How to Get Pregnant the Old Fashion Way
Window of Opportunity
Many patients believe that timing of intercourse requires precision. Conception can actually occur from a single act of intercourse up to 6 days prior to release of the egg, however, the chance of pregnancy appears to be the highest when intercourse occurs within 2 days of ovulation.
How often do you need to try?
Challenges with timing of ovulation can be compensated with more frequent intercourse. Trying every day is not necessary, but there is also no evidence that ejaculation on a daily basis has a negative impact on sperm. Abstinence of more than a week does have a negative effect however. For the purposes of both conception and also sperm testing, please do not abstain for more than 5 days. Frequent intercourse likely improves pregnancy rates but can also cause stress and eventual burn-out if the period of infertility is long. Based on the available evidence, every other day during the fertile window is ok in the absence of ovulation monitoring.
Patients will commonly follow their menstrual cycles and track ovulatory changes to their bodies, including cervical mucous, increased libido, mid-cycle pain, and mood changes. These efforts likely only detect ovulation half the time and there is no scientific evidence that this type of tracking improves pregnancy rates. However, we feel that it is important for patients to be aware of these changes and to relay the relevant information to their fertility team. Urine ovulation predictor kits have been shown to reduce the time to conception, and are likely of particular importance for couples that have intercourse infrequently. We do not have a recommendation for a specific product, but warn against purchasing very cheap kits, for fear that they will give false readings. False-positive test results generally occur in fewer than 10% of cycles.
Despite our best efforts to convince couples that position before and after intercourse make no difference, most women likely lie flat with their legs in the air after sex. Irrespective of position, sperm reaches the Fallopian tubes within minutes, and cervix within seconds. It is normal for most sperm to be lost after intercourse. As shown with intrauterine insemination outcomes, adding more sperm to the uterus in a natural cycle has minimal benefit. Vaginal lubricants should be used with caution as some may potentially impair fertility. Stress and frequent intercourse can cause physical difficulties with intercourse, both male and female. Vaginal dryness can be simply managed with commercially available lubricants. Certain products, as well as cooking oils and even saliva have shown potential sperm toxicity, so please discuss their use with your physician.