Fertility Myths vs Facts: Ten Claims Checked Against the Evidence

ASRM's 2020 committee opinion states that markers of ovarian reserve were poor predictors of reproductive potential as measured by fecundability, and that results are not useful in predicting the likelihood of unassisted pregnancy.

AMH predicts how many eggs a stimulation cycle will yield, which is genuinely useful before IVF. It does not predict whether you will conceive naturally, and ASRM adds that extremely low values should not be used to refuse treatment.

• AMH counts follicles; it does not assess the eggs inside them.
• In 981 women aged 30–44 without infertility, low AMH did not reduce conception by cycle 6 or 12.
• A reassuring AMH at 41 does not change the odds set by age.
• It should not be the sole criterion for denying treatment.

Covered in full in our article on AMH and diminished ovarian reserve.

The WHO reference limits are fifth centiles of men whose partners conceived within a year — a description of a fertile population, not a threshold for diagnosis.

WHO's sixth edition states that reference ranges and fifth centiles are insufficient to diagnose infertility, and it removed diagnostic labels such as normozoospermia. The 2021 limits also differ from the widely quoted 2010 figures.

• Concentration: 16 million/mL in 2021, not the widely quoted 15.
• Volume: 1.4 mL, not 1.5.
• Total motility 42%, progressive motility 30%.
• One sample on one day is not a diagnosis.

Our guide to reading a semen analysis covers what each number means and why a repeat test is usually needed before conclusions.

• IVF Add-Ons: What the Randomized Trials Actually Found
• After a Failed IVF Cycle: What Is Worth Investigating
• Infertility and Mental Health: How Common Distress Actually Is

One good study found an association between a biological stress marker and time to pregnancy — and no association for the marker most people mean. In the LIFE study of 501 couples, high salivary alpha-amylase was linked to roughly twice the risk of infertility, while salivary cortisol showed nothing.

No stress-reduction program has been shown to raise live birth rates. Managing anxiety or depression is worth doing because those conditions matter, not as a fertility intervention — and being told your distress is costing you a pregnancy adds blame the evidence does not support.

• 'Just relax and it will happen' has no evidence behind it.
• Cortisol panels sold as fertility tests are not supported.
• 87% of women in that study conceived within the follow-up period.
• Distress during infertility is the common response, not a personal failing.

Covered in what the evidence shows about stress.

The decline is continuous either side of 35, and the sharpest change in that band is miscarriage risk rather than the ability to conceive. In a Dutch cohort, time to pregnancy at 35.0–39.9 was not significantly worse than at 30.0–34.9.

Miscarriage odds in that same comparison were 2.03 times higher, rising to 4.24 at 40 and over. So the two curves genuinely do not move together, and the popular framing collapses them into one.

• Estimated infertility: 8% at 19–26, 13–14% at 27–34, 18% at 35–39.
• Four in five women aged 35–39 in those data were not infertile.
• Fecundability fell significantly only at 40 and over in the Dutch cohort.
• No supplement has been shown to offset age-related change.

Covered in fertility after 35 and best age to conceive.

Several widely sold tests are specifically advised against. ESHRE's 2023 recommendations state that peripheral NK cell testing is not recommended, uterine NK cell testing is not recommended, and blood cytokine assessment is not recommended.

On embryo testing, ASRM's 2024 opinion is that the value of PGT-A as a routine screening test for all patients undergoing IVF has not been demonstrated. On endometrial receptivity testing, ESHRE finds insufficient data to recommend routine use.

• NK cell testing — not recommended.
• Endometrial receptivity testing — insufficient data for routine use.
• PGT-A as routine screening — value not demonstrated.
• A test that would not change the plan is not worth paying for.

Covered in our article on PGT-A and recurrent implantation failure.

Three questions handle most of them, and none requires a medical background.

• What is the source, and is it a guideline body or a seller?
• Is the outcome live birth, or something easier like clinical pregnancy?
• Is this a population statistic being used as an individual prediction?

The third catches the largest share. Odds ratios, prevalence figures and success rates describe groups; almost every myth in this article is one of those numbers applied to one person as though it were a forecast.