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Not being able to get pregnant is widely recognised as one of the most difficult situations a couple can face and the many myths and old wives' tales surrounding the subject can simply add to the stress involved.
Everywhere you turn there's advice on what you should or shouldn't be doing, and 'helpful' acquaintances or relatives dish up well-meaning but misguided comments of the 'my friend was trying for years and then she went on a macrobiotic diet/ did it upside down/ went on a tropical holiday and got pregnant straight away' variety.
Here we try to cut through the confusion with 10 common myths and realities relating to conception.
1. 'There's always an obvious reason why a couple can't conceive.'
FALSE
Whilst there must be a cause of one sort or another, even after medical investigations, doctors don't find a clear physical explanation, such as blocked tubes or poor sperm quality, in as many as a third of couples with fertility issues.
So-called 'unexplained infertility' can be especially frustrating. However, most people with this do conceive in time, albeit they might need help. For those who end up undergoing IVF treatment, sometimes the process uncovers an explanation, such as poor fertilisation rates.
2. 'People with poor diets the world over manage to get pregnant so what I eat or drink shouldn't make a difference.'
FALSE
Eating a balanced diet with lots of fruit and vegetables is always the healthiest way to live and will of course help you get into tip top condition for that longed-for pregnancy, when it hopefully does happen.
A recently-released study also showed that multivitamins can make a difference to conception. Although the number of women in this study was relatively small, it won't do you any harm to take a supplement, although do choose one designed for pre-conception use, as this will have lowered levels of vitamin A, in case you do get pregnant. Remember too that taking a multi-vitamin doesn't give you a get out clause for having a decent diet!
When attempting to conceive, it's worth avoiding excessive amounts of alcohol and caffeine, as both have been linked with fertility issues. This applies to men as much as women, and whilst the odd beer, wine or espresso now and then won't prevent you becoming parents, if you want to maximise your chances, you might both have to hold off on big boozy nights and caffeine fixes for now.
3. 'You might not be getting pregnant because you're overweight/ underweight.'
TRUE
Sigridur Gudmundsdottir, of the Norwegian University of Science and Technology, who has studied the effects of exercise and weight on fertility, explains that "with women who are obese, reduced fertility is often observed and weight loss produced by physical activity and responsible nutrition may lead to increased likelihood of conceiving."
Being under-weight can be just as much of a problem when it comes to getting pregnant - women at both ends of the scale are less likely to ovulate regularly, which cuts down their chances of conception. In extreme cases if you don't ovulate at all, natural conception obviously becomes impossible.
Check the chart here to see if you need to lose or gain weight and visit your GP if you think this could be an issue for you.
4. 'If you've had one baby, you shouldn't have any problems having another.'
FALSE
So-called 'secondary infertility' is very common (up to a fifth of parents are said to find it hard to conceive second or subsequent times around) but also rather confusing, as many people assume that you've had one baby so you must be able to have another.
There are a variety of reasons why this can happen – you are probably older now which might mean less fertile, it could have been that last time you were lucky if you have sub-fertility (i.e. you are fertile but your chances of success in any given month are fairly low), or you have developed a condition since the last time you tried to conceive and this is stopping you getting pregnant.
As with primary fertility, you should consult your GP after a year of trying to get pregnant and failing (sooner if you are over 35).
5. 'You need to cut down on exercise or you'll never have a baby.'
IT DEPENDS
There's definitely no need to retreat to the sofa and put your feet up if you're embarking on a quest to see a thin blue line on a pregnancy test.
Sigridur Gudmundsdottir advises: "Most women will benefit from regular exercise when trying to conceive. Physical activity has multiple positive effects on the hormonal system and general well-being that may increase the odds of conception."
However she warns: "There have been indications of reduced fertility among women who exercise very intensively, particularly if their energy intake is restricted, and / or if there is extremely high mental pressure associated with their training. Irregular, very short or very long menstrual cycles may be a sign of reduced fertility in these women.
If your exercise programme includes very high frequency and intensity and long duration of each session and you are trying to conceive, I would recommend that you pay particular attention to your eating and resting habits."
She adds: "Otherwise, you're looking at 30 minutes of at least moderate intensity activity most days of the week. For the majority of women it will probably increase their likelihood of a successful pregnancy and childbirth."
5. 'Acupuncture will increase your chances of conception.'
POSSIBLY TRUE
By all means give it a try via a reputable practitioner who specialises in fertility but don't delay seeking the advice of your GP, especially if you are already into your 30s. If there is a physical problem, such as blocked tubes, acupuncture won't help with this and delaying investigations could effect your chances of conceiving.
The British Acupuncture Council's website has more information and lists practitioners.
6. 'Which position you have intercourse in matters when trying to conceive.'
FALSE
Old wives' tales abound about this. Some people think the missionary position is most effective for getting sperm through the cervix, but really, there's no evidence that this, or any other position, makes a difference.
'When' rather than 'how' is more important to achieving your goal of a positive pregnancy test – timing intercourse around when you ovulate can make a big difference (although it might also take the romance out of your encounters!)
Ovulation prediction kits sold in chemists will make it easier to pinpoint when the right days of the month will be.
Lying down for a short while after you've had intercourse was shown to improve pregnancy rate in a study of couples having intra-uterine insemination. So if you've got the time it can't hurt to stay horizontal afterwards for 10 or 15 minutes.
7. 'If you start the adoption process/go on holiday, I bet you'd get pregnant - that's what happened to my friend.'
FALSE
Anyone whose life has been touched by infertility will probably have heard stories of someone's friend/ distant cousin who adopted and then suddenly got pregnant after years of trying. This then gets turned into advice that doing whatever will answer all your problems. If only all of this were as easy as booking a tropical holiday!
The fact is that statistically, yes a few couples out there will conceive after starting the adoption process/ taking time out from trying hard to get pregnant, but they would have done so regardless and it is nothing to do with relaxing or stopping worrying about their fertility problems. Nor could this sort of thing possibly solve some of the physical issues, such as blocked tubes, which could be preventing pregnancy.
8. 'Having saunas/using hot tubs could stop you having a baby.'
TRUE
There's no evidence that either will get in the way of seeing a positive pregnancy test but hot tub use has been associated with higher rates of early miscarriage and also birth defects in those who are pregnant. This is because of the rise in body temperature they cause.
Given you could succeed in conceiving but not know for a couple of weeks, it's probably prudent to avoid both hot tubs and saunas just in case. Hot baths are less of an issue as the water temperature drops fairly quickly, so your body won't stay as hot for a sustained period.
There's also some evidence that men should avoid saunas and hot tubs when trying to conceive as they might hamper sperm production.
9. 'You need to stop getting so stressed as that might be the issue.'
FALSE
Evidence suggests that, contrary to common belief, stress does not affect conception. It wouldn't hurt to try and cut down anxiety if possible anyway though, as this will help you cope more positively with the ups and downs of infertility.
Ideas for ways to make you feel more relaxed include yoga, meditation, deep breathing exercises, and physical exercise.
10. 'If you can't conceive naturally/without help, your only option is IVF treatment.'
FALSE
This is not necessarily the case. Before couples go down this route, fertility specialists will often try less invasive, and indeed less expensive, ways to help couples achieve their goal. This could include the medication clomiphene, which triggers ovulation, lifestyle changes or Intra-ulterine Insemination.
IVF is a last resort in younger couples and is very expensive but there is some NHS funding for those who qualify.
For more information and support about infertility see Infertility Network UK
or the HFEA's website.