Fertility Patient’s Top 10 Questions Answered

We’re listening! We get questions and hear myths from our patients all the time. In this first installment, reproductive specialists and nurses at the Mass General Fertility Center answer the top 10 questions and bust the myths we hear most often.

1. What’s the ideal age to freeze eggs?

This is highly variable depending on each person’s unique situation. However, what we know about egg quality and ovarian reserve (how many eggs a person has) can help guide decision-making for elective egg freezing. A person is most likely to have a good number of healthy, retrievable eggs that could eventually develop into a pregnancy when they are under 35 years of age. It can become more difficult once someone is 40 years of age or older. It does not mean it is not possible, but eggs may not be as healthy, and a higher number of eggs will be needed for a higher likelihood of a successful pregnancy.

It can be helpful to think of egg freezing as an insurance policy. You want to have the best outcome possible if you ever need to use them. We encourage you to consider your age with your future family-building plans. If you have more specific questions, please reach out to reschedule a consultation to talk more about your individual situation.

2. How long can eggs and embryos be frozen?

That exact information is not yet known for eggs due to this technology still being relatively “new.” Egg freezing was still considered experimental until only about 10 years ago. Based on small numbers from emerging research, it is likely they can remain cryopreserved (frozen) for many years–until you are ready to use them.

Embryos can be frozen for as long as they can be kept frozen in good conditions, though most people undergoing IVF don’t keep them frozen for too long. This is the era where we’re seeing embryos that have been frozen for 10+ years being thawed and used so we’ll likely have more specific data in the years to come.

3. Can over-the-counter fertility tests tell me for how much longer I’ll be able to get pregnant and have kids?

No. Over-the-counter (OTC) fertility tests can provide some level of information but getting pregnant depends on a high number of variable factors, including the health of the sperm. If you have questions about your fertility, the most comprehensive way to plan for a future family is to make an appointment with a fertility specialist.

Sperm tests are generally accurate in telling you if you have sperm in your sample or not. Results from an OTC hormonal test should be interpreted with caution and mean little if you haven’t been attempting pregnancy. Anti-Müllerian hormone (AMH) has become popular to test but as of right now there’s no link between AMH levels and the ability to get pregnant spontaneously (i.e., without the help of a fertility specialist).

The guidance for seeking out more information from a fertility specialist is typically if you’re over 35 and have been trying for six months. If you’re younger than 35, it’s recommended to reach out after 12 months of attempting to get pregnant. Or as soon as possible if attempting to conceive at age 40 or older. You can always be seen sooner, particularly if you have any risk factors for infertility (known genetic disorders, history of therapies or diseases that impact fertility, etc.).

4. Why am I being prescribed birth control when I’m trying to get pregnant?

A patient undergoing either egg freezing, or IVF may be prescribed birth control to help your fertility specialist regulate your reproductive system for one cycle and prevent the natural selection of one egg for ovulation. Each month there’s a pool of eggs and your body is programmed to select one to ovulate (ovulation); the rest of those eggs die. We’re trying to be more efficient than that and birth control enables us to synchronize the growth and retrieve those additional eggs. It also helps us understand the timing of a person’s cycle which is critical for timing related fertility treatments.

5. Will laying with my legs up after an IUI increase my odds of success?

No, this is a myth. Laying with your legs up does not increase the chance the sperm will successfully fertilize an egg or that the fertilized egg will successfully implant in the uterus. Gravity is not doing the work in this instance; it is the patient’s cervical mucus and sperm’s motility that’s helping the sperm to meet the egg.

6. Why can’t I decide to transfer more embryos if I want to have twins?

Any pregnancy consisting of multiple fetuses is high risk and comes with a higher likelihood of fetal and maternal complications. Our research and training is to give our patients the best, safest chance of a healthy pregnancy and delivery for the patient and their baby.

7. If I have 12 eggs, why don’t I have 12 embryos?

Unfortunately, there are normal and natural attrition (the reducing or lessening of something) rates even for healthy eggs. The processes of freezing, unfreezing, fertilizing an egg with sperm and then that fertilized egg becoming a healthy, implantable embryo contain a lot of variables, some of which are within our control but many of which are not. Our highly skilled and trained fertility specialists and embryologists use the most advanced technology to give you the best chance of low attrition rates for eggs and embryos.

8. What kinds of things negatively impact sperm count? What should I avoid?

We always encourage our patients to lead a healthy lifestyle because factors like drugs have been shown to impact sperm levels. Hot temperatures also decrease sperm levels, so we don’t recommend sitting in hot tubs for instance. There are three factors we look at: concentration (count of sperm), motility (how active sperm are), and morphology (the shape sperm look like). If there’s any concern, we’d refer the patient to a urologist.

9. What products should I avoid if I’m trying to get pregnant?

As mentioned above, we always encourage our patients to lead a healthy lifestyle to get themselves the best possible chance at a healthy pregnancy. We discourage use of alcohol and drugs, including marijuana, and certain prescription drugs which your fertility specialist will go over in detail if there any potential drug interactions with other medications you’re prescribed.

10. Will I have to be on bedrest after an egg retrieval, intrauterine insemination (IUI), or embryo transfer?

No, you don’t have to be on bed rest. Egg retrieval is considered a minor surgical procedure so we recommend you take the day off to rest though you can do light activity. You should avoid vigorous activity for two weeks to allow the ovaries to return to normal size. For an embryo transfer and IUI you can partake in regular activity with no limitations.