Here is a piece I once wrote for Expat Life in Thailand magazine, about the things people tell one another about fertility and infertility. Part 1 — which of them are true, and which are just a bluff?

1. The longer you save sperm up, the better — and the more of it

A bluff. The longer you save it up, the more of it is sperm cells that have already died — and they release free radicals onto the fresh, good-quality ones. With my own patients I suggest ejaculating every other day for about a week before coming in to give a sample, whether it is for a test or for use in treatment, so that we get sperm that are fresh, with chromosomes that are not fragmented.

2. Getting pregnant on your own at 40 looks easy enough

A bluff, dear. We see Hollywood stars and Thai superstars who are past Lak Si, past Don Mueang, almost at Rangsit, lining up to have babies — some twins, some singletons, everywhere you look — and never a word about where those babies came from. So everyone comes away thinking that a lady out at Don Mueang can get pregnant on her own quite easily. The truth is that a woman's chance of conceiving on her own starts to fall from the age of 30, drops badly from 37, and is in tatters from Lak Si onwards — and you have not even reached Don Mueang yet, my dear. So if you are 37 or over and you have been trying for more than 6 months without success, come in and get checked. (Lak Si, Don Mueang and Rangsit are stops along the road running north out of Bangkok, used here as a joke for age: Lak Si — “marker four” — is forty, and the others lie further out still.)

3. Pregnancy is a natural thing — be patient, it will come on its own

Another bluff. Some couples marry in their late twenties, and then one day it dawns on them — hang on, why has nothing happened? By the time they come to see me they are past the Din Daeng junction and closing in on Lak Si. As a rule: if you are under 37 and you have been trying — WFH, so to speak — for more than a year and it still has not happened, then come and see a doctor, pleeeease.

4. After ovulation the egg lives on for up to two days

A bluff again. Once the egg is released it lives only 12–24 hours. After that it shrivels, breaks down, goodbye. Sperm, on the other hand, can loiter about in the uterus and the fallopian tubes for 3–5 days. Think back to the early days of courting: one of you always has to turn up and wait for the other.

5. Supplements, and sour fruit juices too, will improve your egg quality

This one is a bluff as well. How many times are we going to fall for it? The main thing that ruins egg quality is age. All those supplements you rush out and buy, dozens of them, taken over and over — they do not make the eggs any better. At most they slow down the decline a little. Oh, and with some of them you may take them and the eggs are wiped out without your even knowing. Look carefully. Use your head before you part with your money.

So when should you come in?

37 or over, trying for more than 6 months without success — come in and get checked.

Under 37, trying for more than a year and still nothing — come and see a doctor.

10 fertility beliefs: true or nonsense? Part 1