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. 2019 Oct 5;9:48–63. doi: 10.1016/j.rbms.2019.08.004

Table 4.

Claims presented as statements from websites and social media, divided between categories and topics.

Platform Theme Category Topic Claim(s)
Websites Conception behaviour and monitoring Self-monitoring Cervical mucus Changes when most fertile:
1. Plentiful and slippery
2. Not always reliable, mucus can be affected by medication (dried up)
3. Increased amounts right before ovulation
4. Clear, watery, stretchy, less acidic
Basal body temperature 1. Dips half a degree 24 h before ovulation
2. 35.55–36.66oC orally is average before ovulation
3. Women most fertile 2–3 days before temperature rises
Products Assisted conception 1. Fertility monitor product: indicates 6–7 fertile days each cycle
2. Ovulation kit: detects LH surge
Copulation behaviour Timing 1. 3–4 days before ovulation
2. 24 h after ovulation
3. Some use ovulation/sex timing to sway conception of boy or girl
4. Shettle’s method: closer sex is to ovulation increases chances of conceiving a boy
5. Regular sex 5 days before ovulation and day of ovulation
6. Most fertile 14 days before next cycle starts
7. Most fertile 4 days before/after midpoint of cycle (most women)
Frequency 1. Every other day if not monitoring cycle
2. 2–3 times a week throughout the cycle
3. Too much can result in ‘burnout’ (less desire)
Gamete survival Male: sperm lasting in the female tract
1. 12–24 h inside uterus
2. Up to 3 days
3. 3–5 days in tract
4. Up to 6 days
5. Y chromosome sperm do not last as long (24 h) as X chromosome sperm (4–5 days) in tract
Female
1. 12–24 h after release from ovary
2. 24–36 h after release
Ejaculation 1. Important for penis to remain for a short period inside the vagina post ejaculation
2. Ejaculation is important in improving sperm quality
3. Avoid ejaculation leading up to fertile period to improve sperm count
Timing to conceive 1. 8/10 women will achieve pregnancy within 12 months of trying
2. 1/8 women will have difficulties getting pregnant
3. Half of all couples get pregnant within 6 months
4. 85% get pregnant within a year
5. 3/5 couples conceive within 6 months
6. 1 in 4 couples take between 6 and 12 months
7. 20% chance of falling pregnant each month in a fertile couple
8. Couples can have ‘low’ or ‘high’ monthly fertility
9. 90% of couples will conceive, without medical assistance, within 18 months
Other Gravity
1. Remain lying for half an hour post sex
2. Do not ‘clean up’ straight after sex: wash or wipe
3. It is not important to remain lying post sex
Lubricant
1. Negative effect on sperm: slows motility
Sex position
1. Do not use same position
2. Best position = deep penetration: closer to the cervix
3. Female orgasm: causes mucus to become alkaline
4. Female orgasm: contractions help move sperm
5. Any position is fine

Sex selection
1. Having man ingest caffeine before sex to give Y sperm a boost (Y sperm have short bursts of power – sprinters)
2. X sperm: less nurturing needed (more resilient)
3. X sperm: move slower but retain energy
4. Chances of having boy increased when conception occurs closer to ovulation
Lifestyle and exposure Modifiable Weight 1. Maintain healthy weight
2. Over/under can result in ovulatory disorders
Exercise 1. Strenuous exercise impacts negatively on female fertility (decreased ovulation)
2. Regular and moderate exercise improves fertility
Unhealthy habits 1. Quit smoking: female
 a. Higher miscarriage rate
 b. Earlier onset menopause
 c. Results in SGA
 d. Premature
 e. Still birth
 f. SIDS
2. Quit smoking: male
 a. Reduced sperm count/quality
 b. Higher impotence rates
 c. Asthma rates in children
3. Stop drinking
 a. Causes infertility
 b. Impairs ovulation
 c. Impacts on sperm production
4. Women should reduce caffeine intake
Healthy habits 1. ‘Fertility diet’. Reduce: saturated fat, fast food, chem produced, excessive red meat, refined sugars/carbohydrates. Increase: monosaturated fats, wholegrains, fresh fruit/vegetables, full cream dairy
2. Men: increase intake of zinc
Sleep and sunlight 1. Deficiency in vitamin D results elevated FSH
2. Require 6–8 h of sleep
Other Clothing
1. Men: tight underwear = overheating of testes
Technology
1. Men: electromagnetic radiation from phone/laptop causes poor motility and DNA damage to sperm
Medications Female fertility affected by:
1. Antidepressants
2. Anti-inflammatories
Male fertility affected by:
1. Antihistamines
2. Androgens and beta blockers
Chemical exposure Female
1. Bisophenal A: produce 24% fewer eggs than average, 27% fewer fertilize and fewer implant
2. Polychlorinated biphenyls: chances to get pregnant decrease by 20% when either partner's blood tested high
3. Reduce exposure to:
 a. Toxins
 b. Heavy metals
 c. Organic solvents
Male
1. Avoid pesticides
2. Avoid work with chemicals/radiation
Unmodifiable Age 1. Age impacts number and quality of eggs
2. Egg quality/number declines rapidly after 35 years of age
3. Fertility peaks:
 a. In 20s and 30s
 b. 20–24 years
4. Fertility declines:
 a. ≥ 35 years
 b. Steadily after 40 years
Male
1. can remain fertile into their 60s/70s
Medical Screening Preconception check-up 1. If there are questions about medication
2. Recommendation of folic acid
3. Necessary when pre-existing condition (e.g. polycystic ovary syndrome)
Timing to seek help 1. Under 35 years of age, wait for 12 months of trying
2. Over 35 years of age, wait for 6 months of trying
Reasons to seek help 1. Problem with sexual function or libido
2. Belief of possible fertility problem
3. Genetic counselling: to avoid passing on a genetic disorder
Other Prevalence of infertility 1. 15% of couples
2. Affects men and women roughly equally
3. 40% women, 40% men, 20% unexplained
4. 1/3 female fertility problems, 1/3 male, 1/3 both partners or unexplained
5. 50% women, 40% men, 10% both or unexplained
6. 12–15% of fertility issues are unexplained
7. 1 in 5 infertile couples have male factor
Conditions that impact fertility Female
1. Blocked tubes
2. Polycystic ovary syndrome
3. Irregular and painful menstruation
4. Endometriosis
5. Pelvic inflammatory syndrome (potential for ectopic pregnancy)
6. Poor egg quality
7. Autoimmune diseases (e.g. thyroid)
Male
1. Poor sperm parameters
2. Tubal disorders
3. Overheating of testes (sitting down for long periods, hot tubs/saunas, cycling)
4. Sperm antibodies can affect fertilization
5. Injury to testes
6. STIs (chlamydia and gonorrhoea)
7. Sperm allergy: allergic reaction to self
Social media Fertility Rates of difficulty getting pregnant 1. Having trouble getting pregnant? Don't fret, only 57% of couples become pregnant after trying for 3 months!
2. Approximately one in four women age 35 years or older have trouble getting pregnant.
3. 1 in 8 couples have trouble getting pregnant or sustaining a pregnancy (2006–2010 National Survey of Family Growth, CDC)
4. 1 in 8 couples have trouble getting pregnant, and in 1 out of every 3 cases, the problem is on the guy’s end
5. More than six million women in the USA have trouble getting or staying pregnant. You’re not alone
Benefits of pharmaceuticals 1. Women who take oral birth control have a lower risk of endometriosis and PID
2. Aspirin may help prevent miscarriages
3. ‘Experts have found...no link between taking birth control and having trouble getting pregnant later on’
Natural remedies 1. Acupuncture which can help improve infertility
2. ‘Since my sil and bro are having trouble getting pregnant, I'm sending her ylang-ylang. It's supposed to help infertility. So fingers crossed’
Other 1. Losing 5% of body weight can restore regular menstrual cycles for women with polycystic ovary syndrome
2. Few transgender teens opt for fertility preservation
3. A physically demanding job or erratic work schedules may increase fertility issues in women trying to conceive.
IVF 1. Did you know 70% of couples do not get pregnant the first cycle?

LH, luteinizing hormone; SGA, small for gestational age; SIDS, sudden infant death syndrome; FSH, follicle-stimulating hormone; STIs, sexually-transmitted infections; PID, pelvic inflammatory disease; IVF, in-vitro-fertilization.