Fertility Myths That Won’t Die and What You Actually Need to Know [EP 61]
If you’ve been trying to get pregnant, you’ve probably heard a lot of “facts” that feel urgent, scary, or final—especially if you’re over 35, have a low AMH, or have already been told IVF is your only option. These messages can make you feel like your body is failing you or that you’re running out of time, when in reality, many of these narratives are outdated, misunderstood, or taken completely out of context.
In this episode of The Fertility Dietitian Podcast, I’m walking you through some of the biggest fertility myths that just won’t die, and what both the data and real clinical experience actually show instead. We’ll talk about age, AMH, prenatals, male factor fertility, stress, egg freezing, and—most importantly—what you can actually do to improve your internal environment so you can stop making decisions from panic and start moving forward with clarity and confidence.
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“Age matters, but the environment your eggs are developing in matters way more—and that’s the part you can actually change.”
What You’ll Learn:
How fertility really changes after 35 and what the data says about age and conception
What AMH can and cannot tell you about your chances of getting pregnant naturally
Why a prenatal alone is not a complete preconception plan
Which nutrient forms and ingredients matter most in a high-quality prenatal
How male factor infertility shows up in about half of cases and often goes unaddressed
What changes as men age, and how sperm quality can be affected
How stress impacts fertility and why “just relax” is not helpful advice
What egg freezing can offer and why it is not an insurance policy
How to support your internal environment to improve fertility and egg quality
“Your AMH is one data point, not a verdict on your ability to get pregnant naturally.”
Supplements Mentioned:
High-quality comprehensive prenatals
Methylfolate or folinic acid instead of folic acid
Separate omega-3 supplements
Iron only when clinically indicated
Links Mentioned:
“Male factor is involved in about half of infertility cases, yet the burden of testing and treatment still falls almost entirely on women.”
Transcript:
If you’ve been trying to get pregnant, you’ve probably heard a lot of different things that sound urgent or scary or final, or just questionable. Maybe you’ve heard that you’re over 35, so make sure you don’t wait, or your AMH is low, so you absolutely need to go to IVF right away.
Maybe you’ve heard that if you’re already taking a prenatal, you’re good. There’s nothing else we can do to support preconception. These statements get repeated so often that they start to feel like facts, but many of them are either very outdated, very misunderstood, or taken way out of context.
So today, I want to walk you through some of the biggest fertility myths that won’t go away and what the data and real clinical experience actually show. Because when you understand what’s true and what’s not, you can stop making decisions from panic and start making them with clarity.
Fertility Myth #1: Fertility Falls Off a Cliff at 35
Let’s start with this one because it has created a lot more anxiety than almost any other myth out there. You’ve probably heard that once you hit 35, your fertility just drops off dramatically.
But here’s what the data actually shows. Fertility does decline with age, but it is very gradual. It is much more of a slope, not a cliff.
In your 20s, your chance of conceiving each cycle is around 20%. In your early 30s, it is around 15% per cycle. Then, between 35 and 39, it is closer to 10%.
So yes, that is a decline, but it is not a big old free fall like people have really been led to believe. And the original narrative around the 35-year-old cliff came from historical population data, not modern fertility clinics.
We’re talking about birth records from centuries ago, before modern nutrition, before understanding hormones, before prenatal care. And yet somehow this idea has really stuck around and become a timeline that women are still making major life decisions around.
Age matters, but the environment your eggs are developing in matters way more. Inflammation, nutrient status, mitochondrial function, metabolic health, toxin exposure, those are all things that you have a big influence on.
So instead of thinking, “I’m running out of time,” I want you to think, “How can I improve the environment my eggs are maturing in right now?” Because you can actually have better egg quality in your 30s and even your late 30s than you did in your 20s, based on the environment that you’re creating.
Fertility Myth #2: AMH Tells You If You Can Get Pregnant
Let’s talk about another myth. Your AMH tells you if you can get pregnant. This is one of the most misunderstood labs in fertility.
AMH measures a hormone that’s produced by follicles that are maturing at a certain state. So they’re almost like mid-development. If they’re smaller, they don’t produce AMH. If they’re larger, they also don’t produce AMH.
This lab is often thought of as measuring ovarian reserve, but it’s not a great lab for that. And it’s also not a great lab for telling you anything about the quality of those eggs either.
It does, however, give us information on how safe your body feels to support maturing follicles. So when AMH is low in my practice, I use it as a data point for where to look next.
And I should also say that AMH has zero correlation with natural conception. It’s really more correlated with how you’re going to be responding to IVF, specifically a retrieval cycle and the meds that go along with that.
So if your body is already not feeling safe enough to mature follicles, you can imagine how hard it’s going to be by adding an additional burden of those hormones and medications to get more eggs to mature more quickly. So I don’t put a lot of weight on AMH for this reason.
We put way more weight on how safe your body feels overall. And I also see AMH improve all the time in practice when we focus on those safety factors and look at the body and fertility as a whole.
And just taking a step back again to egg quality, AMH tells us nothing about that. And it’s really the quality that determines whether an egg can actually be fertilized and become an embryo and be able to implant from there.
There was a large study looking at women actively trying to conceive, and we do see that women with low AMH had a very similar chance of getting pregnant within a year compared to women with normal AMH levels.
So know that AMH is one data point that doesn’t mean a whole heck of a lot for natural conception. And we can actually see it improve based on how safe your body is feeling.
On the other side, if you are seeing high AMH, it’s likely because of inflammation, insulin resistance, or basically the body communicating that it is struggling to fully mature follicles. They’re getting stuck in that mid-stage of development, which does decrease quality there.
So there’s a lot that we can do to help support the opposite of that too. High AMH or low AMH can be shifted based on metabolic support and overall how safe your body feels, essentially, to support reproduction.
Fertility Myth #3: You’re Covered Because You Take a Prenatal
Maybe you’ve heard that you’re taking a prenatal, any prenatal, and so that’s good. You’re covered for preconception care.
This one is kind of tricky because it sounds responsible. You’re adding in some support there. And yes, taking a prenatal is a good starting point, depending on the quality of that prenatal, of course, because there’s a really big difference in qualities.
Not all prenatals are created equal. Most are not designed for that preconception window. They’re just a low-quality multivitamin, unfortunately, without much evidence-based support around it.
Two to three months before ovulation or before trying to conceive is really when you want to be thinking very minimally about preconception care because it takes an egg about three months to fully mature. That is the window of maturation where we have the biggest impact on the quality of that egg that you will be ovulating.
That’s really where nutrition has that direct impact, those three months before. If you have not created the healthiest environment in your body, you want more time than that. You want several maturation cycles to see even bigger, significant impact on egg quality and overall reproductive environment, too.
A few things to think about. We want to make sure that your prenatal has the appropriate types of nutrients in it. Many prenatals use folic acid, which your body has to convert into the active form. A significant portion of the population does not actually convert it efficiently.
And then there is a byproduct that builds up because it’s not being converted efficiently, and that is essentially going to be inflammation. It’s going to lead to more issues.
So we want an active, easy-to-use version of folate, not folic acid. Methylfolate is one of those. Folinic acid is actually another one. It’s super confusing, I know, but a form of methylfolate is typically going to be best because it’s already in usable form. The kind that we find in food, leafy greens, and beans, is where we get most of our folate in our diet.
Most prenatals also don’t contain any or enough choline, which is really important for fertility and especially the early developmental stages of conception, but it’s really helpful for egg quality along the way too.
And we also need to think about many other minerals, omega-3s, antioxidants. Some of these we don’t actually want inside of our prenatal, iron, for instance. I would never recommend a prenatal that has iron already in it because not only does it compete with calcium, which is typically in prenatals for a good reason, but not everybody should be supplementing iron because there is a lot of nuance around how your body is able to use it.
We actually make all of the iron that we need every day. If that iron is already being dumped into your tissues and creating more inflammation, supplementing iron is not going to do you any favors.
Omega-3 is also something I don’t recommend being incorporated into the multivitamin version of a prenatal because it’s not stable and oxidizes. You want it separate. You want it to be able to be refrigerated.
So there’s a lot to think about with prenatals, and I do recommend taking one because we need to fill in the gaps of our modern diet, even if you are being really mindful about what you’re eating and making your diet nutrient-rich. Filling in the gaps is still highly necessary.
But don’t assume that checking that box means you’ve fully, just grabbing a random prenatal off the shelf means you’ve really fully checked that box, or that there aren’t other things that you need as an individual. This is really where that specialization comes in and matters big time, too.
As far as some prenatals that I recommend, I am a big fan of very comprehensive prenatals that have the nutrients in the appropriate forms. This includes FullWell Fertility, Needed, as well as FIGS. Really excellent, high-quality prenatals that are going to help fill in those gaps much better than the vast majority of others on the market.
Fertility Myth #4: Infertility Is a Women’s Problem
Another myth I want to talk about is that infertility or struggling to conceive is a women’s problem or the female side. This one needs to go far, far away.
Male factor is involved in about half, if not more, of all infertility cases. That means male factor is involved, not necessarily solely being male factor, but it is a factor in conception.
And yet the burden of testing and treatment, the emotional weight, is typically just placed mostly on the woman.
Standard semen analyses look at things that count, motility and morphology, which is great. And a lot of times, I don’t even see morphology being looked at. But they also don’t look at DNA fragmentation or oxidative stress or a deeper look at the actual quality of the sperm.
Motility and morphology definitely give us insight, but DNA fragmentation is going to be an even better look because we can see high DNA fragmentation, which is actual damage to the DNA being done, even if motility and count are looking good.
Typically we see morphology still being off with high DNA fragmentation, but I recommend looking at it so we have that full picture and know how to best support the quality of that sperm.
I cannot tell you how many couples I’ve worked with where everything is really focused on the female partner while a major piece of the puzzle was really the male side being completely unaddressed. Even though he did have a semen analysis done, those parameters were nowhere near optimal.
They might have fallen into “normal,” but those normal parameters on a semen analysis are really, honestly outdated and not doing us any favors at all.
If you’re trying to conceive, both partners need to be evaluated at the same depth, at the same level of importance, because it really does take two.
Fertility Myth #5: Men Don’t Have a Biological Clock
Men actually do have a biological clock. It just hasn’t been talked about in the same way, because they don’t ever stop producing sperm.
But as men age, sperm DNA fragmentation tends to increase and it becomes a lot harder to decrease into those optimal ranges. This can impact fertilization, embryo development, miscarriage risk, and here’s the catch: a standard semen analysis can still look normal.
So couples are told that everything’s fine, while there are underlying quality issues that were never tested for.
We need to stop acting like male fertility is static. It is very responsive to lifestyle, nutrition, and age, just like female fertility is. So as they age, they might need different types of support.
This is definitely what I see in practice as well. But if we don’t know it’s a concern to be addressed, it’s often just pushed aside as a female issue, unfortunately.
Fertility Myth #6: You Just Need to Relax
Another myth is that you just need to relax and it will happen. You’ll get pregnant.
I had to include this one because it’s one of the most dismissive things that you can say to someone who’s trying to conceive.
Stress absolutely does matter, but not in the way that people think. You didn’t cause infertility by being stressed, and relaxing alone is not a good treatment plan.
What actually matters is how your body is responding to its environment. We can have internal stress that is absolutely going to have a really big impact on how safe your body feels to nourish fertility and get pregnant and have that healthy baby.
Chronic stress can impact things like ovulation and blood sugar, inflammation, and hormone signaling. But the solution is not relaxing. It’s supporting your nervous system, your sleep, your blood sugar, and your overall resilience.
We want to make sure that you’re able to respond to stressors better. So it’s physiology, not just mindset, in that aspect.
Fertility Myth #7: Egg Freezing Is an Insurance Policy
And last but not least, another myth that we have to talk about is that egg freezing is an insurance policy. Egg freezing can be potentially a helpful tool, but it’s certainly not a guarantee.
Each egg that is frozen has a relatively low chance of becoming a live birth. That’s why the number of eggs matters so much. The age at which those eggs are frozen matters.
Freezing eggs at 38 means you are freezing 38-year-old eggs. We can definitely prep for this and improve outcomes a lot, but it does not pause the biological age of the eggs at some earlier point.
This doesn’t mean it might not be the right option for you. It just means that you need to go into it with clear expectations and a strategy. Preconception prep for a retrieval or for egg freezing is a really, really good idea.
And we do know that embryos freeze better than eggs alone, so keep that in mind too. A lot of times we’re freezing eggs because we haven’t found the right partner, which makes sense, but as far as having realistic expectations, that’s an important one to keep in mind as well.
Closing Thoughts
Here’s the truth. Fertility is not as simple as the headlines or social media tends to make it. It’s not just one number, one test, one timeline. It’s a reflection of your internal environment, and that environment is responsive.
When you shift inflammation, when you support metabolism, optimize nutrients, and reduce hidden stressors, you change the conditions your body is working with. That’s where your real power is.
Not in chasing perfect numbers, but in understanding your body well enough to work with it. Because your fertility is not fixed. It’s very dynamic, and we can actually improve it as you age.
And when you know what actually matters for you, you can stop guessing and start moving forward with a plan that makes sense for you and for your male partner.