women feel relaxed and sleepy so that they will lie down after sex and the sperm reach their destination more easily.
The “upsuck” theory: the contractions of the uterus “suck up” the sperm released in the vagina and help them travel through the uterus to the tubes.
Pair bonding: the hormones produced during orgasm (such as oxytocin and prolactin) contribute to warm feelings towards her partner.

Orgasms are not necessary to get pregnant, but there are plenty of good reasons to have one! Nevertheless, it is not uncommon that women trying to conceive link the desire for an orgasm with their desire to have a baby; this leads to psychological pressure and difficulty achieving orgasm, adding frustration to a process that is supposed to be pleasurable…

Try not to consider the orgasm just as goal to get pregnant. Enjoy the intimate time with your partner, without any pressure. If you have an orgasm, great. If not, that’s fine, too!

MYTH #9. We’ve already had one child, so conceiving again will be easy

Perhaps, but it’s no guarantee. Many individuals experience secondary infertility, or difficulty conceiving a second or subsequent child.

Secondary infertility may be caused by age-related factors, both for you and your partner. Sometimes, a new underlying medical condition develops. Eventually, a fertility issue that always existed gets worse; while it didn’t prevent pregnancy before, now it has become a problem. A previous pregnancy may actually be the reason you don’t get pregnant again: surgical complications or infection after childbirth may have provoked scarring, which may in turn led to infertility.

Things change with time. Even if you got easily pregnant on your own before, if you’re struggling to have another child talk to your doctor, who can advice you on the next steps to follow.

MYTH #10. Infertility is a woman’s issue

Typically, the causes of infertility break down like this:

Approximately one third of the couples struggle with male infertility;
In another third, the problem is female infertility;
The remaining third will either face both male and female fertility issues, or a cause will never be found (unexplained infertility).

Common causes of female infertily are: age, PCOS (polycystic ovary syndrome), tubal or pelvic issues, endometriosis, and family history.

Common causes of male infertility tend to be from prior surgery, infection, or a problem present at birth.

As part of the preliminary work-up to determine the cause and treatment of infertility, both women and men will need to undergo clinical and specialized complementary exams.

MYTH #11. Men’s age doesn’t matter

While some men can father children into their 50’s or 60’s, men’s fertility isn’t age-proof: it starts declining in their 40s, although less drastically as compared to women’s fertility.

As a man ages, the concentration of mobile, healthy sperm and semen volume overall will decrease. It is clear now that men over the age of 40 have higher chances of having children with chromosomal abnormalities, causing miscarriages in their female partners. Moreover, researchers have found a direct link between paternal age and an increased risk of autism and schizophrenia.

A man’s age does matter. While men may not have a complete drop off in fertility like women do, “advanced paternal age” is something couples should be aware of. Men’s biological clock is also ticking!

MYTH #12. If I take good care of my general health, my fertility will be in check too

Whereas a healthy body and mind may boost fertility in certain cases, most infertility situations cannot be resolved by a lifestyle or diet change, particularly those related to age.

It is a common belief that certain diet types can help you get pregnant. There is no evidence that vegetarian diets, low-fat diets, antioxidant- or vitamin-enriched diets will increase your chances of having a child.

A woman’s weight plays a role in fertility: those who are either very thin or obese may find it hard to conceive. If you are trying to get pregnant, learn more about some lifestyle tips to boost your chances of getting pregnant here.

MYTH #13. If a man can ejaculate, his fertility is fine

Many myths surround male fertility and their sexual performance. It is a common (and unfortunate) myth that if a man’s fertility is compromised, this means his sexual performance is the problem. This is not true. Problems with sperm count, shape, and movement are the primary causes of male infertility.

Another common myth is that you can tell there is a problem with the sperm just by looking at the semen. In fact, even men that have no sperm cells at all (azoospermia) usually have normal-looking semen.

For the vast majority of men with infertility, there are no visible or obvious signs that anything is wrong. Healthy erectile function and normal ejaculation are not guarantee that the sperm is in good shape.

That said, erectile dysfunction can be a possible symptom of infertility; it may due to low testosterone levels or a physical injury. Difficulty with ejaculation can also be a signal certain medical problems. But these are uncommon signs of male infertility.

If you are struggling to get pregnant, have your partner check in with his doctor. A semen analysis will help clarify whether his sperm are fit for conception.

MYTH #14. The birth control pill will affect your future fertility

All scientific evidence agrees that hormonal contraceptives do not make women sterile. Moreover, they may confer increased likelihood of pregnancy with long-term use, and in certain cases they can also preserve fertility. Read more on the contraceptive pill here.

To summarize:

Myths and misconceptions regarding fertility and conception are, unfortunately, widely disseminated. This is a serious problem, as misinformation may lead not only to unnecessary stress, but also to take wrong decisions…

Get yourself well informed! Consult your gynecologist, who can help you with any concerns you have. Your doctor can also give you some tips on lifestyle changes to optimize your fertility, prescribe some exams, and tell you when to come back if you don’t achieve pregnancy on your own.

Last, a good piece of advice: if you want to get pregnant, have lots of sex – as much as you want, whenever you want – and enjoy it! After you have had sex, do whatever you want – just don’t smoke 😉

Photo credits

Intro: pixabay.com; 1: rma-fl.com; 2: motherandbaby.co.uk; 3: romper.com; 4: pixabay.com; 5: wsaw.com; 6: babycenter.com; 7: nexter.org; 8: irishtimes.com; 9: health.clevelandclinic.org; 10: thefertilechickonline.com; 11: businessinsider.com; 12: hayatouki.com; 13: livescience.com; 14: pinterest.com

18Mar2015

BREAST CANCER RISK: 12 COMMON MISCONCEPTIONS AND CONTROVERSIES

Posted in Health by woman2womenblog

Embed from Getty ImagesBreast cancer is, without any doubt, women’s most feared cancer. In spite of increased awareness through women’s education, campaigns for its early detection and extensive research, some misconceptions persist and many issues are still a subject or debate, even among doctors and scientific organisations.

In this article we will analyse some common misperceptions women have about breast cancer risk. Many of them are myths, others are somewhat controversial…

1. NO ONE IN MY FAMILY HAS HAD BREAST CANCER, SO I AM NOT AT RISK

You are at increased risk of breast cancer if you have a family history, but of all breast cancers, only 5 to 10% are hereditary.

If you have one first-degree female relative (mother, sister or daughter) with breast cancer, then your risk is doubled; with two first-degree relatives, your risk of breast cancer is 5 times higher. If your affected relative is a male (yes, men do get breast cancer, but is very rare), your risk of getting breast cancer is higher. The same seems to be true for having a female relative with breast cancer from your paternal side (e.g. an aunt or your grandmother).

Most (but not all) hereditary breast cancers are caused by a defective gene passed from mother to child, the best known of which are BRCA1 and BRCA2. If you have a family history of breast cancer, you may discuss with your doctor whether you should be checked, what being positive means and what you can do about it. As a rough estimation, while an average woman has about 12% risk of developing breast cancer in her lifetime (that is, of 100 women, 12 will develop breast cancer at some point in their lives), a woman with a gene defect may have 45 to 80% risk (4 to 8 out of 10 women with a gene defect will get breast cancer), according to the gene involved.

2. ANTIPERSPIRANTS CAUSE BREAST CANCER

Some research in the past had suggested that antiperspirants are linked to breast cancer because parabens contained in these products were found in the tissue removed from breast cancer patients. These findings were not confirmed by other studies, and the fact that parabens were found there does not mean that they are the cause of breast cancer.

Aluminum contained in antiperspirants has also been suggested as a possible cancer- causing agent. But this has not been proved by any study.

Another claim is that antiperspirants allow a toxin build-up by blocking the sweat glands. This is another misconception, as toxins are cleared by lymph nodes and not by the sweat glands.

Well-designed epidemiological studies on this issue found no link between breast cancer risk and antiperspirant use, deodorant use, or underarm shaving.

3. UNDERWIRED BRAS CAUSE BREAST CANCER

It has been suggested (mostly by e-mail and internet rumors) that bras, especially those underwired, may cause breast cancer by obstructing the breasts’ lymphatic flow, which is in charge of clearing different toxins that may be present in the breasts. Several studies have been conducted to address this issue, none of them confirmed these fears.

4. I DON’T GET MAMMOGRAMS BECAUSE THEY CAUSE CANCER

Mammograms do involve radiation exposure, but the dose utilised is extremely low. With a newer type called digital mammogram, the radiation exposure is even lower. Controversy exists as to whether this low radiation dose is enough to increase breast cancer risk, and experts opinions are divided.

Some evidence indicates that mammograms might increase the risk of breast cancer in women starting yearly before the age of 35. This is of particular concern when a defective gene (BRCA mutation) is present, since these women are usually advised to start yearly mammograms at young age, and they are the ones that may eventually be more susceptible to the harmful effects of radiation.

For most of the women though, the benefits of mammograms largely outweigh their possible risks.

5. I DON’T GET MAMMOGRAMS BECAUSE THEY DON’T HELP

This is another controversial issue that has fuelled endless discussions among experts. Regular mammograms do not prevent or reduce breast cancer. They just detect breast cancer that already exists, but an earlier stage, thus reducing deaths among breast cancer patients by about 17% if done every two years, by 20% if done annually. Other studies have found a 30% reduction in mortality. In addition, since cancers are found earlier, less mastectomies are needed, and most of the women can be treated conservatively (just removing the lump).

These figures mean that thousands of women get to live thanks to mammograms. However, some experts believe that the reduction in mortality mammograms offer is “modest”, which led to intense confusion and disagreement as to whether mammograms are worth doing, and how often they should be done. Mammogram opponents also state that the exam has a considerable false positives rate (that is, it suggests malignancy when something is benign), leading to unneeded breast biopsies, increased health costs and extra anxiety.

6. BREAST IMPLANTS CAUSE BREAST CANCER

Many studies have been conducted on this subject; breast implants do not seem to increase breast cancer risk. The main problem with implants is an impaired detection of breast cancer since they may yield mammograms and ultrasounds more difficult to perform and interpret.

A very rare type of lymphoma called anaplastic large cell lymphoma might be linked to breast implants. Since this tumor is so uncommon, is very difficult to prove an implant causative role.

A faulty French implant (PIP) was linked to increased risk of breast cancer, leading to massive implant removals.

7. I BREASTFED MY CHILDREN, SO I WON’T GET BREAST CANCER

The protective effect of breastfeeding is modest at best, and seems to be true mostly for women who breastfed (each child) for more than 1 1/2 to 2 years. Breastfeeding has many benefits, both for the mother and the baby, but its protection against breast cancer is doubtful.

8. I AM YOUNGER THAN 40, I’M NOT AT RISK FOR BREAST CANCER

Breast cancer does occur in younger women. Of all cases of breast cancer, about 7% are diagnosed in young women below the age of 40; furthermore, breast cancer is the most common cancer diagnosed in this age group. Several studies show that this age population tends to have more aggressive cancer types. Family history and genetic mutations account for increased risks of breast cancer in premenopausal women. Other possible factor that may increase risk are long-term use of oral contraceptives and high animal fat diet consumption. Although mammogram is not recommended in this age population unless there is a family history, an annual breast examination is strongly encouraged.

9. I AM OLDER THAN 70, I DON’T NEED MAMMOGRAMS ANYMORE

Breast cancer incidence is strongly related to age; the older a woman is, the higher her breast cancer risk becomes.

In the UK, an average of 80% of breast cancer cases are diagnosed in women over 50s, and around a quarter (24%) are diagnosed in women aged 75 and over. Breast cancers diagnosed in this age population though, tend to be less aggressive. Controversy also exists as to when to stop doing mammograms. In the UK, women in this age group are invited for mammogram every three years; in the USA most experts consider that there is no upper age limit for mammogram as many studies show that even older women benefit from it.

10. I HAVE FAMILY HISTORY OF BREAST CANCER; I CAN’T DO ANYTHING TO DECREASE MY RISK

Just because someone in your family had breast cancer doesn’t mean you will get it. Genetic testing can help you understand your inherited risk and allow you to make choices about your future care. Some studies have shown that a low-fat diet, physical activity and cutting down on alcohol consumption seem to reduce breast cancer risk.

If you are at high risk for breast cancer you will need to do breast examinations and other tests such as mammogram, breast ultrasound and eventually magnetic resonance imaging (MRI) more often; these exams may help you find cancer at a much earlier stage.

A drug called tamoxifen may reduce the risk of breast cancer in certain high-risk women, although more research is needed to precise which women will benefit from this treatment. A lot has been said lately about prophylactic double mastectomy. This is indeed a viable option for women with a very high risk, as it can reduce the incidence of breast cancer by more than 90%, usually with excellent cosmetic results.

11. I HAVE SMALL BREASTS, THEREFORE I HAVE SMALL RISK OF BREAST CANCER

It has been long said that there’s no connection between breast size and risk of getting breast cancer. But some recent studies have challenged this old perception: women with very large breasts, besides being harder to examine, do seem to have increased breast cancer risk.

This doesn’t mean that women with small breasts are safe; all women with any breast size should undergo breast cancer screening.

12. I HAVE DENSE BREASTS, SO I HAVE HIGHER CHANCES OF HAVING BREAST CANCER

Breasts are made up of fatty, fibrous and glandular tissue. Dense breasts (as seen on a mammogram) have more glandular and fibrous tissue and less fatty tissue.

It is controversial whether breast density is an independent cancer risk factor, but most studies agree that women with dense breasts have 1,2 to 6 times higher breast cancer risk than women with average density. What is clear is that dense breasts make cancer detection more difficult. A number of factors can affect breast density, such as age, menopausal status, certain medications (including menopausal hormone therapy), pregnancy, and genetics.

If you are interested in learning more about breast cancer risk, you may check this article of the American Cancer Society here

Additional bibliography

Mandelblatt JS, et al. Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms. Ann Intern Med. 2009 Nov 17;151(10):738-47.

When to Get a Screening Mammogram. Web MD

Poly Implant Prothèse. Wikipedia.org

Hussein A, et al. Epidemiology and prognosis of breast cancer in young women. J Thorac Dis 2013;5(S1):S2-S8.

Breast Cancer Risk in American Women. National Cancer Institute

Breast cancer incidence statistics. Cancer Research UK

No Upper Age Limit for Mammograms: Women 80 and Older Benefit. Breast Cancer.org

Eriksson N, et al. Genetic variants associated with breast size also influence breast cancer risk. BMC Medical Genetics 2012, 13:53

Breast Density and Cancer Risk: What Is the Relationship? JNCI J Natl Cancer Inst, 2000, Volume 92, Issue 6, Pp. 443

Photo Credits