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4 myths about getting pregnant that you should stop believing — including that stress is a common cause of infertility

Mar 25, 2023, 05:28 IST
Insider
Dr. Steven PalterGold Coast IVF
  • Fertility doctor Dr. Steven Palter is popular on TikTok for demystifying infertility.
  • He said patients often believe they've done "all the tests" or that infertility is stress-related.
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Over about the past year, Dr. Steven Palter and the reproductive endocrinologists he trains have seen about one patient a week who has pursued an unproven fertility "treatment" they've learned about on TikTok.

So Palter, the founder and medical and scientific director of Gold Coast IV, in Woodbury, New York, decided to join the platform himself to combat fertility misinformation and demystify his field's processes and solutions.

"I started sharing what they needed to know, where mistakes could be made, and explanations of complex processes and fertility to help them become more empowered partners in their care," he said. He now has about 200,000 followers on his social media platforms combined.

"Once patients get an answer, there's this enormous relief," he said. "Getting those answers takes them from feeling lost and hopeless to having a clear thing to fight, and a path on how to overcome it."

Palter talked to Insider about some of the biggest fertility myths, and how patients can find solutions that work for them.

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Myth: You should try to get pregnant naturally for a certain amount of time before seeking help

Medical organizations tend to recommend people seek fertility help after one year of trying to conceive "the natural way" if they are under age 35, and 6 months of trying to conceive if they're over age 35.

But Palter said even six months is too long to wait if you or your partner have certain risk factors, like being over 35, lacking a menstrual cycle, experiencing severe period pain, or having a partner who's undergone chemotherapy.

In those cases, "you should get evaluated right away," Palter said, so you can save time by identifying potential barriers early and finding possible solutions.

For example, someone with a history of period pain may have undiagnosed endometriosis, and further delaying treatment won't help their odds of conception.

Myth: You think you've taken "All the tests"

Palter said he regularly sees patients who say they've had "all the tests" and still don't know why they can't get pregnant.

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But Palter said there isn't one universal panel that covers all possible causes of infertility, and even if there was, how clinicians conduct and interpret the results can vary widely.

"Just because a physician told you that you were tested for everything, doesn't mean that that test was complete, properly done or properly interpreted," he said. "And I see this all the time."

For example, doctors can miss abnormal results on genetic tests; test results can get lost, leading patients to assume everything is fine; and imaging tests can be read by non-experts.

Palter had one patient who'd been trying to get pregnant for more than five years and had been told her fallopian tubes were normal, per an X-ray. But when Palter got a hold of the original X-ray, he noticed that the tubes were actually blocked, which can be treatable though hard to spot, especially if it's fluid blocking the egg's path.

How accurate the results of scans like X-rays and ultrasounds are "is enormously dependent on the skill of the person performing the test and the person interpreting it," Palter said. "And very often the fertility doctor will just rely on the radiologist interpretation, and not look at the original images. There are constantly things that are missed."

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Myth: "Unexplained infertility" means there isn't a cause

Often, when doctors say "unexplained infertility," they simply mean it makes more sense to move forward with infertility treatments than to conduct invasive testing to pinpoint the underlying cause. "For example, there could be a problem with a woman's egg, but you wouldn't see that problem until you did IVF," he said.

Still, Palter said, about 30 percent of the time, women are told they have unexplained infertility when they really just haven't had a thorough-enough evaluation.

"We see patients who are in their 40s and are perimenopausal, and are told it's unexplained. It's not: It's clearly age-related. Or, they're not ovulating or they have endometriosis, but no one has thoroughly evaluated them," Palter said.

Myth: Stress and weight are common infertility culprits

Palter sees patients who've been told they're just not trying hard enough, or that they just need to lose weight or reduce stress. But not only does telling someone to de-stress not work, it's also inaccurate. "Stress almost never causes infertility unless it's to the point where your cycles are stopping," he said.

And while being at a higher weight can impact fertility, in part due to the way excess fat interacts with sex hormones, it's no reason not to treat other contributing factors to infertility, Palter said.

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"Weight may be a contributor, but that doesn't mean you don't treat them with medications to fix the hormonal problems," he said. "Brushing people off without making a diagnosis, based on them being under stress or overweight, is a terrible disservice."

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