10 Uncommon Fertility Questions You Haven’t Asked
Trying to conceive can raise countless questions, but what about the ones you didn't think to ask? Dr. Roland Chieng helps to uncover 10 uncommon questions that could offer fresh insight into your fertility journey.
1. Does IVF remove all your eggs?
Many patients worry that undergoing IVF might use up all their eggs. That’s not the case.
When you go through IVF, fertility medications encourage multiple follicles to mature simultaneously. That way, instead of just one, doctors can retrieve several eggs, including some that would have naturally been lost that month.
In other words, IVF doesn’t pull eggs out of your overall lifetime supply—it simply collects more from the same group that your body had already activated. The total number of eggs remaining (your ovarian reserve) isn’t significantly affected by this process.
Studies show that even after multiple IVF cycles (up to four), key markers such as AMH (Anti-Müllerian Hormone) and FSH (Follicle-Stimulating Hormone) remain stable, indicating your ovarian reserve is not substantially depleted[1].
2. How long do IVF medications stay in your body? Is it necessary to “detox” the body for balance?
Once your IVF cycle is completed and egg retrieval has been done, the fertility medications used for ovarian stimulation leave your system relatively quickly, usually within a few days. By the time your next period begins, your body has naturally processed and cleared the medications.
So, no special “detox” is needed. Your body has its own very effective detox system—your liver and kidneys do this job naturally.
In fact, in some cases, the body may respond better to stimulation when doing back-to-back IVF cycles without waiting in between, especially in patients with a lower ovarian reserve.
The idea of needing to detox after IVF is a common misconception. While it's always good to eat healthily and stay hydrated, there’s no scientific evidence that a special cleanse or detox improves recovery or fertility outcomes after IVF medications.
3. What is considered advanced maternal age? Is 45 too late for IVF?
In Singapore and most parts of the world, advanced maternal age typically refers to women who are 35 years old and above. This is the age when fertility naturally starts to decline more noticeably, and the chances of getting pregnant (either naturally or through IVF) begin to drop.
Although there is a defined upper age limit for women to undergo IVF treatment, success rates for women aged 45 remain significantly low, with medical evaluation. This is primarily because a woman’s egg quality and quantity decrease significantly with age, especially after the age of 40. At 45, even with the help of IVF, the chances of achieving a successful pregnancy using your eggs are low, often below 5% per cycle[2], depending on your individual health and fertility profile.
So, while 45 is not "too late" in the legal or medical sense, realistically, the chances of pregnancy success are very limited, and it's important to have open conversations with your fertility specialist about your options, expectations, and next steps.
4. Is a failed IVF cycle considered a pregnancy loss?
If the embryo doesn’t implant and no pregnancy occurs, it’s considered a failed cycle, not a pregnancy loss.
However, if implantation happens and the pregnancy ends early (like in a chemical pregnancy or miscarriage), then it is considered a pregnancy loss.
5. Does an IVF miscarriage make you more fertile afterward?
Not exactly—but it can offer important insights.
Having a miscarriage after IVF shows that implantation did occur, which is a positive sign in itself. It means the embryo was able to reach and attach to the uterus, and that the body was capable of starting a pregnancy.
While a miscarriage doesn’t physically make you “more fertile,” doctors sometimes view it as an encouraging sign, especially if implantation had previously been a challenge. It indicates that your uterus is capable of supporting future implantation, and your body knows how to initiate the pregnancy process.
6. Can a young person experience premature ovarian aging?
Yes, it’s possible.
Even if someone is young—like in their 20s or early 30s—they can still experience premature ovarian aging. This means their ovaries are losing eggs faster than expected for their age, leading to a lower egg count or reduced egg quality.
It doesn’t always cause symptoms, but it can affect fertility. That’s why some young women are surprised to find out they have a low ovarian reserve when they try to conceive.
The good news is that early detection through AMH (Anti-Müllerian Hormone) or antral follicle count (AFC) screening can help identify the issue and guide fertility planning or treatment.
7. Can previous abortions affect my fertility?
In most cases, a previous abortion won’t affect your future fertility. Medical abortions, particularly, haven’t been found to affect a woman’s fertility.
Sometimes abortion may affect your fertility in case of an infection that develops in the uterus and spreads to the ovaries and fallopian tubes if left untreated. In very rare cases, women who have had several surgical abortions can develop Asherman’s syndrome, in which scar tissue forms inside the uterus. This tissue can be removed through surgery, which should improve fertility.
8. Do Recurrent Miscarriages mean you cannot get pregnant?
No, it is still largely unknown. If you’ve had two or more miscarriages in a row (known as recurrent miscarriage), your chances of a successful pregnancy may be lower, but it’s still very possible. In such cases, your doctor may recommend tests to identify underlying causes and provide treatment if necessary.
9. Do e-cigarettes, as a “safe substitute” for conventional cigarettes, affect fertility in both males and females?
Yes, they can.
Although e-cigarettes are often seen as a "safer" alternative to smoking, they still contain harmful substances, even though they can be nicotine-free[3]. These chemicals can induce oxidative stress in the body, disrupting hormones and damaging reproductive cells.
Vaping may also carry risks during pregnancy. So, while it may be less harmful than smoking traditional cigarettes, it is not risk-free, especially when it comes to fertility and reproductive health.
10. Does taking CoQ10 as a supplement help with fertility?
CoQ10 (Coenzyme Q10) is a supplement often discussed in fertility circles. While it seems to have a more established role in improving sperm quality[4], the research on CoQ10's impact on female infertility is still at an early stage[5].
So, while some people take CoQ10 when trying to conceive, its benefits are more clearly seen in men than in women, and it’s always best to speak with a doctor before starting any supplement.
[1] Bu X, Ma Y, Jia C, Liu Y, Zhang Q, Wang S. The effects of multiple controlled ovarian hyperstimulation over a 2-year period on ovarian reserve and reactivity: a retrospective clinical study. Ann Palliat Med. 2021 Apr;10(4):4391-4397. doi: 10.21037/apm-21-330. PMID: 33966440. https://pubmed.ncbi.nlm.nih.gov/33966440/
[2] Hakan Cakmak,When is the right time to stop autologous in vitro fertilization treatment in poor responders? Fertility and Sterility, Volume 117, Issue 4, 2022, Pages 682-687, ISSN 0015-0282 https://www.sciencedirect.com/science/article/pii/S0015028222001467)
[3] Montjean D, Godin Pagé MH, Bélanger MC, Benkhalifa M, Miron P. An Overview of E-Cigarette Impact on Reproductive Health. Life (Basel). 2023 Mar 18;13(3):827. doi: 10.3390/life13030827. PMID: 36983982; PMCID: PMC10053939. https://pmc.ncbi.nlm.nih.gov/articles/PMC10053939/
[4] Alahmar AT, Calogero AE, Singh R, Cannarella R, Sengupta P, Dutta S. Coenzyme Q10, oxidative stress, and male infertility: A review. Clin Exp Reprod Med. 2021 https://pmc.ncbi.nlm.nih.gov/articles/PMC8176150/
[5] Florou P, Anagnostis P, Theocharis P, Chourdakis M, Goulis DG. Does coenzyme Q10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials. J Assist Reprod Genet. 2020 Oct;37(10):2377-2387. doi: 10.1007/s10815-020-01906-3. Epub 2020 Aug 7. PMID: 32767206; PMCID: PMC7550497. https://pmc.ncbi.nlm.nih.gov/articles/PMC7550497/