Infertility Causes: What's Real and What Isn't?

Maybe you want to start a family next year, or in ten years, and you want to take steps now to support your fertility health. Even if babies are not on your radar today, it’s better to rest easy and know that you’re setting yourself up for success when you’re ready. 

Does birth control affect long-term fertility?

No, birth control does not impact your long-term fertility. “One of the biggest myths is that birth control is bad for a woman’s fertility,” says Dr. Jamie Knopman, M.D., a reproductive endocrinologist at the Colorado Center for Reproductive Medicine, New York. “That is completely inaccurate.” You may find that it takes a month or two for your cycle to self-regulate after you go off birth control, but most women will start ovulating again within a few weeks. What we will say is that being on the pill may keep you from identifying hormonal issues, like early menopause, but that’s not the same thing as birth control causing infertility.

Back in the 1980s (which feels like the 1880s in science years), the old IUD designs used were known to contribute to women developing pelvic inflammatory disease (PID), which sometimes led to infertility by damaging the fallopian tubes and uterus. But those are now completely out of use. The copper models used today pose absolutely no known threat to your fertility.

Does having an abortion or taking Plan B affect long-term fertility?

Unless you had any (very rare) complications or infections from the abortion, you should have no issue carrying out a healthy pregnancy when you’re ready to do so. The same goes for Plan B. While Plan B can possibly shift the rhythm of your cycle — like creating a delayed ovulation in the month following its use — it doesn’t have any long-term effects on your fertility.

What to know about STDs/STIs, and their impact on fertility

Some sexually-transmitted infections do have an impact on fertility. This makes prevention, early detection, and treatment extra important. Let’s take a look at the most common STIs: 

• Chlamydia: When diagnosed and treated quickly, chlamydia will most likely not affect your chances of a healthy conception. But if you’ve had chlamydia, talk to your doctor when you’re ready to start trying, just to be sure. Alternatively, if chlamydia goes untreated, it can develop into PID (see above). This can also result in an increased chance of an ectopic pregnancy (where the zygote implants in the fallopian tubes and not in the uterus), which you definitely don’t want. All of this emphasizes the importance of getting tested and getting treatment, ASAP.
• Herpes: According to Dr. Knopman, a herpes outbreak could alter how you deliver a baby when that time comes, and prophylactic medication may be needed if you want to have a vaginal delivery. However, if your herpes is closely monitored and treated, your fertility should see no significant effects. That said, there is one rare strain that has been found in the uterine linings of some women with previously unexplained infertility. A 2016 PLOS One study speculates that their immune response to this strain of herpes causes their bodies to fight off any “invasive species,” including a potential pregnancy. And a 2012 Journal of Biomedical Research study also found that men with asymptomatic herpes (with no outward signs of the disease) may experience a decrease in sperm quality and/or quantity. In short: test early; treat early.
• Bacterial vaginosis: The real danger with BV seems to be PID. If BV is left untreated, PID can creep in and wreak havoc on your reproductive organs. There have been some recent studies showing that BV is more likely to be found in infertile women verses fertile ones, but we’ll say it one more time: test and treat as early as possible. “Any infection left untreated is not good,” says Dr. Knopman.

Egg freezing

The unavoidable truth is that as you age, you have fewer and lower quality eggs. It happens at different rates, but it happens to all women. Freezing your eggs is one way to give your future self younger, healthier eggs to use when the time comes to start your family.

We’ll level with you: freezing your eggs does not guarantee you’ll get pregnant with those eggs down the line. But it does increase the chances. A Journal of Assisted Reproduction and Genetics study showed that for women under 35, freezing nine eggs leads to a 70% chance of a live birth. The same study found that for women under 35, the average number of eggs retrieved is 18-21. Importantly, the age at which you freeze makes a huge difference. The older you are, the more eggs you will need to freeze as each egg is more likely to be genetically abnormal. A team of experts from NYU Langone Fertility Center found that women’s ability to get pregnant using their frozen eggs is heavily influenced by the patient’s age at the time of freezing and the total number of eggs on ice (also influenced by age). 

We believe that you should build a family on your own timeline. Egg freezing helps get you closer to that, and we are committed to making it accessible to more women. Learn more about our egg freezing services, including our Split program where you can freeze for free when you donate half of the eggs retrieved to a family that can’t otherwise conceive. 

‍But can egg freezing or egg donation affect future chances of getting pregnant naturally?

Nope! Research suggests that egg freezing will not decrease your chances of a natural pregnancy in the future and that it won’t take eggs away from the rest of your ovarian reserve. 

The egg freezing process captures and preserves eggs that would otherwise die off during each menstrual cycle. Hormone medications can help multiple eggs grow — to be frozen for the future — vs. the usual one egg per cycle.

So there you have it. Hopefully this will help you see more clearly as you work your way through the fertility weeds and think about the future. Arm yourself with the facts and block out all the nonsense. We’re wishing you all the best!