Deborah Howell (Host): This is the Time to Talk Fertility Podcast. In a world filled with information, it's easy to stumble upon myths and misconceptions, especially when it comes to fertility. Many hopeful parents find themselves navigating a maze of well meaning advice and age old tales, only to feel more confused and overwhelmed. Today, Dr. Karine Matevossian, a Reproductive Endocrinologist with Fertility Centers of Illinois, will help to unravel these myths with clarity and compassion. I'm your host, Deborah Howell. Dr. Matevossian, it's so nice to have you with us today.

Karine Matevossian, MD: Thank you so much for having me. I'm looking forward to debunking some fertility myths today.

Host: Well, let's get right to it then. What are some of the most common myths about fertility treatments that you've encountered in your practice?

Karine Matevossian, MD: I think that a lot of the myths I hear about are actually focused on in vitro fertilization, or what's known as IVF, because one myth is that this is the only treatment option for couples who need help getting pregnant. Some other misconceptions I've encountered are that IVF is only a treatment for female infertility issues, or that fertility treatment can work regardless of age, and that if you do IVF, you're going to end up with twins or multiples.

Host: Always, right? Now, is there a specific myth that you find particularly worrisome as a Reproductive Endocrinologist?

Karine Matevossian, MD: Yeah, I think one that I find worrisome is that IVF causes menopause or takes away eggs that you could have used in the future. But actually IVF does not decrease the reserve of immature eggs. When you have a menstrual cycle, multiple eggs are recruited and then die off with only one dominant follicle going on to ovulate.

 So what IVF is essentially doing is rescuing those follicles that would have otherwise been lost naturally.

Host: That's a great explanation. Can you also explain why fertility issues are not solely a woman's concern?

Karine Matevossian, MD: Definitely, and this is a big myth that's out there. But actually male factor infertility is responsible for about 20 percent of couples who have infertility and then is also a contributing factor for another 30%. So when couples come in, it's really important that both partners get evaluated.

Host: And how can we better educate people on the fact that men also play a significant role in fertility?

Karine Matevossian, MD: Yeah, I think things like this podcast are a really great start because we just need to normalize discussions around male fertility, especially in healthcare settings. So we can do that by raising awareness and just being cognizant of the fact that there may be a stigma around seeking help for fertility. So we just need to continue to break down barriers to care.

Host: Right. There's less stigma now than there used to be, though, for sure, right?

Karine Matevossian, MD: Yeah. I think so. And I think that that's because of all of the awareness that's been raised on the issue.

Host: So we touched on this earlier, but what role does age really play in fertility for both men and women?

Karine Matevossian, MD: So, age plays a really big role when it comes to female fertility, for two main reasons. One is that, as women age, their chance of spontaneous conception decreases. But in addition, there's an increased risk of miscarriage because of a decline in egg quality. So what that translates to is that at age 40, there's only about a 5 percent chance of pregnancy each month, and each pregnancy has about a 40 percent chance of miscarriage. One misconception is that men have the same fertility their entire lives, but actually, they do also experience a decrease in fertility after age 40.

It's just less dramatic than it is in their female counterpart, but you will see about a 30 percent decrease in conception. And when fathers are older than 45, there's more likely to be complications with the infant. So there's a higher risk for prematurity, low birth weight, or needing a NICU admission.

Host: Okay. Now, IVF often gets the most attention in discussions about fertility treatments. What are some other options available that people might not be aware of?

Karine Matevossian, MD: Yeah, this is a really great question, because as I was saying before, people think that IVF is the only option, but there are many other treatments, and that can include oral medications that help with ovulation or ovulating more than one egg a month. Another option is called intrauterine insemination, which can be done alone, or with oral medication or injectable medication.

And then there can be other treatments like surgeries for endometriosis, fibroids, or polyps. And finally, for male infertility, there can also be medications and procedures that can help.

Host: That's a whole world beyond IVF. So what are some common misconceptions about the safety and risks of fertility treatments?

Karine Matevossian, MD: I think one of the biggest myths that I want to debunk and that I've heard from patients before is that, IVF can cause cancer, but actually there's been extensive research on this topic and that's not been found to be the case. There is a short term elevation in hormones because of the medications we use during IVF, but it's not been associated with increased cancer risk.

Like any other medical procedure, there are still some risks, but overall, this is a low risk procedure and it's generally safe.

Host: There is though, a lot of talk about alternative and natural remedies for fertility. What should people know about these options versus medical treatments?

Karine Matevossian, MD: Yeah, I think these remedies can be really helpful for your overall well being, stress reduction, and lifestyle changes. However, it's important to be aware that some of them have limited research on effectiveness and that not all of them are well regulated. I think alternative therapies can definitely be incorporated with medical treatment and allow for a balanced approach.

And one example of that is using acupuncture during an IVF cycle, for example, before and after an embryo transfer.

Host: Interesting. Now, how does stress and emotional well being affect fertility and what strategies can help manage these factors?

Karine Matevossian, MD: So, stress in and of itself does not directly cause infertility, however, infertility and its treatment can lead to significant stress. I think there's many strategies to manage stress and this is particularly useful when going through fertility treatment because one of the main reasons that people stop treatment is because of stress.

So, patients can use yoga, exercise, therapy either individually or in a group setting, or just anything that helps them, like talking to family, those are just a few that come to mind.

Host: And some lovely music, right?

Karine Matevossian, MD: Music, yeah, that's a great one.

Host: So there's a perception that fertility treatments are only for those with significant financial resources. Can you possible discuss the affordability and insurance coverage of these treatments?

Karine Matevossian, MD: So currently there's 21 states that have an insurance mandate for fertility treatment, and that includes Illinois. In addition, there are about a third of employers that actually provide fertility coverage as a benefit. However, the patients that find that they have no coverage either through their employer or insurance, can reach out to, there's several organizations that actually provide grants to help pay for treatment.

Host: I should have known that, back in the day. The biggest and last question I have for you today is, how can patients differentiate between credible information and myths when researching fertility treatments online?

Karine Matevossian, MD: Yeah, so I think, kind of like anything else, there's tons and tons of information on the internet and it's just really important that you know the source that you're getting information from is credible and that it's using an evidence based approach. Two websites that I recommend to patients are American Society of Reproductive Medicine, which is our main governing body, as well as Resolve, which is a non profit organization.

 And then just to put a plug for our own website at Fertility Center of Illinois, we have lots of wonderful resources like blogs, webinars, and this podcast.

Host: Great, and I'll give that in just a second. Well, this has been wonderfully illustrative and just so informative. Thank you so much, Dr. Matevossian for being with us today.

Karine Matevossian, MD: Thank you so much. It was so great talking to you.

Host: That was Dr. Karine Matevossian, a Reproductive Endocrinologist with FCI. You can schedule an appointment to talk to a fertility specialist at 877-324-4483 or visit fcionline.com for more info. And if you enjoyed this podcast, you can find more like it in our podcast library, and be sure to give us a like and a follow if you do.

This has been the Time to Talk Fertility Podcast. I'm your host, Deborah Howell. Have yourself a terrific day.