Five Fertility Facts (or Fiction?) part 1

Dr Patsama Vichinsartvichai MD MClinEmbryol. Fertility Specialist, Medical Director INSPIRE IVF

There is much information regarding fertility that you can access at your fingertips. Unfortunately, not all of what you read is true. Especially in Thai internet support groups, you read a lot of incorrect information, herbal tea recommendations or famous ritual practices for having children.

Here are five common fertility facts (or fiction?) we often find:
Sperm: the older, the better – fiction

Let the edible stuff like wine and cheese get better with age. Sperm doesn’t! After sperm cell division and shaping into head, neck and tail (spermatogenesis and spermiogenesis), sperm is then transported into a storage tube called the ‘epididymis’ where the motility is gained. The longer they stay there, the more dead sperm are contained in the epididymis. Finally, there is an increase in reactive oxygen species (ROS) and sperm DNA damage prevails. The sperm DNA damage is correlated with poor embryo development and miscarriage. Frequent ejaculation every 2/3 days for 2/3 weeks before semen collection for IVF is recommended.

40 is the new 30 – fiction

When we put the female factor into limelight, the younger, the better prevails. Fertility in women declines right after the age of 30 years and steeply declines further after 37 years. Pregnancy is almost impossible after 40 years without donor oocytes and Preimplantation Genetic Test for aneuploidies (PGT-A). Don’t let those Hollywood celebrities who just delivered twins in their 40s and 50s everywhere mislead you that you can do it too.

Almost certainly these are donor- egg IVF babies, where the embryo is produced from an egg donated by an anonymous younger woman, then implanted to grow in the uterus of the older woman. Donor egg IVF is a wonderful family-building option for many couples, but the emotional and psychological reality adjustments of not contributing their genetics to their baby are needed.

Just relax and you’ll get pregnant right away – fiction

Many couples get married in their late 20s, relax for over a decade, then decide to visit a fertility specialist in their early 40s (when women are halfway through menopause). Twelve months of relaxing is more than enough in a young couple but six months may be too much if women are aged over 35 years.

After an egg is released, it can be fertilised for up to two days – fiction.

While sperm can hang around and wait for their date with an egg for three or more days, the shelf life of an egg after release is only 12/24 hours. The chance that you can have natural conception is maximum 2 days before ovulation until the day of ovulation. Just one day after ovulation, the chance of pregnancy falls to zero.

Fertility diet can improve your egg quality – fiction.

There is no evidence that any diet or supplements can improve the quality of an egg beyond its current potential. Supplements might slow down the degenerative process of eggs but they can’t make the egg better. The age of the women is the main determinant of the egg quality.

Please look for Five “Fertility Facts (or Fiction?)” part 2 in the next issue of Expat Life in Thailand.

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