Timing or Not Timing Sex: What’s Good for Couples Trying to Conceive?
Several factors may affect a couple’s ability to get pregnant, including poor timing of intercourse. While couples are sometimes advised to have intercourse frequently (at least three times per week), conception can only occur around the time of ovulation, i.e., about five days before up to several hours after the egg is released. Consequently, to increase your chances of conception, you should have intercourse during your fertile period.
By timing intercourse, you’re prospectively identifying when you ovulate and, thus, your fertile period to increase your likelihood of getting pregnant. The following methods can help you predict ovulation:
- measurement of luteinizing hormone (LH) and estrogen using an ovulation predictor kit or fertility monitor,
- calendar charting,
- cervical mucus examination,
- tracking basal body temperatures using a bbt thermometer, and
- ultrasound scans.
However, not everyone shares the view that timed intercourse is beneficial to couples trying to conceive. Although some ob-gyns acknowledge that timed intercourse may increase a couple’s likelihood of conception and decrease the need for unnecessary (and sometimes costly) interventions, they believe that timed interourse can be time consuming and stressful. (Think about the negative effect of stress on fertility.)
But what does the greater evidence say about timed intercourse? To answer this question, lets take a quick look at what a group of researchers found after analyzing data from randomized controlled studies comparing timed intercourse versus intercourse without ovulation prediction.
A Quick Glance at What Investigators Found
Two studies did not find a difference in pregnancy rates (confirmed by ultrasound) between couples who had timed intercourse and those who had intercourse without ovulation prediction. There was also no difference in the quality of life (stress levels, for example) between couples in the two groups.
Four studies found higher pregnancy rates (self-reported and clinically confirmed) between couples who had timed intercourse and those who had intercourse without ovulation prediction. Furthermore, investigators found that if the likelihood of getting pregnant was 13% among couples who had intercourse without ovulation prediction, the probability of a pregnancy was between 14% and 23% among those who had intercourse with ovulation prediction.
Timed intercourse is associated with higher pregnancy rates in couples trying to get pregnant, although it is also likely to be stressful to some couples.
What Couples Frequently Ask when Trying to Get Pregnant?
1. When should we have sex?
You should have intercourse during your peak fertility window and that is five days before and during the day of ovulation. In women who have a 28-day cycle, ovulation occurs about midway during the cycle, i.e., cycle day 14. However, note that you do not necessarily ovulate on the same day and your ovulation day can vary every month. Ideally, you should start having intercourse about five days before your expected ovulation day (i.e, cycle day 10 for a woman with a 28-day cycle) and continue until the day following ovulation since the egg can live for 12 to 24 hours after it is released.
2. What is the best method of detecting ovulation?
This post describes the methods that you can use to monitor ovulation. You can select the method that you are most comfortable with. Many women have found that they are very comfortable using ovulation predictor kits to give them an idea of when when they ovulate. An ovulation predictor kit (commonly also referred to as OPK) can be used in conjunction with a basal body temperature thermometer to know whether ovulation occurred.
3. How is IUI different from timed intercourse?
Contrary to timed intercourse where the couple has sex during a woman’s fertile period, in intra-uterine insemination (IUI), a male partner’s sperm is prepared and placed in the woman’s womb at the time of ovulation to increase the likelihood of pregnancy in couples with unexplained fertility problems.
The video below demonstrates how IUI is performed.
4. Is our chance to conceive increased if we have intercourse every day?
There is no additional benefit if you have sex every day. Sperm can live for about 72 hours inside the female reproductive tract, so it wouldn’t matter whether you had sex every day or every other day. Sexual frequency has been a subject of debate among fertility doctors; however, there has been no research-based consensus on how frequent couples should have sex to increase their chance of conception.
Most fertility doctors advise couples to have intercourse every other day around the time that a woman suspects she is going to ovulate if she is not using an ovulation predictor kit. If the couple is using an ovulation predictor kit or fertility monitor, the chance of pregnancy is highest if the couple has intercourse just before or on the day of ovulation.
5. For how long should we keep trying before consulting a doctor?
The American Society for Reproductive Medicine recommends trying for one year if a woman is less than 35 years and if the couple has no underlying medical condition that can impact their sexual health. Older women (35 years or older) should seek professional help after trying for six months. Women who are 40 years or older should book an appointment with a fertility consultant immediately if they plan to try for a baby.
Now that you are ready to embark on the baby making journey, remember to stay healthy, take prenatal vitamins, and enjoy the process instead of feeling stressed out. After everything getting stressed out won’t help you getting any closer to your goal of starting a family with your partner.
3. National Collaborating Centre for Women’s and Children’s Health; National Institute for Health and Clinical Excellence. Fertility: assessment and treatment for people with fertility problems. London: Royal College of Obstetricians and Gynaecologists; 2013. (NICE CG156). [Issued February 2013]