<p>There’s a lot of information out there on the topics of fertility, infertility and how best to get pregnant—but how much of it is true? In this article, we examine 12 fertility and pregnancy myths that have been passed down for generations, fact-checking them against current scientific knowledge.</p><h2 id="myth-1-infertility-is-rare"><strong>Myth #1: Infertility is rare.</strong></h2><p>Many people know relatively little about infertility unless they are affected by it themselves. A common belief is that infertility—defined as failure to achieve pregnancy after 12 months of regular unprotected sexual intercourse—is rare. This is probably because fertility problems are often a taboo subject. Despite this, statistics show that infertility is quite common: according to the <a href="https://www.who.int/news-room/fact-sheets/detail/infertility?ref=cada.com">WHO</a>, one in six people of reproductive age will be affected by infertility during their lifetime. In Switzerland, about <a href="https://www.bag.admin.ch/bag/en/home/zahlen-und-statistiken/zahlen-fakten-zu-fortpflanzungsmedizin.html?ref=cada.com">7,000 couples</a> seek treatment at a fertility clinic each year.</p><p>Read more about infertility in our <a href="https://cada.com/en/blog/infertility/">general</a> and <a href="https://cada.com/en/blog/how-to-know-if-you-are-infertile-male/">male</a>- and <a href="https://cada.com/en/blog/what-causes-infertility-in-women/">female</a>-specific overview articles.</p><h2 id="myth-2-infertility-lies-with-the-woman-alone"><strong>Myth #2: Infertility lies with the woman alone.</strong></h2><p>In fact, <a href="https://www.nichd.nih.gov/health/topics/menshealth/conditioninfo/infertility?ref=cada.com#f4">one-third of fertility problems</a> are due to male factors, and one-third to female factors. In the remaining third, both partners or an unknown factor contributes to the problem.</p><p>For this reason, it’s a good idea for both partners in a couple experiencing infertility to have fertility analysis to investigate the cause and initiate possible treatment steps.</p><h2 id="myth-3-men-don%E2%80%99t-have-a-biological-clock"><strong>Myth #3: Men don’t have a biological clock.</strong></h2><p>Women can’t have children after menopause. But a man can get a woman pregnant throughout his entire life... right?</p><p>While it’s true that men can father children well into old age, their fertility also declines <a href="https://pubmed.ncbi.nlm.nih.gov/14704244/?ref=cada.com">after their late thirties</a>. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253726/?ref=cada.com">Reasons</a> for this include lower sperm concentration, reduced motility (ability to swim well) and increased abnormalities in sperm size and shape.</p><p>The risks associated with late paternity are also only partially known. Increased rates of genetic disorders, cancers, autism and certain mental health problems are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3854059/?ref=cada.com">documented</a> among children born to older fathers. However, currently there is no way to screen or test for disorders based on fathering a child later in life.</p><h2 id="myth-4-if-a-womans-cycle-is-irregular-she-can%E2%80%99t-become-pregnant"><strong>Myth #4: If a woman's cycle is irregular, she can’t become pregnant.</strong></h2><p>It is true that women with irregular cycles may ovulate less frequently than women with regular cycles. But that doesn't mean they can't get pregnant.</p><p>When periods are not regular, it can be more difficult to pinpoint ovulation and figure out the best time to have intercourse. This can make it more difficult to get pregnant, but monitoring basal body temperature or cervical mucus, as well using as ovulation tests, may be helpful.</p><p>Triggers for an irregular cycle can include factors such as stress, hormonal imbalances, or weight fluctuations. Cycle irregularity can also be caused by conditions such as polycystic ovary syndrome (PCOS). If a woman’s cycle is irregular on a long-term basis, it’s a good idea to seek advice from a healthcare provider.</p><h2 id="myth-5-after-a-miscarriage-a-woman-is-less-fertile-or-even-infertile"><strong>Myth #5: After a miscarriage, a woman is less fertile or even infertile.</strong></h2><p>Miscarriage (the unintended termination of pregnancy in the first trimester or second trimester, before 20 weeks of pregnancy) is often viewed as an event that harms a woman’s body and affects her fertility.</p><p>An unintended pregnancy loss can be a painful and even traumatic event. At the same time, miscarriage is a relatively common occurrence. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384447/?ref=cada.com">incidence</a> is 15% to 27% in women ages 25 to 29 years old and increases to 75% in women over 45.</p><p>It is also true that the chances of having another miscarriage are increased for women who have already lost a previous pregnancy. The <a href="https://www.ncbi.nlm.nih.gov/books/NBK532992/?ref=cada.com">risk</a> of miscarriage in a future pregnancy is about 20% after one miscarriage, 28% after two consecutive miscarriages, and 43% after three or more consecutive miscarriages.</p><p>The good news: most women who suffer a miscarriage are able to conceive later without problems and have a healthy pregnancy. There is no medical evidence that miscarriage, on its own, causes infertility.</p><h2 id="myth-6-prolonged-use-of-hormonal-contraceptives-leads-to-infertility"><strong>Myth #6: Prolonged use of hormonal contraceptives leads to infertility.</strong></h2><p>Hormonal contraceptives, such as the pill, typically use estrogen and progestin to adjust a woman's hormonal balance, suppressing ovulation and preventing pregnancy.</p><p>It is commonly believed that prolonged use of contraceptives leads to infertility. However, a growing number of <a href="https://link.springer.com/article/10.1186/s40834-018-0064-y?ref=cada.com">studies</a> show that women who have used hormonal contraceptives for a long time are just as fertile as women who have never used hormonal contraceptives.</p><h2 id="myth-7-if-a-woman-has-been-pregnant-once-it%E2%80%99s-easy-for-her-to-get-pregnant-again"><strong>Myth #7: If a woman has been pregnant once, it’s easy for her to get pregnant again.</strong></h2><p>It’s often assumed that a woman who has already had one child will get pregnant without any problems the second time. In reality, however, there are many factors that influence pregnancy and that can change continuously. A woman may experience disorders that affect her fertility after her first pregnancy, such as endometriosis, thyroid disease, or polycystic ovary syndrome (PCOS). Such disorders can make it more difficult to get pregnant, and conditions should always be cleared by a gynecologist.</p><p>In addition, the woman's <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721003/?ref=cada.com">age</a> may be an important factor. Women aged 35 to 39 are about half as likely to become pregnant on their own as women aged 19 to 26. Within one year, the pregnancy rate for women aged 35-39 is about 60%, while after two years it is about 85%. Women have only a limited number of eggs, the quantity and quality of which decreases over the years. That is why the chance of getting pregnant decreases.</p><p>Another factor that can affect fertility is lifestyle. Women who smoke, drink alcohol, or use drugs are more likely to have trouble getting pregnant. Being overweight or obese can also affect fertility. Stress, anxiety, and depression can also negatively affect fertility.</p><h2 id="myth-8-a-woman-can-only-get-pregnant-if-she-has-sex-on-the-day-she-ovulates"><strong>Myth #8: A woman can only get pregnant if she has sex on the day she ovulates.</strong></h2><p>That women can only get pregnant on the day they ovulate is a common misconception. Ovulation is when a woman's ovaries release an egg that travels down the fallopian tube into the uterus. In the fallopian tube, the egg can be fertilised. Ovulation occurs on average on <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164578/?ref=cada.com">day 15</a> of the 28-day menstrual cycle. However, cycle length and day of ovulation vary from woman to woman.</p><p>It is true that after ovulation, the mature egg is viable for only around 24 hours. However, because sperm can survive for <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/andr.13179?ref=cada.com">up to five days</a> in a woman's body, sex on the days leading up to ovulation can also result in pregnancy. This means that a woman has a fertile window of six days during each ovulatory cycle in which she can possibly get pregnant.</p><h2 id="myth-9-a-woman-can%E2%80%99t-get-pregnant-during-her-period"><strong>Myth #9: A woman can’t get pregnant during her period.</strong></h2><p>Since the menstrual cycle can vary from month to month, it may be possible for a woman to get pregnant even during her period. Although unlikely, this can happen if her cycle is short and her ovulation occurs within five days of her menstrual period, which is the amount of time that sperm can typically survive in the female reproductive tract. </p><h2 id="myth-10-a-woman-should-lie-with-her-legs-elevated-after-sex-to-increase-the-chances-of-pregnancy"><strong>Myth #10: A woman should lie with her legs elevated after sex to increase the chances of pregnancy.</strong></h2><p>The belief that lying down after intercourse helps with conception is based on the assumption that this keeps sperm in the body longer and gives them more time to find their way to the egg. But in reality, there is no evidence that this position improves sperm survival or increases their ability to reach the egg. In fact, within <a href="https://academic.oup.com/humupd/article/12/1/23/607817?ref=cada.com">minutes</a> of ejaculation, sperm are already moving through the cervix. From here, a small group swim on to the fallopian tubes, where fertilisation can occur. Lying legs-up has no effect on how fast or how far the sperm travel, as they are propelled by the movement of small finger-like structures called cilia in the cervix and fallopian tubes.</p><h2 id="myth-11-if-a-woman-has-an-orgasm-during-intercourse-she-is-more-likely-to-become-pregnant"><strong>Myth #11: If a woman has an orgasm during intercourse, she is more likely to become pregnant.</strong></h2><p>This myth probably arises from the fact that female orgasm causes the muscles in the pelvic area to contract, which could in theory cause a male partner’s semen to be propelled more quickly and effectively into the uterus. However, studies find <a href="https://www.sciencedirect.com/science/article/abs/pii/S0003347213002121?ref=cada.com">no link</a> between orgasm and fertility.</p><p>The bottom line: if a woman has unprotected intercourse during her fertile window, there’s always the possibility of pregnancy.</p><h2 id="myth-12-a-collection-of-common-pregnancy-myths"><strong>Myth #12: A collection of common pregnancy myths.</strong></h2><p>Once a woman becomes pregnant, she may find herself on the receiving end of old wives’ tales offered by well-meaning friends, colleagues, relatives and even strangers. Some of the most commonly shared stories include:</p><p><strong>You know the sex of your baby if…</strong></p><p>Onlookers may attempt to predict the baby’s sex, based on one or more of the following:</p><ul><li>the shape of a woman’s belly (a pointed belly is said to indicate a boy and a round belly a girl)</li><li>The fetal heart rate (if this is known based on ultrasound or Doppler tests during pregnancy; a faster heart rate is commonly said to indicate a female fetus)</li><li>The severity of morning sickness (with more nausea and sickness indicating a girl)</li></ul><p>In truth: bellies containing both sexes come in different shapes and sizes, and the majority of pregnant women experience symptoms such as nausea and heartburn, regardless of the sex of their baby. However, women carrying female fetuses do report <a href="https://link.springer.com/article/10.1007/s00404-020-05839-1https://link.springer.com/article/10.1007/s00404-020-05839-1?ref=cada.com">more morning sickness</a>. Another thing that differs significantly between male and female babies is weight, both in terms of <a href="https://pubmed.ncbi.nlm.nih.gov/10559673/?ref=cada.com">birth weight</a> and even that <a href="https://www.tandfonline.com/doi/abs/10.3109/14767058.2015.1019457?ref=cada.com">during the first trimester</a>.</p><p><strong>Pregnancy means eating for two</strong></p><p>Another myth relates to cravings: pregnant women are said to become ravenous and to crave highly specific and/or odd foods throughout pregnancy. It is true that once pregnant, the female body undergoes hormonal changes and has a need for extra calories, even if “eating for two” is something of an exaggeration. However, it has not yet been proven whether this results in specific pregnancy cravings. In general, it’s advisable to try to maintain a balanced diet during pregnancy.</p><p><strong>Caffeine is not allowed during pregnancy</strong></p><p>Much advice surrounds what a woman can and can’t eat during pregnancy—how many cups of coffee are safe? Are soft cheeses allowed? What about the mercury content of swordfish? Is it a good idea to eat spicy foods if you’re at the point of wanting to induce labour?</p><p>It’s important to know that guidelines for food restriction during pregnancy can differ by country, and that evidence regarding some things is being continually updated. It’s a good idea to seek the advice of your ob/gyn.</p><h2 id="takeaway"><strong>Takeaway</strong></h2><p>If you’re thinking about and/or trying to get pregnant, you may find yourself hungry for knowledge about what can improve your chances. It’s important to be aware that there is a lot of folklore mixed in with the evidence surrounding fertility and pregnancy. It’s advisable not to believe everything you hear, and to seek out good sources of knowledge, such as reputable medical websites and organisations. If you continue to have doubts and questions, it’s a good idea to consult your doctor.</p><p>Have you been trying to conceive for some time, but without success? We at Cada will be happy to help you figure out possible causes and treatments.</p>

12 Common Fertility and Pregnancy Myths

<p>Learning that you have an ovarian cyst can be concerning. But what does it mean for your health and fertility? Below, we explain the different types of ovarian cysts, how they could impact your chances of becoming pregnant, and how they're treated.</p><h2 id="what-are-ovarian-cysts"><strong>What are ovarian cysts?</strong></h2><p>Ovarian cysts are sacs containing fluid or tissue which can be found on or inside of the ovaries. They are common, with <a href="https://pubmed.ncbi.nlm.nih.gov/23969786/?ref=cada.com">one study</a> finding that 35% of premenopausal and 17% of postmenopausal women examined by transvaginal ultrasound had at least one. Most ovarian cysts are small and harmless, resulting in no symptoms or pain. This is why they usually go undetected, disappearing over time without the need for medical help.</p><p>However, cysts may also cause pain and discomfort, especially if they grow to a certain size, and they can indicate certain conditions that make it more difficult to become pregnant.</p><h2 id="types-of-ovarian-cysts-and-how-they-develop"><strong>Types of ovarian cysts and how they develop</strong></h2><p>Ovarian cysts can form on the surface or inside of an ovary. They can be either solid or filled with fluid, and typically range in size between 1–4 cm in diameter (although they can sometimes grow to 5 cm or more). Below, we outline the main types and how they come about.</p><table>
<thead>
<tr>
<th>Cyst type</th>
<th>Cause</th>
<th>Contents</th>
<th>Impact on Fertility</th>
</tr>
</thead>
<tbody>
<tr>
<td>Functional</td>
<td>Normal follicle development leading to ovulation (failure of ovarian follicle to release an egg or blockage after release, leading to fluid buildup in the corpus luteum)</td>
<td>Fluid</td>
<td>Generally none</td>
</tr>
<tr>
<td>Cystadenoma</td>
<td>Growth on the surface of the ovary</td>
<td>Fluid or mucous</td>
<td>Generally none</td>
</tr>
<tr>
<td>Dermoid</td>
<td>Bodily tissue collecting in an unusual place (here, the ovary), usually before birth</td>
<td>Tissue (skin, hair or even teeth)</td>
<td>Generally none</td>
</tr>
<tr>
<td>Endometrioma</td>
<td>Endometriosis, in which tissue similar to the endometrium (uterine lining) grows outside of the uterus (here, in the ovary)</td>
<td>Menstrual fluid (the appearance of old blood gives them the name “chocolate cysts”)</td>
<td>Possible impact</td>
</tr>
<tr>
<td>PCOS-related</td>
<td>Polycystic ovarian syndrome (PCOS), which is associated with clusters of small ovarian cysts. These occur when a woman’s ovarian follicles do not successfully release their eggs.</td>
<td>Fluid</td>
<td>Possible impact</td>
</tr>
</tbody>
</table><h2 id="what-are-the-risk-factors-for-ovarian-cysts"><strong>What are the risk factors for ovarian cysts?</strong></h2><p>In addition to their association with <a href="https://cada.com/en/blog/how-to-get-pregnant-with-endometriosis-naturally/">endometriosis</a> and <a href="https://cada.com/en/blog/ways-to-get-pregnant-with-pcos/">PCOS</a>, ovarian cysts are more likely to develop when a woman has a pelvic infection. Pregnant women are also more likely to have corpus luteum cysts. A history of ovarian cysts is also a risk factor—women who have had one before are more likely to get one again.</p><h2 id="what-are-the-symptoms-of-ovarian-cysts"><strong>What are the symptoms of ovarian cysts?</strong></h2><p>Most ovarian cysts are harmless, cause no symptoms, and resolve on their own in time. However, large cysts are more likely to cause discomfort, especially if they grow rapidly, or cause the ovary to become displaced or twisted (known as ovarian torsion). It also sometimes happens that a cyst ruptures (bursts), at which point its contents are released into the abdominal cavity. While the body can often reabsorb this material, it is also possible for it to lead to infection.</p><p>Symptoms of cysts can include:</p><ul><li>Pelvic pain or abdominal pain which radiates to the lower back</li><li>Frequent bloating or indigestion</li><li>Changes in your bowel habits including difficult and painful movements</li><li>Pain during sex</li><li>Nausea and vomiting</li></ul><h2 id="how-do-ovarian-cysts-affect-fertility"><strong>How do ovarian cysts affect fertility?</strong></h2><p>Functional cysts, cystadenomas, and dermoid cysts generally do not affect one’s chances of becoming pregnant, even though they may require surgical treatment if they continue to grow. Cysts that are associated with endometriosis or PCOS may be associated with infertility, but it is <a href="https://pubmed.ncbi.nlm.nih.gov/24559614/?ref=cada.com">unclear</a> whether this is due to the cysts themselves, or more due to the underlying condition. Studies show that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538128/?ref=cada.com">30–50%</a> of women with endometriosis experience infertility, while fertility problems are also common with PCOS. It is also worth mentioning that procedures to remove cysts can themselves <a href="https://pubmed.ncbi.nlm.nih.gov/24559614/?ref=cada.com">impact fertility</a>.</p><h2 id="how-are-ovarian-cysts-diagnosed"><strong>How are ovarian cysts diagnosed?</strong></h2><p>The diagnosis of an ovarian cyst may begin with a pelvic exam, during which a healthcare provider may feel for a cyst or discover one by chance. This would normally be confirmed by an ultrasound scan, either performed over the abdomen or using a wand inserted into the vagina (known as a transvaginal ultrasound). In some cases, laparoscopy is also used. This involves inserting an instrument with a camera through a small incision in the abdomen. Some cysts can also be directly removed during the laparoscopy procedure.</p><h2 id="how-are-ovarian-cysts-treated"><strong>How are ovarian cysts treated?</strong></h2><p>Treatment for ovarian cysts typically depends on the type and size. Initial treatments may include monitoring and medication, such as hormonal birth control pills, to slow the cyst’s growth. If ovarian cysts do not resolve on their own, are resistant to treatment, or are causing increasingly painful symptoms, it may become necessary to have a surgical removal. It is highly recommended that surgery be carried out before pregnancy to avoid complications.</p><p>Cysts may be drained using single-cut <a href="https://www.notion.so/18c062482fa3400fba37321effd53451?pvs=21&ref=cada.com">laparoscopic surgery</a>, which requires only one small incision below the belly button. Through this single incision, specialized instruments are inserted, including a tiny lighted camera which the surgeon uses to guide the procedure. The surgeon then collapses the cyst and removes it.</p><p>Catching a cyst early can help ensure that it does not cause problems in the future. If you have pain that may be caused by a cyst, it’s a good idea to get in touch with your doctor.</p><p><strong>Treatments for conditions that cause ovarian cysts</strong></p><p>While many women living with PCOS manage to conceive naturally, some may require intervention to help regulate their ovulation or to help ovulation to occur. Medication is often prescribed to women with PCOS to stimulate release of eggs by the ovaries. However, this medication <a href="https://elsevier.health/en-US/preview/reproductive-health/clomiphene?ref=cada.com">should not be given</a> to women who have enlarged ovaries or a cyst that is not due to PCOS, as it could cause further growth.</p><p>If medication is unsuccessful in helping a woman with PCOS, a further step may be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013239/?ref=cada.com">laparoscopic ovarian drilling</a>, a minor surgery which is carried out under general anaesthetic. Here, a small incision is made in the lower abdomen and a laparoscope (instrument with a camera) is passed through. The ovaries are then exposed to heat or lasers. This destroys excess ovarian tissue and reduces the production of male sex hormones (androgens) which characterises the syndrome. This could then increase the chances of regular ovulation and of getting pregnant.</p><p>Treatment for endometriosis ranges from pain relievers to hormonal therapies to surgery. In recent years, a <a href="https://academic.oup.com/humrep/article/31/8/1765/2379930?ref=cada.com">study</a> found that endometriosis-related surgery was a risk factor for infertility, while the endometriomas that can develop as a result of the condition were not. If you have endometriosis, your doctor can provide advice based on your particular situation.</p><h2 id="takeaway"><strong>Takeaway</strong></h2><p>Ovarian cysts, growths on or inside the ovary which are filled with fluid or tissue, are common in women during their reproductive years as well as after menopause. They can occur in the course of the normal menstrual cycle, or due to additional causes, such as hormonal imbalance or infection. They tend to disappear on their own, without causing problems or affecting fertility. In some cases, however, they can become large and require treatment. Ovarian cysts may also be the result of conditions—such as PCOS and endometriosis—that are associated with difficulties in conceiving. A gynecologist or fertility specialist can offer advice regarding the likely cause of cysts, and help to navigate treatment options.</p><p>Fortunately, many women who have been diagnosed with a cyst are able to have a healthy pregnancy. If you are concerned about ovarian cysts impacting your fertility, contact us for an appointment. Cada’s compassionate team of specialists will be happy to advise you.</p>

Can Ovarian Cysts Cause Infertility?

<p>Men who suffer from erectile dysfunction (ED) have difficulty maintaining an erection that is firm enough for sexual intercourse. Older men tend to be more affected by this problem, but younger men can also suffer from ED. This condition can pose an additional burden when those affected have an unfulfilled desire to have children.</p><p>Several oral medications are available that help to promote erections in men with ED. Below, we discuss everything from why purchasing these drugs without a doctor's prescription can be life-threatening, to how they affect sperm quality.</p><h2 id="what-are-erectile-dysfunction-medications"><strong>What are erectile dysfunction medications?</strong></h2><p>Also sometimes called sexual enhancers or potency enhancers, oral medications for erectile dysfunction help to promote an erection by increasing blood flow to the penis. They tend to be the first treatment option for men experiencing erectile dysfunction.</p><p>Probably the best-known sexual enhancer, Viagra was originally developed and tested by the pharmaceutical company Pfizer as a medication for high blood pressure. Many test subjects reported the positive side effect of increased erectile function. Since then, it has been prescribed to men with erection problems.</p><p>There are now several sexual enhancers from pharmaceutical companies, all of which fall into the category of phosphodiesterase-5 inhibitors or PDE-5 inhibitors. The best-known of these include:</p><ul><li>Viagra (with active ingredient sildenafil)</li><li>Cialis (with the active ingredient tadalafil)</li><li>Levitra (with vardenafil as the active ingredient)</li><li>Stendra (with the active ingredient avanafil)</li></ul><p>As the patents for Viagra have now expired, other pharmaceutical companies are now allowed to produce medications with sildenafil. Certain other of the brand names listed above are also available in generic forms. Generic medications contain the same active ingredients, but are typically offered at lower prices. Natural (mostly plant-based) medications for erectile dysfunction are also available, as we discuss below.</p><h2 id="how-do-they-work"><strong>How do they work?</strong></h2><p>Erectile dysfunction medicines work in combination with sexual arousal. If a male is sexually aroused, an erection can occur and can be strengthened by the medication, but men do not get erections simply by taking the medication.</p><p>When sexual arousal is registered by the brain, a signal is sent to the penis via the spinal cord, and blood flow to the erectile tissue of the penis is increased through relaxation and dilation of blood vessels. This produces an erection.</p><p>ED medications help the arteries in the penis to relax and dilate. They also prevent the breakdown of the messenger substance, so that blood flows less quickly away from the penis.  Provided that there is continual mental or physical sexual stimulation, this maintains the erection longer.</p><p>Medications for ED also have varying periods of effectiveness: some wear off after a few hours, while others can be effective for up to 36 hours. For more information on this, see our FAQ section below.</p><p>Priapism, a state in which an erection is involuntarily maintained for a long period, is an uncommon but serious side effect of ED medication. Men who experience this phenomenon should see a doctor after four hours at the latest, as prolonged erections can cause damage to the penis.</p><p>Other side effects occur more commonly with ED medications. These include headache, upset stomach, and dizziness.</p><h2 id="oral-ed-treatments-and-male-fertility"><strong>Oral ED treatments and male fertility</strong></h2><p>Various studies have investigated erectile dysfunction medication in terms of its effect on sperm.</p><p>In 2004, a <a href="https://www.sciencedirect.com/science/article/pii/S0015028206043871?ref=cada.com">study</a> of 57 males found that sildenafil, the active ingredient in Viagra, significantly increased the number and speed of sperm. However, the scientists also found that the medication negatively impacted the sperm’s ability to fertilise an egg. A subsequent <a href="https://onlinelibrary.wiley.com/doi/10.1111/and.12097?ref=cada.com">study</a> found no evidence of this effect with either sildenafil or tadalafil.</p><p>In a 2021 <a href="https://academic.oup.com/smoa/article/9/3/100377/6956878?login=false&ref=cada.com">journal article</a>, the European Society of Sexual Medicine advocated the prescription of ED medications for couples experiencing infertility for whom sexual activity is difficult due to problems with erectile function. According to the authors, where ED is a problem, ‘PDE-5 inhibitors should be suggested to ensure an effective and satisfying sexual relationship of the couple.’</p><h2 id="use-caution-when-purchasing-online"><strong>Use caution when purchasing online</strong></h2><p>PDE-5 inhibitors are available as prescription medications for the protection of the patient. One reason for this is that erectile dysfunction can be an early signal of other men’s health problems, <a href="https://pubmed.ncbi.nlm.nih.gov/21920268/?ref=cada.com">heart disease</a> in particular. Thus, men who are experiencing ED should begin by consulting their doctor.</p><h3 id="dangerous-interactions"><strong>Dangerous interactions</strong></h3><p>Potentially life-threatening interactions can occur when an individual seeks out ED medication on their own. This especially applies to patients taking antihypertensive drugs with nitrates, such as nitroglycerin, to treat high blood pressure or kidney disease. When combined, nitrates and PDE-5 inhibitors can cause dangerously low blood pressure; this is because both ingredients encourage blood vessel dilation and work against hypertension (high blood pressure).</p><h3 id="questionable-ingredients"><strong>Questionable ingredients</strong></h3><p>ED pills are easy to find online. However, they are in many cases counterfeit. In Switzerland, online purchase of prescription drugs is only possible if: a) you have a prescription and b) the pharmacy has a licence to ship medicines. Purchases from abroad are illegal and may be prosecuted. According to Swissmedic, erection enhancers are still the <a href="https://www.swissmedic.ch/swissmedic/en/home/humanarzneimittel/market-surveillance/medicinal-products-from-the-internet/statistical-data/illegale-arzneimittelimporte-2022-beschlagnahmte-sendungen.html?ref=cada.com">most common medicines</a> illegally imported into the country.</p><p>Anyone purchasing online should be particularly critical if the medication arrives without packaging and without a leaflet. In addition, be aware that ED drugs from <a href="https://www.swissmedic.ch/swissmedic/en/home/humanarzneimittel/market-surveillance/medicinal-products-from-the-internet/warnings-related-to-medicinal-products-from-the-internet/smc-warnt-vor-erektionsfoerdern.html?ref=cada.com">internet suppliers</a> often come in incorrect or inappropriately high dosages, and can contain toxic as well as addictive substances.</p><h2 id="natural-sexual-enhancers"><strong>Natural sexual enhancers</strong></h2><p>Some men with erection problems prefer to take natural supplements, which are often available over the counter. If you search the internet for natural supplements, you will probably find ones with the following ingredients: Ashwagandha, Yohimbine, Maca, L-Arginine or Spanish Fly.</p><p><strong>Ashwagandha</strong>, also known as Withania somnifera, Indian ginseng and sleeping berry, was found in a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5833251/?ref=cada.com#B34">systematic review</a> to have certain positive effects on sperm. There is no high-quality evidence that it reduces erectile dysfunction.</p><p><strong>Yohimbine,</strong> or Pausinystalia johimbe, is extracted from the bark of the yohimbe tree in Central Africa. In folk medicine, yohimbine is used as a preparation for erectile dysfunction or an aphrodisiac (means to increase sexual desire). Yohimbine is an alpha-blocker, which promotes relaxation of blood vessels.  A <a href="https://pubmed.ncbi.nlm.nih.gov/9649257/?ref=cada.com">meta-analysis</a> from 1998 concluded that yohimbine can have a positive effect as a treatment for ED. In the past, however, there have also been <a href="https://www.sciencedirect.com/science/article/abs/pii/S0379073821000256?ref=cada.com#:~:text=A%20single%20oral%20dose%20of,can%20cause%20severe%20acute%20poisoning.&amp;text=The%20concentration%20of%205631%20ng,turned%20out%20to%20be%20fatal.">cases of fatal overdose</a> related to the drug.</p><p><strong>Maca</strong> is a Peruvian plant, which is why it is sometimes called Peruvian ginseng. A <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1439-0272.2008.00892.x?ref=cada.com">study</a> of 50 men suggested it to be effective in improving erectile function in men with mild erectile dysfunction.</p><p><strong>L-arginine</strong> is an amino acid produced naturally in the body that is important for the formation of nitric oxide. Taking it leads to improved blood flow, which is why some men use it for erectile dysfunction, though there is insufficient evidence to support this use.</p><p><strong>The Spanish fly</strong>, also called blister beetle, produces a substance called cantharidin. The use of this substance goes back a long way and is said to lead to an increase in libido in women and potency in men. From a scientific point of view, there is no basis for using cantharidin for the problems mentioned above. Instead, it is known that the substance can cause <a href="https://pubmed.ncbi.nlm.nih.gov/8765116/?ref=cada.com">serious side effects</a>. These include painful urination or blood in the urine, bloody vomiting, kidney failure, bleeding in the abdomen, strokes or coma.</p><p>If you are thinking about taking natural sexual enhancers, you should consult your healthcare provider first. He or she will determine whether there are any interactions with other medications, recommend the correct dosage and explain any possible side effects.</p><h2 id="lifestyle-changes"><strong>Lifestyle changes</strong></h2><p>It’s worth noting that men with erectile dysfunction are often recommended to make <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291878/?ref=cada.com">lifestyle changes</a>, as these can have a significant positive impact on the condition, without the need for medication. They can also help to improve certain underlying causes of ED, such as low testosterone. These lifestyle modifications include things like weight loss, moderate exercise, and adopting a healthy diet.</p><h2 id="procedural-therapies"><strong>Procedural therapies</strong></h2><p>Yet another category of treatment for ED consists of procedural therapies, including options such as alprostadil (which is either injected into the penis or inserted in pellet form into the urethra), vacuum devices, and surgical implants. For more information, check out our related article.</p><h2 id="frequently-asked-questions"><strong>Frequently asked questions</strong></h2><h3 id="is-ed-medication-dangerous">Is ED medication dangerous?</h3><p>In general, prescription medications for ED are safe when used after seeking advice from a doctor. It is important to follow advice regarding the correct dose and to be aware of possible side effects and interactions with other medications. When ED medication is purchased online and/or taken without first consulting a medical professional, it is more risky due to the unverified contents and strength of the medication, as well as the possibility of unaddressed health conditions that could be causing the ED.</p><h3 id="what-is-the-best-oral-medication-for-ed"><strong>What is the best oral medication for ED?</strong></h3><p>To find out which PDE-5 inhibitor is best for you, you should talk to a healthcare provider or specialist in urology. These medications come in different dosages, take different lengths of time to work and sometimes have to be taken on an empty stomach. Possible interactions with other medications you are currently taking should also be considered. In some cases, combinations of different PDE-5 inhibitors may be suggested.</p><h3 id="how-long-does-it-take-for-sexual-enhancers-to-start-working-and-how-long-do-they-last"><strong>How long does it take for sexual enhancers to start working and how long do they last?</strong></h3><p>Depending on the active ingredient and the dosage, ED medications work differently. The following information is therefore only a guide.</p><ul><li>Sildenafil (e.g. Viagra): Takes effect within 30–60 minutes and lasts approx. 4 hours.</li><li>Tadalafil (e.g. Cialis): Works within 30–60 minutes and lasts up to 36 hours.</li><li>Vardenafil (e.g. Levitra): Works within 25–60 minutes and lasts up to 4 hours.</li><li>Avanafil (e.g. Stendra): Works within 15–30 minutes and lasts up to 6 hours.</li></ul><h2 id="takeaway"><strong>Takeaway</strong></h2><p>Erectile dysfunction is a common problem affecting men’s sexual health and wellbeing. It’s important to investigate the causes of ED with a healthcare professional before beginning to treat it, so that that health conditions such as heart disease can first be ruled out.</p><p>There are many oral medications on the market for men with erection problems. Since the patent on many of them, including Viagra, has been lifted, there are also a number of generic products that are cheaper from a cost point of view. As far as fertility is concerned, there is no clear evidence that these medications are a hindrance to conception.</p><p>It is not recommended to try to purchase such medications on the internet, both because the advice of a health professional is important, and because online offerings can pose serious health risks.</p><p>Are you experiencing problems with erectile function? Get in touch with us; Cada's empathetic team of experts would be happy to offer you specialist advice.</p>

How Do Erectile Dysfunction Medications Affect Male Fertility?

<p>It is well known that <a href="https://cada.com/en/blog/female-fertility-after-35/">female fertility decreases with age</a>. But what about the fertility of men over the age of 35? Are there reasons that men should also think about preserving their fertility?</p><p>In this article, we explain the benefits of sperm freezing and describe how this form of fertility preservation works in Switzerland.</p><h2 id="what-is-sperm-freezing"><strong>What is Sperm Freezing?</strong></h2><p>Sperm freezing is a reproductive medicine procedure in which sperm are frozen for possible future family planning. When it comes to sperm freezing, a distinction is made between social freezing and medical freezing.</p><p>Sperm collection and freezing is done in the same way with social and medical freezing. The main differences are reflected in the reasoning, and legal and financial aspects (as medical freezing is often covered by health insurance companies).</p><table>
<thead>
<tr>
<th></th>
<th>Social Freezing</th>
<th>Medical Freezing</th>
</tr>
</thead>
<tbody>
<tr>
<td>Reasoning</td>
<td>Freezing for social reasons, such as wanting to have the freedom to prioritise their career or waiting to find the right partner.</td>
<td>Freezing for medical reasons, like testicular cancer, undergoing cancer treatments (chemotherapy or radiotherapy), or surgery on prostate or testicles.</td>
</tr>
<td>Cost</td>
<td>Not covered by Swiss health insurance and must therefore be borne in full by the private individual.</td>
<td>Covered by Swiss health insurance for <a href="https://www.fedlex.admin.ch/eli/oc/2019/355/de?ref=cada.com">men up to the age of 40 for sperm freezing</a> if there is a more than 20 percent that they may end up with azoospermia (complete absence of sperm in the ejaculate).</td>
    <tr>
<td>Legal</td>
<td>Sperm may be frozen and then used within a maximum of 10 years.</td>
<td>Sperm may be frozen and stored for beyond 10 years with authority approvials. Thawing and using the cryopreserved sperm can only be done if it is proven that the patient can have a good quality of life.</td>
</tr>

</tbody>
</table><p>In Switzerland, the usage of frozen sperm also differs between social and medical freezing; in the latter case, thawing and using the cryopreserved sperm can only be done if it is proven that the patient can have a good quality of life. This means that if they have a malignant disease (one that gets progressively worse), there must be a reasonable belief that they will still have a normal life expectancy.</p><h2 id="why-do-some-men-freeze-their-sperm"><strong>Why do some men freeze their sperm?</strong></h2><p>There are several reasons why men have their sperm frozen without medical indication:</p><p><strong>Age:</strong> Like female fertility, <a href="https://link.springer.com/article/10.1007/s10815-018-1304-4?ref=cada.com">male fertility</a> also decreases with age. It is <a href="https://academic.oup.com/humrep/article/36/4/833/6104812?login=false&ref=cada.com">half as high</a> in men over 35 years of age than in men over 25 years of age. It continues to decrease more rapidly towards their 70s or 80s. Much more important for family planning is the fact that <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/and.13874?ref=cada.com">sperm quality</a> decreases with age. Increased paternal age is associated with a higher rate of miscarriage, hereditary occurrences of ADHD and schizophrenia, premature birth, and preeclampsia in women.</p><p><strong>Inability to be present during assisted insemination procedure:</strong> Assisted reproductive techniques, like IVF, require the man's ejaculate at a specific point in time. For this, a man usually goes to the fertility center and masturbates there to provide a fresh semen sample. However, if this is not possible due to scheduling reasons (e.g. because the man has to travel on business on the day of the artificial insemination), he can provide a sperm sample in advance and have it frozen.</p><p><strong>Dangerous Occupations:</strong> Certain occupations carry a high risk for male infertility. Males who are occupationally exposed to radiation or toxins may also consider social freezing. In some countries, even soldiers have sperm frozen so that if they die in the war, their wives can father a child post mortem. In Switzerland, no germ cells from deceased partners may be used for artificial insemination. You can read more about this in <a href="https://cada.com/en/blog/surrogacy/">our article</a> on the legal basis of artificial insemination in Switzerland.</p><p><strong>Sperm Donation:</strong> Men who donate their sperm also go through the sperm freezing process, as their sperm are cryopreserved until perhaps chosen by a couple. Their sperm samples can be stored in a sperm bank. According to the Swiss Reproductive Medicine Act, frozen donor sperm may remain in long-term storage for five years, with potential to extend the deadline to ten years.</p><h2 id="how-does-sperm-freezing-work"><strong>How does sperm freezing work?</strong></h2><ol><li><strong>Preliminary clarification:</strong> If you want to have sperm cells removed and frozen, you first go to a fertility center. There, your medical history will be taken and the procedure explained. You will also have a blood test for any infectious diseases, such as HIV or hepatitis C.</li><li><strong>Sperm provision:</strong> Unlike women, who have to first go through hormone therapy and then have eggs surgically removed, men typically only need to provide a sperm sample. This is usually done at the fertility clinic through masturbation. There are also men who prefer to masturbate at home and then hand in the sample to the clinic. However, you need a special container for this, and you have to hand in the sample to the clinic immediately afterwards.</li></ol><p>If a man suffers from anejaculation, i.e. he has no ejaculation despite having an orgasm, a process called electroejaculation may be used to get the sperm. During electroejaculation, various nerves that are responsible for ejaculation are stimulated and thus produce an ejaculation. Another issue can be that a male can ejaculate, but has an extremely low sperm count or there is no sperm in the semen sample (called azoospermia). In this case, the surgical removal of testicular tissue (TESE) for sperm collection is possible.</p><ol><li><strong>Sperm analysis &amp; sperm processing:</strong> Performed in a laboratory, a semen analysis considers many factors of ejaculate, including semen quality, sperm count, sperm morphology and sperm motility. These influence how likely it is that sperm can fertilise an egg. The sperm are processed, meaning that the most mobile and qualitatively best sperm are separated from the other substances in semen. The remaining sperm are then placed in a vial.</li><li><strong>Freezing &amp; Storage:</strong> Now the sperm are frozen in liquid nitrogen, usually at -196 degrees Celsius, and stored in special containers. The containers are placed in the so-called cryobank until they are fertilised. After ten years, the germ cells must be disposed of properly. In the case of cancer patients, the deadline may be extended.</li></ol><h2 id="what-happens-after-the-thawing-process"><strong>What happens after the thawing process?</strong></h2><p>If a couple chooses sperm from a sperm donor, or fails to conceive naturally, the frozen sperm are thawed. The functional sperm are then used in fertilisation by assisted reproductive technology (ART). </p><p>If there are a great number of high quality sperm, a sample may be used for intrauterine insemination (IUI), where sperm is injected directly into the uterus. In most cases, the thawed sperm will be used in intracytoplasmic sperm injection (ICSI), which is a form of in vitro fertilisation (IVF). You can find more information about the process of ICSI and IVF in <a href="https://cada.com/en/blog/ivf-process-start-to-finish/">our article</a>.</p><h2 id="how-much-does-freezing-sperm-cost-in-switzerland"><strong>How much does freezing sperm cost in Switzerland?</strong></h2><p>The cost of sperm freezing varies depending on the fertility clinic. Patients can expect costs of between CHF 500 and CHF 1,500 for the procedure up to freezing and annual costs of between CHF 200 and CHF 500 for storing the sperm in the cryobank. If the patient requires additional services, such as electroejaculation, testicular sperm extraction (TESE) or genetic testing, the price will be adjusted upward. It is also important that you are aware that after thawing, there will be further costs for the assisted reproductive technology.</p><h2 id="how-can-i-support-the-process"><strong>How can I support the process?</strong></h2><p>There are numerous measures you can take to improve your own fertility. First and foremost, you should aim to freeze your sperm before the age of 40. If you are over that age, visit a fertility clinic to find out your options.</p><p>You can also opt for a number of lifestyle changes, including:</p><ul><li>A healthy and balanced diet</li><li>Regular physical activity</li><li>Maintaining a body mass index &lt;25 and &gt;18.5</li><li>Reduction of as many stress factors as possible</li><li>Avoidance of cigarettes and alcohol</li><li>Getting enough sleep.</li></ul><p>See <a href="https://cada.com/en/blog/tips-for-getting-pregnant-with-low-sperm-count/">our article on sperm count</a> for more detailed information on male fertility. Please note, however, that the quality of the egg cells and the general state of health of your partner also have an influence on the success of subsequent fertilisation.</p><h2 id="what-else-is-there-to-consider"><strong>What else is there to consider?</strong></h2><p>There is debate among experts about the benefits of cryopreservation for men. As explained at the beginning, the quality of the sperm decreases with advancing age, and certain diseases can be traced back to the increased age of the father.</p><p><a href="https://www.mdpi.com/1422-0067/24/5/4656?ref=cada.com">Previous research results</a> further show that cryopreservation can also have negative effects on sperm or even damage them. However, this has no significant impact on the chances of successful conception. This was shown by <a href="https://academic.oup.com/humrep/article/16/3/495/642432?login=false&ref=cada.com">a study</a> in which the fertilisation rate, embryo quality and pregnancy rate of thawed and fresh sperm in ICSI treatments were compared. In principle, we recommend that you check with your fertility specialist in advance whether the age-related risks outweigh the genetic risks of cryopreservation.</p><p>The same should be considered before a vasectomy (a surgical procedure that prevents sperm from mixing with semen and being ejaculated). Some doctors recommend that their patients freeze their sperm before undergoing this procedure. An <a href="https://pubmed.ncbi.nlm.nih.gov/35396922/?ref=cada.com">international study</a> involving 228 urologists from six European countries has shown that there is no uniform consensus when it comes to recommending conservation of sperm before a vasectomy.</p><p>It should also be noted that neither social freezing nor any assisted reproductive technology can guarantee that the desire to have children will be fulfilled. In general, it is best to get several opinions and to inform yourself about the possible risks and side effects of cryopreservation.</p><h2 id="frequently-asked-questions"><strong>Frequently asked Questions</strong></h2><div class="kg-card kg-toggle-card" data-kg-toggle-state="close"><div class="kg-toggle-heading"><h4 class="kg-toggle-heading-text"><strong>Up to what age is sperm freezing possible?</strong></h4><button class="kg-toggle-card-icon"><svg id="Regular" xmlns="http://www.w3.org/2000/svg" viewbox="0 0 24 24"><path class="cls-1" d="M23.25,7.311,12.53,18.03a.749.749,0,0,1-1.06,0L.75,7.311"/></svg></button></div><div class="kg-toggle-content"><p>The medical literature reports an increasingly significant decrease in sperm quality after the age of 35, with the benefits of sperm freezing being greatest before the age of 40. Accordingly, the sperm should—if possible—be frozen beforehand. However, there is no legal age limit for sperm freezing. Some clinics set their own maximum age. It is therefore best to find out more directly from the clinic of your choice.</p></div></div><div class="kg-card kg-toggle-card" data-kg-toggle-state="close"><div class="kg-toggle-heading"><h4 class="kg-toggle-heading-text"><strong>Do I have to take a day off for the process?</strong></h4><button class="kg-toggle-card-icon"><svg id="Regular" xmlns="http://www.w3.org/2000/svg" viewbox="0 0 24 24"><path class="cls-1" d="M23.25,7.311,12.53,18.03a.749.749,0,0,1-1.06,0L.75,7.311"/></svg></button></div><div class="kg-toggle-content"><p>No. In general, your appointment for providing a sperm sample will take around 30 minutes or less. If you have other concerns about the timing required, feel free to ask your fertility specialist.</p></div></div><div class="kg-card kg-toggle-card" data-kg-toggle-state="close"><div class="kg-toggle-heading"><h4 class="kg-toggle-heading-text"><strong>Can I deduct sperm freezing from my taxes?</strong></h4><button class="kg-toggle-card-icon"><svg id="Regular" xmlns="http://www.w3.org/2000/svg" viewbox="0 0 24 24"><path class="cls-1" d="M23.25,7.311,12.53,18.03a.749.749,0,0,1-1.06,0L.75,7.311"/></svg></button></div><div class="kg-toggle-content"><p>Social sperm freezing costs are not tax deductible. For cancer patients, the costs for medical freezing are often covered.</p></div></div><div class="kg-card kg-toggle-card" data-kg-toggle-state="close"><div class="kg-toggle-heading"><h4 class="kg-toggle-heading-text"><strong>Does sperm freezing have any side effects?</strong></h4><button class="kg-toggle-card-icon"><svg id="Regular" xmlns="http://www.w3.org/2000/svg" viewbox="0 0 24 24"><path class="cls-1" d="M23.25,7.311,12.53,18.03a.749.749,0,0,1-1.06,0L.75,7.311"/></svg></button></div><div class="kg-toggle-content"><p>No, there are no side effects for men. However, the delivery of the sperm sample is uncomfortable for some, because it requires masturbation in the fertility clinic. If you are uncomfortable with providing a sperm sample or are feeling nervous about the process, it is a good idea to talk to your fertility specialist. They can assure you that the process is common and provide suggestions for how to make it easier.</p></div></div><h2 id="takeaway"><strong>Takeaway</strong></h2><p>Social sperm freezing is one way to preserve male fertility and take control of your family planning. Although the body of literature on the influence of paternal age on the health of offspring is not as comprehensive as that on the age of mothers, it is nevertheless clear that the father's age should be taken into account when planning a family.</p><p>The procedure of cryopreservation may impact sperm parameters. However, research is relatively unclear, with at least one study showing that the process does not significantly impact conception. Despite this, men who consider social sperm freezing at a later date due to possible family planning must weigh the genetic risks of older age and those of the procedure itself with the help of a medical professional.</p><p>Are you interested in freezing your sperm or would you like to know how your fertility is doing? Our empathetic specialists are at your disposal.</p>

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