Thankfully, medical advances such as in vitro fertilization (IVF) have made it possible for certain couples to conceive. Picture: EPA

Washington - Infertility - the inability to get pregnant after 12 months of regular, unprotected sexual intercourse - affects about 1 in 10 couples. 

A diagnosis can alter relationships, lead to depression and anxiety, and threaten lifelong expectations of parenthood. Thankfully, medical advances such as in vitro fertilization (IVF) have made it possible for certain couples to conceive, but these treatments carry risks and are often poorly understood. Here are five common misconceptions.

Myth No. 1: Stress causes infertility

An article on WebMD claims that doctors believe "the stress of actually undergoing infertility treatments can be so great it can stop even the most successful procedures from working." Anyone who has personally experienced infertility has heard some variant on the advice : "Relax, you're trying too hard. Just take a break and you'll get pregnant."

While stress and infertility can be connected, stress does not cause infertility or treatment failure. A meta-analysis of 14 studies with 3 583 women undergoing fertility treatments found that pretreatment emotional distress was not associated with outcomes. 

Research showing an association between stress and infertility usually does not fully account for the indirect effects of stress, such as alcohol use, increased smoking, infrequent sex and dropping out of treatment.

Myth No. 2: Women are more likely to be infertile than men

Because women get pregnant and men don't, people often believe that infertility must be related to what's happening in the female body. Historically, biblical writings, Egyptian papyruses and the medical texts of the classical Greeks show that infertility was a common condition and that women were primarily blamed. 

These convictions formed cultural traditions and misperceptions that have lasted for centuries. While the Centers for Disease Control and Prevention's website correctly notes that infertility is not always a woman's problem, it still incorrectly reports that in just 8 percent of infertile couples, the man is solely responsible.

In fact, men and women are equally responsible for an infertility diagnosis. 

Myth No. 3: Science and healthy living have extended the biological clock

In 2003, a 60 Minutes report found that educated professional women who intended to delay childbearing to pursue their careers had significant misperceptions about age and fertility, believing that medical treatments and good health could extend the biological clock well into a woman's 40s and even 50s - an attitude that has also been found in undergraduate students. 

Fertility clinics can also perpetuate this myth with well-intentioned but misleading statements, such as the Fertility Centers of Illinois' assertion that "advanced medical technology . . . allows us to extend the biological clock for many women."

Myth No. 4: In vitro fertilization works for most patients

In an IVF procedure, a sperm and an egg are fertilized outside the body, and the resulting embryo or embryos are transferred to the uterus. Although it has miraculous promise, its success rates and stresses are largely misunderstood. 

A study of 8 194 people from eight countries, including the United States, found that "close to 90 percent of the adults surveyed knew about in-vitro fertilization (IVF), but less than one-quarter of them knew about the chances of success of this assisted reproductive technology." 

OB/GYN residents have likewise been found to have unrealistic expectations and incomplete information about IVF, as have men who believed they were fairly knowledgeable about the procedure.

Myth No. 5: My doctor will tell me what I need to know about infertility

A 2018 study found that 76 percent of women prefer counseling from their doctors when it comes to age-related pregnancy risks. Other research has found that a similar proportion of women believe that their providers are the best sources of information about reproductive health. 

Medical professionals themselves concur that it's important to have these conversations.

Yet these discussions rarely take place, and research indicates that gynecologists and nurses have gaps in their knowledge about issues such as the management of polycystic ovary syndrome and the impact of smoking and age on fertility. 

Even when physicians do have the right information, many are reluctant to engage with patients for fear they might increase their patients' emotional distress or be perceived as pushing childbearing.