[beginning fertility issues]

Information for TTC Couples...

Written by TTC Couples.


Low-Tech Ways to Help You Conceive - Chapter 10

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Low-Tech Ways to
Help You Conceive


    10.1 Does intercourse take place on any usual schedule near the relevant time? If so, what was the frequency (e.g., daily / every other day / 3 times per week)? [the latest evidence suggests daily sex during fertile part of cycle is best for men with normal sperm counts; every-other-day sex is best for men with low or marginal sperm counts]

    10.2 Is intercourse timed to occur in relation to any of the ovulation-prediction methods? If so, what is the time gap between the "signal" and the intercourse (e.g., intercourse one hour after stretchy clear cervical fluid observed; intercourse 3 days in a row before BBT rise.) [latest evidence suggests intercourse within 24 hours before ovulation offers best odds]

    10.3 Does intercourse take place at any particular time of day (e.g., morning)? [some believe that fertility is at maximum upon first awakening]

    10.4 Was any "extra" lubrication used during intercourse? If so, what was it? (e.g., egg whites, Astroglide, KY jelly, saliva [hers/his/both], Vaseline, vegetable oil) [I have arranged these common lubricants in approximate order of most to least "conception-friendly," according to some experts - it's not a complete list, and some are controversial, such as egg whites]

    10.5 What was the position of intercourse? [most evidence suggests that missionary or face-to-face is best; for some, rear-entry is best; female-on-top or standing positions are not recommended]

    10.6 Was there deep penetration into the vagina during ejaculation? In particular, at the beginning of ejaculation? [ideally, sperm should be placed as deep as possible, closest to cervix; semen contains higher proportion of sperms in the first few "spurts"]

    10.7 Did he continue thrusting movements during ejaculation, or stay still? [some believe that continued thrusting can result in a stronger male orgasm, and/or propel sperm closer to cervix; others suggest that staying still and deep is best]

    10.8 How soon did he withdraw after ejaculation? [quick withdrawal may reduce odds by causing spillage of semen; delaying withdrawal can increase odds by blocking sperm from travelling the "wrong way," back down the vagina]

    10.9 Did intercourse take place on a hard or soft surface? (e.g., waterbed versus floor) [can affect depth of penetration; a "firm" surface is usually better]

    10.10 Was intercourse occasionally or typically painful to her? [can indicate fertility problems such as endometriosis]

    10.11 Did she reach orgasm? Was it before / during / after his orgasm? [evidence suggests that the female's orgasm after the male's will draw semen up through cervix into uterus]

    10.12 Was she able to lie down for some time after intercourse? For how long? [sperm shouldn't be fighting gravity!; about 20 minutes is the standard advice]

    10.13 Did she elevate her legs and/or pelvis after intercourse? For how long? [allows sperm a "downhill" path; about 20 minutes is the standard advice]

    10.14 Was any other method used to prevent semen from spilling out afterwards (e.g., keeping legs crossed)? [may help prevent leakage of semen]

    10.15 Did she ordinarily have orgasms in-between acts of intercourse (i.e, without semen present in the vagina)? [these orgasms may propel acidic cervical fluid into the uterus, creating sperm-hostile environment]

    10.16 Can other sexual practices have some effect on conception? [there is controversy about whether women can develop antibodies to sperm through oral sex (fellatio), by swallowing sperm; at present it appears the risk from swallowing sperm is not large; anal sex without a condom should be avoided (contact of sperm with the bloodstream through small tears in the rectum or anus can develop antibodies)]

10.1 Did intercourse take place on any usual schedule near the relevant time? If so, what was the frequency (e.g., daily / every other day / 3 times per week)?

RAH - Frequency of intercourse is one of the top two or three questions on the newsgroups, judging by frequency of discussion :-). This indicates that people are confused about just how often they should be having intercourse for maximum fertility. (It may also indicate that people just like to talk about sex; but that's a different FAQ, I think :-)).

Despite this apparent confusion, the question of ideal frequency is actually one of the easiest to answer. If his sperm count is normal, intercourse EVERY DAY is best; if his sperm count is low or marginal, EVERY TWO DAYS is best. (How do you know if your sperm count is normal? The only way to tell for sure is through a laboratory semen analysis, which in fact should be one of the first diagnostic procedures if and when you do seek medical help. In the absence of a known problem, however, assume your count is normal.)

What happens if you have intercourse less often than every other day, or more often than once a day? Less-frequently means that sperm count and quality can deteriorate; it's wise to ejaculate at least several times a week, if you want to maintain optimal sperm quality. On the other hand, there's little evidence either way about the effects of too-frequent intercourse; as you will see below, some believe twice a day or more was helpful for them in conceiving. (If you try this, just make sure you aren't too worn-out, or sore, to keep up the pace through the fertile part of the cycle!)

The separate but closely-related question of ideal timing for intercourse (i.e., what days during the cycle should you do it) is covered in Sec. 10.2, immediately following. - RAH

Frequency: Intercourse every 24 hours during the 5-to-zero days before ovulation is best for men with normal sperm counts (i.e., most couples); if a man has low sperm counts, every 48 hours is preferable.

It's possible that sex more frequently than 24 hours might be even better, but as far as I know that's never been confirmed scientifically. I can't think of any reason why it would *decrease* fertility to have intercourse 2 or 3 times a day, unless you count the effects of fatigue :-).

There was one thing that a friend of mine mentioned to me -- I'm not sure if it's from the same study. He said that apparantly your chances of conception are higher if you have very frequent sex. What happened to every other night, in order to allow the sperm to build up and develop, etc., between tries? Does that still hold, or do we now have to have "baby sex" every single night??? But what were the sperm counts of the men in the study? Surely this would make a big difference in whether you would want to try every night.

Yes, one RE told me that every night sex probably does increase the chances of conception in normal, fertile couples, but if there is any problem at all with the man's sperm, every other night is recommended. I think that's why it's typically recommended in infertility clinics, but if the man has a normal sperm count and morphology, trying every day for the several days before ovulation may increase the couple's chances.

I saw a documentary on the BBC recently about fertility. They said the answer to this questions was More Sex.

Apparently, the couple should have sex at least 3 times a week, and preferably both orgasm. If they do this, they are bound to have sex within 72 hours of any ovulation, which is the best time to conceive, without the stress of testing urine every day etc.

Just another perspective but I think it depends on your husband's sperm count in general. My husband and I were told that because he had such a good count we should have sex every day over the period when I'm ovulating.

Interestingly enough when we did GIFT back in August, my husband was asked to go back the next day to provide another sample to try and get more eggs fertilized (this was a big problem). Anyway, it turned out that the second sample he gave the day after GIFT was better than the first sample given the previous day.

My husband and I really wanted to get pregnant. We decided to try to have sex twice a day eveyday, morning and evening, for the week prior and ending just after expected ovulation time. But you can try for two week if your are really up to it or have a longer cycle. We ended up pregnant and due in september. Good Luck and enjoy yourself.

Our last sperm analysis showed 37 million sperm and I got pregnant in December (later miscarried) having sex every day (once per day) from days 10 thru 20. Every day worked in our case (my husband thinks he's being neglected in the "every-other-day" scheme and assures me that he _feels_ much sperm being produced :) ).

The method that worked for me (twice):

Divide your cycle into thirds; mine was between 29-35 days, so I averaged it to be 33 (divides nicely by 3). During the middle part of your cycle, have sex every other day. I started with day 11 of my cycle, and continued to day 23.

It only took one month the first time, and three months the second time.

Oh, one other thing I did was sometimes during the key week (days 14-20), I would try to time the sex every 36 hours, instead of waiting the full 48. (This really only worked well for us on weekends ;-)

My doctor suggested having intercourse every other day. He said that alot of his patients were having intercourse 3 or more times a day and he said,"your husband has one sperm left and he's swimming around looking for a friend." He was being silly on purpose to cheer me up, but it sort of made sense.

He said that ovulation involves alot of sperm breaking the barrier for one sperm to finally get through, so it's better to have your husband take a day off and "stock up."

Has anyone else been told this, or read this?

The old wisdom used to be to give the guy a day off to replenish sperm supplies. A recent article in the New England Journal of Medicine [in Dec. 1995 -- see Sec. 2.4] instead suggested that the best chance for conception was for the couple to have intercourse every day for the six days before ovulation occurs. If you've been trying for a while, this is a grueling thought.

I know that you should "ration" sperm, but I'm getting mixed messages. My wife's Dr. said to wait 3-4 weeks, but most everything else I see says to wait 3-6 days. Additionally, some articles say that waiting longer may decrease sperm effectiveness due to older sperm being present. Any advice?

Male fertilitiy cycles run 48-72 hours. Too much abstinence is as bad as too little abstinence. Sperm counts do not increase with abstinence, but volumes of ejaculate can - as seminal fluid is produced.

Double check with your doctor's suggestion. Maybe he said 3 - 4 days...

For those of you who have gotten pregnant before, maybe you can help me out with this... What is better for getting pregnant: To have intercourse A FEW TIMES a day during your "fertile" week, or just ONCE every day or day in a half? It kinda makes sense to have intercourse as much as possible, but if you wait, the sperm will have a chance to mature, where in the latter, the sperm will be less mature...

This supposedly depends on your partner's sperm count. For normal to high sperm counts, as often as possible is considered best. Start about 4-5 days before you expect to ovulate, and keep going until you ovulate. However, if his sperm count is on the low side, every other day is supposed to be optimal.

My doctor said that every other night/day is the best. My best friend got pregnant trying it every day so we tried it and I got pregnant that month. Unfortunately ectopic (tubal) but are trying again. Basically, if sperm counts are normal, then every day or every other day should be fine.

I was always under the impression that every other day is preferable if there is a problem with the sperm. In our case the count was normal but there was low motility and a high incidence of misshapen sperm . When we were trying "naturally", we would do it every other day.

When I started doing IUI' s though, I noticed that the overall number of motile sperm was always higher on the second day of IUI, sometimes almost double, which I thought was surprising.

So now when we are trying naturally, I will make a point of doing it every day.

The article in [December 1995 NEJM] says... that there is a six day window, beginning with the five days before ovulation and including the day OF ovulation. IT suggests that frequency of intercourse [every day] during this time is ideal. Says that ovu-kits predicting the surge are kind of "too late" but can be useful if used for several months to begin predict when the six day window will occur. Probability of conception ranges from 10% when intecourse occurs five days before ov to 33% when it happens on day of ovulation itself. Daily intercourse during the window produces a 37% chance of pgcy.

These researchers figure that since one-third of all pgcies end in miscarriage the actual birthrate is lower than this 37% of course, but that in a typical month there is a 10% chance of successful pgcy/birth if couples have intercourse once a week,a 22% chance if every other day, and 25% with daily.

Could you please tell us which new reports say that frequent intercourse is okay or better for men with LOW sperm counts?

My doctor told my husband this. He said that men with low sperm counts or poor motility should ejaculate at least twice a week, more if possible. He said that sperm is created on demand, basically, and if you don't get rid of the old sperm (which loses it's motility if it's left sitting around), you won't create any new sperm and when you do ejaculate, the sperm that comes out won't be much good.

So basically, getting rid of the old stuff on a frequent and regular basis results in more production and better quality.

To clarify, women are only fertile for one day, the day that they ovulate. The ovum is alive for 12 to 24 hours after it is released from the ovary. But, it's wise to have intercourse as much as 5 days prior to that time to give the sperm enough time to travel up to the fallopian tube to meet the egg. You're working with a lot of unknowns, you don't know how long your sperm is going to live and you don't know how long it will take to get to the fallopian tube, but you want to make sure that you give it enough time to get up there, but if you give it too much time, it will get up there and then die before the ovum is released.

So, that's where the 5 day figure comes into play. So as for having intercourse a lot during the week that you should ovulate, that depends on you. Too often will only effect the concentration of the sperm, but you'll make up for that by having intercourse more often. Not often enough will effect the motility of the sperm. That means if you let them sit around too long without being ejaculated, their quality will degrade and they won't swim so fast or so straight which means that they won't ever get where they are going.

The main thing to remember is your frame of mind. Can you have intercourse a lot during a short period of time without it feeling like work?

Its more important to have intercourse because you want to rather than because you don't want to miss your chance to conceive. The former will work out much better.

Interesting tidbit on abstaining to increase fertility. My husband has a high sperm count....really high. The last IUI we did I looked at the count and said what happened here....only 50 million swimmers (good swimmers after cleaning... low for him). The RE said, But look here: the next day it was way back up. We did two IUI's, one 24 hours after the first. She pointed out that he abstained longer than usual....a whole 7 days, and that lowered his good count. One day of cleaing them out and the next day he was back to his outstanding counts again.

We read that you should abstain no more than 5 days before the fertile day/time to maximize the # of good quality swimmers. After seeing these test results we are sure believers now.

My husband's analysis showed him to be within the normal range as far as "amount" of sperm, but he was at the low end. AND motility was also low...possibly due to some white blood cells in the urinary tract. He was put on an antibiotic to "clean up the urinary tract" and therefore increase motility.

The doctor recommended that we hold off, and allow for my husband to "stock up" as you mentioned above. Fortunately, I seem to ovulate on the same day each month, so I'm hopeful this will work.

We've been trying to conceive -- trying HARD -- for the past 4-5 months -- and following the advice of the [Dec. 1995 NEJM] article mentioned... with no luck. Our doctor thinks, that in our case and due to my husband's "sperm status" that the New England article was probably not helpful in getting us a baby. My doctor also doesn't agree with alot of the information provided in that article..... but sometimes big changes in thought meet with a lot of negative thinking. Who knows.

Most of us have been married for some time, and I'm sure that "the act" isn't always as "hot" as it was when we first met our mates (I'm trying to word this as nicely as possible).

Does anyone think , other than the fact that we just don't do it three times a day like we all used to, that the biological factors that are different now compared to the "newness" of a relationship have any effect on fertility?

Sex? Well, that sounds like a good low-tech fertility-enhancing method :-), so I'm willing to think out loud here...

I think there may be a degree of truth in this idea. My wife's issue of Glamour magazine this month [Feb 96] has an article on the male orgasm, which I read. (Well, it was more interesting than my Newsweek story on Bob Dole's presidential candidacy :-) ). This article discussed the fact that some male orgasms are very intense while others are not, and one of the differences is that the intense orgasms include noticeably greater "pumping" sensations. In other words, the intense orgasms have a higher volume of semen.

As I understand it, the first few spurts of the ejaculation contain the highest proportion of the actual sperms, and the later spurts contain more of the fluid from the seminal vesicles and prostate (the liquid that sperm need to survive their first few hours in the female tract.) And the more intense male orgasms are *really* intense at this early stage.

So, at the beginning of a couple's relationship, when the excitement is still there, it makes sense that you have a higher sperm count in the ejaculation. Also, there is a higher volume of semen overall, which will mean the sperm presumably have a friendlier medium in which to survive. And another factor is that the intense orgasms are more forceful, so maybe the sperm are propelled that much closer to the cervix.

In my <*blush* personal experience, I can testify that intensity, volume, and depth are all directly related. Since our birth-control method was always condoms, it was obvious to me that the intense orgasms prouced more volume. I think this is parallel with the post on semen-collection condoms that was posted a few days ago -- intercourse is always more intense than the ol' "aim for the jar" business -- ugh -- and as was pointed out, the counts can be dramatically higher with the condoms, also.

On the female side, orgasms probably happen more often and are more intense early in the relationship. Female orgasm seems to help draw the semen up into the uterus, according to at least one clinical study, so that would help -- at least, provided her orgasm was during or after his.

Another factor, as mentioned, is that you have sex more often in the beginning, while the spark is still strong. As the studies consistently show, intercourse every day (normal counts) or every other day (marginal counts) is best for conception. I think I read in Ann Landers that couples in their 20s have sex around 4-5 times a week, but by their 40s it drops to 3-4 times a month (don't quote me on the figures but it was along those lines.) We know that sperm counts, motility, etc. all drop if you abstain too long, so this all makes sense.

I don't know how often is TOO often, though. I think most guys have a reduction in the intensity if sex is too frequent, and reduction in volume, too. I can say that, after 5 or 6 ejaculations in one day you do tend to, um, run dry :-) ).

Now obviously none of this is relevant for those with other difficulties -- blocked tubes, PCOS, LPD, and the like. But for those with SUBfertility as opposed to INfertility, maybe there's something to it.

I'd say there's no harm in getting the ol' excitement back into the relationship, and it could have a lot of benefits besides conception :-). So, schedule a trip to Victoria's Secret, everybody :-).

Read all the opinions on this and I still say NOPE. All my conceptions (6) were, to my knowledge, the result of having "done it" on the right day. That is to say, they were acts of procreation and not acts of hot sex.

No doubt about it... I hope I didn't give anyone the wrong idea with my opinion on the subject. It makes sense to me that the hot sex might increase the odds of conception a little bit, but I'd guess it's closer to a 5 percent greater chance than a 50 percent greater chance. And that's assuming all the other systems are okay! I do think that from the male perspective, hot sex does mean a better orgasm, which in turn leads to a better concentration of sperm; but obviously there's a bunch of other steps in the process that need to take place as well.

I would conclude that, in the low-tech department, passion is no substitute for charting BBT, or avoiding hot tubs for men. On the other hand -- hey, it can't hurt... dunno how much it helps, but it's more fun than giving up caffeine... :-)

Sperm counts are a balance:

    (1) decreased with increased frequency of intercourse

    (2) increased with increased time of excitatory phase (pre-ejaculation)

    (3) decreased with age

I suspect that factor two is what you are thinking about. You need prolonged arousal for a good squirt. The only facts for this come from experiments on bulls (their sperm, of course, being big business). If anyone knows of real human data I would like to know.

Here is an article from sexual health that I thought everyone might find interesting.

When couples have trouble conceiving, they often try artificial insemination, which involves collecting semen and infusing it into the uterus with a syringe. In a recent Japanese study, fertility expert Dr. Nikolaos Sofikitis asked 19 patients to produce six semen samples for insemination while viewing X-rated videos and six samples without watching. Astoundingly, average sperm counts of the samples collected while the men watched dirty movies were more than twice as high, plus the percentage of fast-swimming sperm (which are considered to be healthier) were much higher when the men were watching the illicit films.

So I guess we can't complain too much if they watch dirty movies if it helps us in the end. Maybe this will help with men who have low counts.

I have found that when I actively "help" my husband collect his sample (whether for testing or IUI) his volume is much higher, which of course helps the total count.

FWIW, the use of magazines doesn't seem to help him at all.

I have heard conflicting views on the subject of male masturbation affecting one's sperm count. Does anyone know if masturbation really does or does not lower a man's sperm count?

Yes, it does significantly lower your sperm count but the effect is only temporarely. The testicles create the sperm and store in the epididymas. This 'storehouse' needs about 40 hours to be completely refilled from the testicles after every ejaculation (intercourse or masturbation) Masturbation seems to have no harmful influence on a man's fertility. The storehouse in the epidydimas can keep the sperm healthy for up to maximally a week. After this periode the sperm is not very viable anymore. So with other words, regular intercourse or masturbation seems to be positive concerning your 'sperm health' ;-)

[RAH - The 40-hour "refill" time mentioned here has been refined to the 24-hour figure noted as optimal elsewhere in this section. - RAH]

does frequent masterbation increase motility and morphology problems? if one masterbated frequently and then stopped for a while and got tested and the tests showed 25% motility and morphology, could one expect that these numbers would improve over time if the masterbation stopped? Is there something that one could take to improve the results? this is an embarassing question, so treat it with some dignity please. I am just trying to get as much information as I can.

I am sorry, but I don't think that would make a difference. I believe there is some research that indicates that men who orgasm more regularly have higher counts, but I have never heard that masturbation or even regular intercourse (what is the difference physiologically after all?) would affect motility and morphology.

Good luck to you!! [And we talk about much more embarassing things here (Roger's boxers!), so don't be embarassed.]

Does anyone know the "most fertile" time.

When my husband and I started trying, my OB/GYN said to, umm, "do it" every other day, beginning on the 10th day of your wife's cycle. (first day of her period = day 1) Most women ovulate on or about day 14.

This is the "shotgun" method -- enough buckshot means that you're bound to hit the target sooner or later :-) . If you want to go that route, and assuming your sperm counts are not abnormally low, then sex *every day* from Day 9 through Day 16 or so would be even better than every other day, according to the latest reports.

BTW, that may *sound* like fun, but you'd be surprised how much of a chore it can be. My wife and I set up a 9-10 times a week schedule when we were trying for our first. It did work, and she conceived during the first month we tried, but that routine got pretty grueling :-).

It's much better if you can learn some simple, low-tech methods such as charting BBT and monitoring cervical [fluid]. If you learn the basics of checking fertility, you can time intercourse more precisely and aviod the guesswork. Get hold of a copy of the book _Taking Charge of Your Fertility_ by Toni Weschler, copyright 1995; it explains it all, and is enjoyable to read besides.

start having sex several days before ovulation as the sperm can live up to 5 days. Hope this helps.

where did you ever hear sperm can live 5 days? i think you're wrong [i hope not], but i could of sworn my Dr. said 48 hrs.

Well, you're *both* right :-). The lifespan of sperm inside the female reproductive tract is dependent on (among other things) the presence, quantity, and quality of cervical [fluid]. With little or no [fluid] present (i.e., during most of the monthly cycle), sperm won't last more than a matter of hours. At the other end of the scale, 5-6 days is not unreasonable for sperm that have a lot of good-quality [cervical fluid] to swim around in.

All of which means, of course, that you get the best bang for your buck if you have sex daily, starting when you first spot the [cervical fluid] :-).

My RE is really frustrating me!! I'm taking my BBT chart and on clomid. I asked him when and how often we should have intercourse and he said not to plan it, to do it when we feel like it. I don't think that's the way to go.

Nope, it's not!! "When you feel like it" is pretty variable from couple to couple (especially when you consider that it's not especially likely to happen unless you *both* feel like it. Or if one of you is good at begging, of course :-) ).

So I've got us on an every-other-day starting at day 10 program (I think every day would kill my husband). I figure the sperm should still be living and able to fertilize after 48 hours, right?

If you are fairly sure you ovulate around day 14 or so, starting intercourse on day 10 and doing every other day through day 16 (just for good measure) should get the timing right. Sperm can live much longer than 48 hours in good [cervical fluid] (I believe it *can* live 4-5 days in good [cervical fluid], lots of resources mention _more than_ 72 hours).

I just wanted to confirm that, in favorable cervical [fluid], sperm can live up to 5 days. At the other extreme, they die off within a few hours if they don't have anything except their own semen to sustain them.

And, concerning sex everyday versus every-other-day: I thought the everyday thing would be 7th heaven, until we tried it. We actually set up a 9-10 times per week schedule during the relevant weeks (and "schedule" is the right word). Toward the end, I felt like one of those machines they have in the paint stores to mix up your paint :-).

Every day *is* better if the man's sperm count parameters are normal, if you can manage it; but nobody should feel bad about taking a night off sometimes. And if you aren't sure, or his count is low or marginal, every other day is better anyway.

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10.2 Was intercourse timed to occur in relation to any of the ovulation-prediction methods? If so, estimate the time gap between the "signal" and the intercourse (e.g., intercourse one hour after stretchy clear cervical fluid observed; intercourse 3 days in a row before BBT rise.)

RAH - Much of the timing information is covered in previous sections dealing with specific fertility indicators. The basic rule of thumb is as follows: You should learn your own signals that indicate the time of ovulation for you -- this may be through BBT dip or rise, cervical fluid, cervical position, or any other reliable signal. The key to timing is to make sure you have intercourse every day, or every other day (see Sec. 10.1 to know which), during the "window" of fertility from 6 days before conception, through the day of conception. If you want to be extra-sure and you can manage it, try adding a day or two before and a day or two after this 6-day window.

The following section is lengthy, but I include it to show you the variety of different timing strategies that proved unsuccessful or successful for different couples. - RAH

Timing: The latest recommendations are for intercourse between 5 days before ovulation, through zero days before ovulation. You can *usually* predict ovulation approximately 12-24 hours in advance with an ovulation predictor kits (OPK). I think some OPKs claim to predict even further in advance. Over the long haul, charting basal body temperature and observing cervical fluid and cervical position are even better predictors than OPKs (partly because OPKs measure a surge in hormones, not ovulation itself); but in the short run OPKs are usually helpful. This can be complicated to explain - your best bet is to look at a good book on the subject. I'd recommend _Taking Charge of Your Fertility_ by Toni Weschler, which just came out last year [1995] and is an excellent piece of work.

According to a recent study published in the New England Journal of Medicine [in Dec 95], if you did ovulate on day 16 and didn't have sex until day 18, your chances of pregnancy are slim. However, if you had sex during the six days before ovulation, you may be pregnant.

The study involved 200 couples and showed that conception was most likely to occur when the couples had sex within the six days before ovulation (ending with the day of ovulation). I think your chances were about 3% with sex on day 6 before ovulation, rose to 30% on the day of ovulation, and fell to 0% the day after ovulation. The egg only survives 12-24 hours after ovulation, and it takes the sperm a long time to reach the tube for fertilization. The explanation is that you're most likely to conceive when the sperm are already in place when the egg arrives.

I know when I was taking Anatomy and Physiology class that I learned that the sperm, once ejaculated, needs between 8-10 hours to "capacitate" and be ready to fertilize an egg. This process only takes place in the woman's body (or in a test tube in the case of ART). Maybe that's why there's such a very small window of opportunity on the actual day of ovulation and it makes sense that the sperm be already waiting by the time of the egg release. It's interesting that no one has ever mentioned this when discussing optimal timing. Anyone else have any information on this? The exact info that I have on this directly from the Anatomy book, published in 1991 states "Although sperm undergo maturation in the epididymis, they are still not able to fertilize an oocyte until they have remained in the female reproductive tract for about 10 hours." Also, in the case of IUI's, this step is accomplished during the sperm washing, so I imagine that doing the IUI on the day of ovulation (in addition to the day before) makes sense as well.

I had already read in several books that waiting for ovulation, like waiting for a temp. rise, is often too late and that it is best to have the sperm ready and waiting prior to ovulation. The thing that was annoying about the CNN report on TV was that they interviewed a woman who said she believes that ovulation predictor kits let you know when you have already ovulated, making it too late. I cringed when she said this, on national TV no less, because everything I read says you get an LH surge PRIOR to ovulation. ( My kit says ovulation occurs 24-36 hours prior to ovulation.) So, don't throw away your OPkits yet!

I also read somewhere that your best [cervical fluid], the egg-white kind, could end by the time an LH kit shows a surge. Maybe this is why it is good to have intercourse even prior to the anticipated LH surge and whenever you see the egg white stuff.

I think the "new" part is that before this [Dec 95 NEJM] study, it was also thought that intercourse within 24 hours after ovulation could result in a pregnancy (since the egg is viable for 24 hours) and this study apparently shows that in practice this never happens.

This is what I walked away with. The article questioned whether an unfertilized egg could survive more that a couple of hours after ovulation. If I remember correctly, they questioned the whole practice of family planning based on sex immediately after ovulation if your goal is pregnancy. By then its too late.

I don't stay up evenings tracking this stuff, but to me it questioned several preconceived notions I had over the whole fertilization process.

I have mentioned before that my husband and I planned to get pregnant at the time I was already pregnant. Needless to say, I am not a pro at figuring out my system! We are not sure what birth control to use now, and while we decide, we are out of control, so a few questions:

1) Does the "cycle" start at the sight of blood at my period? Or is it after the bleeding stops?

It starts on your first day of flow (i.e., the first day you have to use a tampon or pad.)

2) When is the ovulation most likely to occur from the date I figure from above? (I heard on "Dateline" the most fertile time is right before the cycle begins...only I can't figure it out.)

If "Dateline" said that, they're nuts! In most (not all!) women, ovulation is very close to 14 days *before* the beginning of your *next* cycle. If your cycles are regular in overall length,and if you keep track for a few months, you can make a reasonable guess as to when you will ovulate in a given cycle. Charting Basal Body Temperature (BBT), monitoring cervical [cervical fluid], and/or using Ovulation Predictor kits (OPKs) are all better methods, however.

I'll second the recommendation for Toni Weschler's book _Taking Charge of Your Fertility_; it will explain how to do all of these things, and also explains Fertility Awareness Method, a natural form of birth control.

You can E-Mail to me, or post it here, but it seems everyone here knows what is going on! (I feel like an idiot...no lie, I missed this discussion in class when I was a kid, and am a fool when it comes to figuring it out!)

Hey, don't feel bad -- in my school, the boys never even GOT that class. I guess they figured it was none of our dang business when women ovulated :-).

I am wondering if anyone here has concieved the morning of the rise in temp. Suppose you ovulate the night before. Would the temp still rise the next morning?? The epitome of irony is we had sex the night I ovulated, but he was so tired that he couldn't climax. So when my temp was high the next morning I went ahead and tried anyway.

We conceived our son on the morning of the rise of my BBT. So it is possible ! Good luck to you.

I believe that a very recent study found that highest conception rates were acheived from intercourse on the 2 days prior to and/or on the day of ovulation. Thus you'd want to make love for a day or two *before* the LH peak indicated on the OPK... not the 1-3 days after. (Of course this all depends on how soon after your LH peak you ovulate.) I think this may be attributed to the time it takes sperm to travel. . .and that it's best if they are there waiting for the egg when she comes skipping down the tube :)

I've followed my cycles long enough and am regular enough that we can usually guess when my LH peak will be and we try to start every other day sex a little in advance of that.

We were too uptight about this [timing] to allow more than 36 hours (usually 24) to pass without having sex during the 4 days before ovulation was expected or two days after ovulation occurred (in case we'd gotten the BBT thing wrong). Starting with two days before the *earliest* predicted day for ovulation (i.e., day 10, since ovulation once occurred on day 12 during the test BBT phase) and continuing through the *latest* predicted day for ovulation (i.e., day 16, since I have once or twice ovulated as late as day 16).

I think that timing is the most important point. Of the many months in which we had unprotected intercourse 6 or more days in advance of ovulation, I never conceived. The two months in which we did this with a timing of 3.5 to 4 days before ovulation, I did not conceive. The two months in which we had sex without contraception within 3 days before ovulation--as well as two days before ovulation, one day before ovulation, the day of ovulation, and the next day, too, in case ovulation really hadn't occurred yet--we conceived both times.

... what I meant was that we CONTINUOUSLY have sex until AFTER my temp goes up (thereby allowing my poor dh to take a much needed break!) We start trying week to two weeks before anticipated rise in temp. (no male factor problems).

You are doing it right -- this is what all the experts say (Toni Weschler, etc.) The variability ... may be in the fact that the [cervical fluid] cycles and the BBT cycles aren't always perfectly in sync, because they are caused by different hormones: the [cervical fluid] is triggered by rising estrogen levels, but the BBT rise is triggered by progesterone. The two hormones are linked in the cycle-sequence, of course; but they don't necessarily follow the same pattern in everyone, every month.

It's all so much like hitting a target -- you are better off using a shotgun with lots of little pellets (sex frequently throughout mid-cycle) than one big bullet. It's different with male-factor problems, of course -- with male factor, the problem is that you only have a few pellets in your shotgun shell, or the pellets go flying off in all different wrong directions. So you save 'em up, and blast off with a big ol' artillery shell every 2 days or so.

The experience of the Couple-to-Couple League for Natural Family Planning has been that, for whatever reason, if you are trying to *avoid* pregnancy, you generally need to wait for at least 2 days after the temperature shift is detected before resuming intercourse. (See "The Art of Natural Family Planning", John & Sheila Kippley, for details on the rules for determining the beginning of post-ovulation infertility.)

The Couple-to-Couple League recommends the first day of drying up *after* peak day as being most likely for achieving pregnancy; however this assumes that you are actually ovulating. Tracking your Basal Body Temperature (BBT) for a cycle or two might give some indication if you are ovulating; [cervical fluid] patterns don't reveal that information.

Three months is well within "normal" time frames for trying to achieve pregnancy, so you probably don't need to get concerned yet. If you've been trying for eight months to a year without success, you might want to consult with a specialist, or at least begin trying some "low-tech" fertility enhancement techniques.

What are the chances of a woman getting pregnant if she has intercourse the day after her period ends, compared to having it a week or two later? How long can sperm 'wait' in the uterus for ovulation to occur?

It is pretty unlikely, unless the woman has short menstrual cycles. The longest that sperm has been found to live in the latest studies is 5-6 days, and that is probably higher than average.

Theoretically, a woman who ovulates on day 14 could get pregnant from intercourse on day 9 or so, but she wouldn't get pregnant from intercourse on day 5 or 6 unless she ovulated early that month. On the other hand, she may well ovulate early! I normally ovulate on day 14, but last month I ovulated on day 12, so even day 6 might not have been safe (it was in my case, though! :-( ).

If a woman has short cycles, though, such as 21-day cycles, she would typically ovulate around day 7, so the day after her period ends would almost surely be *unsafe*. It is pretty dependent on the individual woman. If she averages 35-day cycles, she can be pretty sure that intercourse the day after her period ends won't result in pregnancy. It is helpful to chart BBT (basal body temperature) and pay attention to cervical [fluid] changes, so that a woman can have a good idea of when she normally ovulates. It has certainly been an eye-opener for me! There is usually a lot of info about this posted on misc.kids.pregnancy.

Is it possible to get pregnant when having intercourse during the menstruation phase of a period?

Yes -- [and in fact] depending on the length of your cycle some women may [find it] impossible ... to get pregnant without intercourse during menstruation. That said -- this is by far NOT the norm. It is rare, but true.

[RAH - The reason behind this phenomenon is that some women have a pre-ovulatory phase (after period ends but before ovulation) of only a few days, due to unusually-short cycles (25 days or less as a rule), and/or unusually long periods (seven days or more of bleeding). Since the fertility-window is the 5-6 days before ovulation, for a women in this situation intercourse in the last day or two of her period will fall within the time frame. - RAH]

I am 13 weeks pregnant with my first child, and have been using the rythym/BBT/cervical [fluid] method of birth control for about two years, obviously it finally failed us - but that's o.k. Let me just say that because of using this method I know my cycle very well, and believe it or not I conceived 3 days after ovulation - yes, I'm absolutely sure it was at no other time that month. So I really am not convinced of all the new research that has been done latley - according to them, even on the 2nd day ofter ovulation you are 0% chance of conceiving.

Not to discount what you said by any means; it just triggered some food for thought. I read recently that cervical [fluid] can peak BEFORE ovulation. Also, I don't think you can count on temp. rise to indicate that ovulation has already occurred. I have noticed my temp. rising the day after I did an LH test which indicated ovulation to start within 24-36 hours. Also, sperm can live up to a week, I read, so conception can be a result of intercourse that occurred very early in the cycle. Still, I try not to rely on any one study or method. If trying to get pregnant, better to err in the direction of overshooting the 6 day window of fertility, I say.

After a few months without success, I got a home test for testing ovulation; as soon as the test signaled that I was beginning to ovulate, we tried at least once a day. I know they say that this isn't best, I believe the [Dec 1995] NEJM report said it IS best (with normal sperm count) to have intercourse daily during the 5 -6 day window of fertility. It's just that it won't be effective the day after ovulation... but we did it anyhow. That month, I conceived. Keep in mind the new research that just came out about ovulation and conception, however -- that conception actually occurs in the week prior to ovulation rather than the few days during and after. So probably your best bet is to have intercourse as much as possible throughout the month. I can think of worse things to do...... ; - ).

I'm sure you didn't mean to say this, but thought I'd point out that "conception" could not occur in the week prior to ovulation -- there can be no conception without ovulation for the egg and sperm to unite. It is just that the NEJM study confirmed that the best days to have intercourse if you want to conceive is the five days prior to and the day of ovulation (if you can pinpoint this, as someone else pointed out. Now, that's a challenge.) I think this is because sperm can live long and well in the woman's body (with fertile [cervical fluid]) and need time to capacitate before being able to enter the egg. Having sex all month can get to be a chore and just won't happen with most couples. Some couples have been trying for years! Instead of feeling guilty or worried about missing a day of intercourse, a couple can try to predict ovulation and focus on the 5-6 day window of fertility. Those LH kits give about 24-36 hours notice. I conceived this way (lost it, but irrelevant to this post). Also, charting BBT (really not good for predicting ovulation in advance though) and checking for cervical [fluid] may add some informational pieces to the puzzle.

My husband and I have been trying to conceive since August. I was on the pill for about ten years. No luck yet. We may have screwed up our timing on several occasions, however. We would appreciate your best hints for getting pregnant. For example, how often? How did you know it was the right time? Any particular positions? Etc,etc....

Timing is probably the problem. I'm assuming that your cycle is regular (that is every 28 days). If it is then you probably ovulate around the 14th day of the cycle. The first day of your period is considered day 1 so it would be 14 days later. You might be waiting too long. You should probably have sex every other day leading up to day 14. Because the egg only lives for about 24 hours, having sex on the 15th or 16th may be too late. As far as positions are concerned I have heard that the man on top is the best for conception. I hope this is of some help. Good luck.

This is my first message to the group; after a few weeks of reading I haven't seen this question come up. I have been charting BBT for 9 months, started using an OPK 3 months ago. I noticed that the rise in BBT doesn't occur until three days after I get a positive test. So, in other words, positive OPK on Day 14; BBT rise on Day 17. This seems a bit odd, given the timing I have read for ovulation (within 24 hours of positive test, and then the temp rise should occur.) I am pretty sure it's not a false positive, as when the BBT rises on Day 17, it stays up there for the rest of the cycle.

[RAH - Actually, a three-day lag from a positive OPK result to the BBT rise is within the normal range. The LH surge may not trigger ovulation immediately; and the progesterone may be slower than usual rising to a high-enough level to cause the BBT rise. - RAH]

My question is, what would be the best timing for intercourse? Assuming that you are on an every-other-day schedule, and have a positive OPK on Day 14, is it better to choose Days 14 & 16, or wait until Day 15? Or maybe it's not that important, as long as it's within that timeframe.

-------------------- reply ------------------------

It's my understanding that you should have intercourse as soon as your OPK reads a positive - ovulation can happen between 10 and 48 hours and sperm can last up to 1 1/2 - 7 days in your system.

I got pregnant using clomid and a OPK (ovuquick). My OPK showed positive on the 17th day of my cycle. We had intercourse the 17th and 18th day.

It is also important what OPK you use. Some are of no use what so ever. I get mine from a hospital pharmacy. It's more expensive, but as you can see...it worked.

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10.3 Did intercourse take place at any particular time of day (e.g., morning)?

RAH - The evidence that time of day can make a difference is strictly anecdotal, as far as I'm aware. However, as you can see, there are those who swear that "morning sex" is the answer! It's another method that does no harm to try, if you can manage. - RAH

We know that male hormone levels are highest in the morning. Thoughts anyone? I think the hubby and I will go for the sunrise tango this cycle ourselves.

Yes, and I believe I've read that sperm counts tend to be higher in the morning as well, and it's always seemed to me that I have more fertile [cervical fluid] in the morning, probably just because it's accumulated. Makes sense -- why not try it?

We got pregnant from morning sex (also had sex the night before). I ovulated several hours after morning sex - I could feel it. This was after 13 months of trying. Who knows what really did it, but definitely gives room for thought - certainly doesn't hurt to try it.

Morning sex worked for us when we conceived our second child. He will be six in December. This was after 21 months of trying and about a week before my husband was scheduled to have surgery for bilateral varicocele. I was very depressed because the andrologist had told us,"with veins like these, it could take up to another year to get pregant even after the surgery"- also had a score of zero on the old hamster test, which is supposed to determine if the sperm can penetrate an egg. That month was the first time in almost a year that I did not use an ovulation predictor test - I just knew I was ovulating and even though neither my husband nor I had much hope at that point, that was the month that it worked.

By the way, my husband had the surgery, because of course, we had no idea that we had conceived. About l0 days after his surgery, I did a home pregnancy test which was positive - I called him at work and gave him the news. I said, I have good news and bad news - bad news - you had surgery for nothing - good news - I'm pregnant!

We would love to have another child - thought the surgery would only make things better, but it hasn't worked out that way - now there are some additional problems with me. But we definitely got very lucky once - thanks to morning sex.

The fact behind this one [keeping the testicles cool], is that the higher the temperature, the more sperm get damaged or killed. Therefore, long-term wearing of boxers is necessary to lower temperture in testicles. Also, sex in the early am (after sleeping) is better for conceiving because of the body's temperature being lower all night (therefore, cooler testicles, and happy sperm :-))

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10.4 Was any "extra" lubrication used during intercourse? If so, what was it? (e.g., egg whites, Astroglide, K-Y Jelly, saliva [hers/his/both], Vaseline, vegetable oil).

RAH - The question of artificial lubricants and their relative conception "friendliness" is one of the more controversial in low-tech fertility -- if discussion on the newsgroups is any guide. I have gone out on a limb and given my judgment on the issue, by arranging common lubricants from best-to-worst in the list above. Egg whites are listed as best, although they are controversial -- few people quation that they are very effective in mimicking cervical fluid, but there is considerable worry about whether their use poses a danger of salmonella infection. Mixed opinions abound on the two water-based commercial lubricants, Astroglide and K-Y Jelly; I picked Astroglide ahead of KY based on the study by Pomeroy and Savage, whose abstract is quoted below. Presumably, other water-based commercial lubricants such as Replens would fit into the same general ranking. Saliva (from either partner) is not considered very sperm-friendly, although there's plenty of evidence that people successfully conceive all the time with saliva as their only "artificial" lubrication. Vaseline and vegetable oil are not recommended (although Pomeroy and Savage did report that Vaseline wasn't as bad as some others they tested, and in fact had some benefits.) Vegetable oil is not good for sperm and in addition carries its own health risks.

I should note that K-Y Jelly has recently been reformulated by the manufacturer. According to Pomeroy and Savage's study, the new formula is considerably less toxic to sprm than the old. I can't say how much of the data below reflect "classic" K-Y versus "new" K-Y, but it seems reasonable to elevate it a notch or two on the scale.

Finally, two points: (1) every couple's reproductive chemistry can be different,and it's possible that you'll find a low-ranked lubricant works just fine for you and your partner; and (2) if you have to use lubrication to have sex, go ahead -- your odds are surely a lot better than if you don't have sex at all! (not counting medically-assisted methods, of course). - RAH

Thanks to all of you who replied to my question about what lubricants are safe to use when trying to conceive.

I wanted to give an update because I've done some research and have more info to share. I wrote RESOLVE, and they said:

saliva -- no! KY Jelly -- no! egg whites -- ok Replens (a product available at most drugstores) -- ok

I also wrote Toni Weschler--author of Taking Charge of Your Fertility--who wrote me a very sweet, personalized letter in response (I like her even more!). She sent me 7 pages of various studies on the subject. While I won't take the time to copy the info here, my conclusion based on the research is that egg white is the way to go (7 sources recommend it if lubrication is needed). As for the concern of salmonella, none of the studies refer to it as a concern. Here's what Toni said in response to my question about it:

"...the best I can tell you is that while it's true that people have stopped eating as many raw eggs as they used to,
the risk is still considered small. And keep in mind that these people are *ingesting* them. But in the end, as with
infections, it is unfortunately a risk you need to consider and discuss with your doctor."

Just a quick summary of what other people have replied [in response to a posted request for information]. Quite a few people said they used a regular lubricant, such as K-Y Jelly, and had no problem conceiving. However, one person did report having trouble conceiving until they stopped using the lubricant. Several people recommended "Astroglide" lubricant, which is supposed to be lighter than K-Y jelly. Other people suggested using vegetable oil as a lubricant. The most popular alternative lubricants mentioned were spit and egg whites.

I don't know the answer to your question but one thing I can tell you is that if you need to use a lubricant most books suggest using egg-white (at room temperature.) Both saliva and lubricating jelly can be hostile to the sperm.

I have read in several magazines that egg whites are good for [lubrication]. Evidently, it is sperm-friendly.

I have read a news report that egg whites are also an effective lubricant because of the protein it contains.

Your best bet is egg white. It is sperm friendly and has the same consistency as [cervical fluid] around the time of ovulation. Saliva is something you can try but it is not sperm friendly..KY-Jelly is also ok..but it dries up quickly and usually more is needed.

From what I have read and heard, I would definitely avoid using the egg white. The risk of Samonella is pronounced, and a nasty yeast infection is the least that could happen. On the other hand, I have not heard of saliva or lubricating jelly acting effectively as a spermicide, unless the jelly was in fact a contraceptive jelly.

I read about egg whites too, how romantic, lets go beat an egg before sex, then lets stand on our head for a while, and then........ :-)

Anyway, my doctor was concerned with Salmonella. She told me to try a water-based lubricant called Astroglide. Sounds like something they would have come up with at the Kennedy Space Center. Anyway, they had an 800 number which I called. The woman there said that "anything" will inhibit the little monsters from getting to their destination - if you know what I mean - but that Astroglide is better than most other lubricants. Hang on to you wallet though - the price is $9.00 for a bottle. Hang onto your partners too, gals - the box says to wipe up any spills quickly since the stuff is extremely slippery - whooopeee!!!!!

Try buying the Astroglide from Wal*Mart. It cost us only $5.99 and you can find it in the section with the condoms, OPKs and pregnancy tests.

I don't know, but I would imagine egg whites would be likely to exacerbate yeast problems (which I get quite often). I have never heard that KY has any effect on conception. I always use it, due to a physical problem I have and it was never mentioned when I was looking into a possible fertility problem (I tried for [my daughter] for 14 months). As I cannot have sex without it, I don't worry. I figure that it's even harder to get pregnant without having sex!

::Greetings. My husband & I hope to conceive soon, but I am a little ::worried because we have not been very successful at having intercourse ::without a lubricant. However, I have heard that using any lubricant can ::affect sperm motility & make it difficult to become pregnant. We ::definitely don't want to do anything that would decrease our odds of ::conceiving, but on the other hand, we can't easily conceive if we can't ::have intercourse! Does anyone have any suggestions? Or has anyone used ::lubricant & still conceived without too much trouble? I am wondering if ::using something like Replens could help without actually interfering with ::intercourse as much as K-Y Jelly or something.

:We used vaseline (petroleum jelly) - the first month I was off the pill, I :conceived... does that help? :)

i have friend that is telling me that petroleum jelly is NOT good for the environment of the vagina since it is not biodegradable.. or not water soluable and clogs pores.

i don't think "astroglide" will cause any fertility problems.

Ever tried Astroglide? Yes, it's a silly name, but it's water based. It's very helpful for those of us who did Synarel or long term Lupron for endometriosis and never got that ol' lubrication response back.

It says in big letters that it is not a contraceptive or a spermicide. It contains purified water, glycerin, propylene glycol, polyquaternium #5, methyl paraben, propyl paraben. Any chemists out there care to translate?

On a more humourous note, they used to only sell this stuff at the kind of place where you could get just about any part of your body pierced or buy chain mail underwear! Now, Walmart carries it in the condom section.

Ingredients in anything are usually listed in the order of descending amounts - in other words, the ingredient in greatest quantity in this stuff is water.

Purified water is likely to mean it's run past a few columns to remove organic (carbon based molecules) impurities and so forth.

Glycerin is probably the main "lubricant" in this stuff - it's used a lot in the lab to allow easier sliding of tight-fitting tubes onto glass tubes etc. It is VERY slippery!

Propylene glycol I beleive would be used to give the stuff some "weight" - just glycerin and water would be very liquid like and not be easy to, um, "use"

The other ingredients are probably trade names for compounds - I don't recognize them. They may be compounds to improve the scent or feel or color of the product, or to prevent unwanted reactions or microbial growth.

Hope this helps. Personally, (not having experience with synarel or lupron) I would go with FOREPLAY!!!! Lots and lots of foreplay!!;-)

I got pregnant while using a water based lubricant so it can happen.

DON'T use vaseline. It is not water soluble and may trap bacteria and cause a yeast infection. It is best to use KY or some other water soluble lube. I don't know if KY will affect sperm.

My reading indicated that K-Y Jelly was just fine. You want water based lubricants that don't interfere with the environment of your vagina. We got KY during our efforts for the same reason.

We have been using KY too. My wife is now 3-months pregnant.

DON'T use vaseline. It is not water soluble and may trap bacteria and cause a yeast infection. It is best to use KY or some other water soluble lube. I don't know if KY will affect sperm.

Well after trying for 17 months (on clomid and using KY) we decided to try without the KY and conceived the first month without it! Clomid dries up your [cervical fluid] so that was a little tricky! Saliva worked for us! :) (boy the things we tell on the net...) good luck!

My RE told me NEVER to use KY b/c even though the normal KY is not a spermicide (it does come w/ spermicide, too!), it inhibits the sperm's ability to swim quickly. For those who are lucky enough to be very fertile, they would probably get pg using KY, but for those of us who are fertility-impaired, I would stay away from it.

I just talked with my obgyn about using saliva as a lubricant. We have to use some form of lubricant or entering me is like hitting a brick wall:(! We tried egg whites because I read that they are most like seminal fluid. We were both pretty grossed out. I felt like we had reached new level as I reached into a bowl of egg whites! My obgyn said that because my DH's sperm count is good, it probably wouldn't be a problem to use saliva as a lubricant.

I got pregnant twice with a water based lubricant! My body does not produce enough estrogen which is what aids in personal lubrication so I've always had to use a lubricant. Plus this time I'm nursing which is supressing any estrogen production I might have had. It took a little longer to get pregnant this time but I think it had more to due with the nursing than the lubricant. :-)

When my dh and I went to a urologist last year, of course he asked a lot of personal questions about how,where and when we have sex. He said saliva is detrimental to sperm and that if we did need a lubricant to use egg whites.

: Our Dr. suggested vegetable oil for lubrication. Has anyone else heard : of this? Is it safe?

vegetable oils, though sound good in principle, are full of contaminants or other nasty stuff from the refinement process where the oil itself has been changed in to some thing else. quite possible they are sterile since even bacteria might not want them! even oils in health food stores share the same story. i believe there are some companies like "Omega XYX" bottle the oils, prepared in the best possible way. you might find them in the local health food stores.

i believe egg white is a good lubricant. if you are using this, please make sure you don't keep the egg white floating around for a long time since it can attract bacteria from the air. 20 minutes to me sounds to be too long.

We used almond oil with a drop or two of lavender. I was a little concerned about this after I read that lubrication can be spermicidal, I read that article well into my cycle past ovulation. Well, we conceived on the first month... we also used KY and something water-soluble called Wet Stuff which we can't find anymore.

I'm not recommending oil on that basis but I don't know that at least KY wouldn't be okay?? I didn't think vaseline was really great on the vagina, but I think I agree somewhat that if you need the lubrication... sex with it is better for conception [than] none at all!

Well, my doctor said to use vegetable oil (safflower oil, he specified). But on the i-list and alt.infertility last year, there were threads about lubricants and the conclusion was that nothing was any good (water has clorine or other things, saliva kills sperm, oil causes all sorts of problems that I didn't really understand, egg whites can carry salmonella). So, who knows? We used oil when we absolutely needed to use something (before a post-coital test) and it didn't seem to affect the results. But I still worry about my tubes being gummed up from the oil... even though I personally think that sounds a little bogus!

I asked my dr. a similar question [about lubrication], only it related to using KY Jelly. He said to ... use vegetable oil if natural lubrication isn't working out. Anything else could be detrimental to the sperm.

Since greasing up with Mazola really isn't my idea of a good time, we've been going the natural route. It takes more time, but the time taken CAN be fun!

Roger, it's always been my understanding that vegetable/olive, etc. oils are not easily disposed of by the body and can cause a disruption in bacteria head-count (i.e. yeast) or other vaginitis. I'd be carefuly, stick with the stuff that's designed for lubricaton like KY and find a new doctor.

[From Dr. Kimball O. Pomeroy, Ph.D.:] We have recently done a study to compare different lubricants and their spermicidal poperties. Our results indicate that the Vaseline we used (in sterile pouches) was not spermicidal and in fact enhanced sperm parameters and enhanced long term motility over controls. KY jelly, which used to be toxic, has been reformulated and is not very toxic especially if a small concentration is used. Astroglide was also tested and was minimally toxic. I would try Vaseline before I'd try egg whites, although some have been worried about the petroleum-based lubricants as they may allow for the growth of certain bacteria [note: Vaseline is the most-familiar petroleum-based lubricant - RAH.] Incidentally, we also tested ultrasound gels and found one, Clear Image, that was extremely toxic. Some physicians may use this gel on the outside of the probe prior to insemination to check for follicle collapse. This could kill the sperm if the gel mixes at all with the sperm. (KY-jelly appeared to be more toxic than Astroglide.)

[Follow-up to above:] Roger, Yes, any information I give anyone they are free to use. Here is a rough draft of the abstract for this toxicity data:

The Toxicity of Lubricants on Sperm by Kimball O. Pomeroy, Ph.D. and Will Savage.

Inadequate vaginal lubrication is sometimes found in infertility patients. These patients are usually advised to not use any lubricant due to sperm toxicity. We examined the toxicity of 4 commercial lubricants using a sperm survival assay. Two hundred microliters of Percoll-prepared sperm from 7 men were exposed to approximately 20 mg of lubricant (KY-Jelly, Astroglide, Vaseline and Clear Image ultrasound gel). Semen parameters were measured on a Hamilton-Thorn IVOS system after 1 hour and after 24 hours of exposure to the lubricants at ambient temperature. Controls consisted of sperm not exposed to lubricant. Clear Image was extremely toxic to sperm; all but one specimen had no motile sperm after 1 hour exposure. Motility was significantly decreased in sperm exposed to KY-Jelly and Astroglide when compared to controls after both 1 hour and 24 hour exposure. When the semen parameters of sperm exposed to Vaseline were compared to controls, the sperm exposed to Vaseline had significantly higher percent of rapid cells, higher velocity parameters (VAP, VSL and VCL) and higher parameters of straightness (STR and LIN). Although KY-Jelly and Astroglide were toxic in this assay, they would probably not be present in a high enough concentration or exposure time would be too small to have a significant effect on sperm. Clear Image, though, is quite toxic and should not be used as a lubricant or as an imaging gel if exposure to sperm is anticipated. Interestingly, Vaseline appears to stimulate sperm motility.

    MEAN VALUES AFTER 24 HOURS      Ct      KY      AG      VS      CI
    % Motile                                                     59      22        37        64       2
    % Progress                                                 20       9         14        28        1
    % Rapid                                                      44      15        27        52        2
    VSL (u/sec)                                                  27      15        26        32        2
    STR                                                              68      44        68        71        5
    ALH (u)                                                        3.7     1.5       3.4       4.0      0.2

    Ct = Control
    KY = KY-Jelly
    AG = Astroglide
    VS = Vaseline
    CI = Clear Image

    % Motile = motile sperm/total sperm
    % Progression is a measure of sperm velocity and how straight sperm swim
    % Rapid is a measure of the percent of fast swimming sperm
    VSL is the velocity of the sperm in microns/sec
    ALH is how far the sperm head shakes back and forth
    STR is a measure of how straight sperm swim (100% is a straight line)

Kimball O. Pomeroy, Ph.D.
Andrology and Embryology Director
The Samaritan Institute of Reproductive Medicine
Phoenix, AZ

These are just my own opinions and are not to be construed as offering diagnosis or treatment.

, but I wonder if anyone can tell me what is the problem with artificial lubricants? I have been using KY ever since my cryosurgery because it says it is not a spermicide but I have never gotten pg. Is KY spermicidal? I've been hearing that practically _nothing_ is good. Egg whites were supposedly the only decent thing that wouldn't kill off sperm, but that idea was shot down in this newsgroup. Holy salmonella batman! Spit got a bad rap, KY also. Any other ideas! I recently read that anything "water" based was the best option.

KY is not spermicidal but can trap sperm and act like a barrier contraceptive (though I would not trust it as a contraceptive). Remember that 90% of sperm ejaculated in the vagina is going to be lost anyway (due to the acid conditions in the vagina) and only a small portion will actually make it into the cervical [fluid]. If you further reduce that population, your chances for conceiving may be diminished.

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10.5 What was the position of intercourse?

RAH - With the human body as flexible as it is, I am sure that people have conceived in every "conceivable" sexual position! :-) Nevertheless, for those seriously trying to maximize the fertility odds, we can quickly narrow down this Kama Sutra of possibilities to a favored few. Most of the experts, and most anecdotal evidence also, points to two positions as the most favorable for odds of conception: Missionary or face-to-face position, and rear-entry position, also less-elegantly called "dog-style." (For those who've always wondered: The missionary position is so called because of a story -- maybe true, maybe legend -- that South Pacific islanders, who always practiced rear-entry intercourse, happened to see some Christian missionaries engaged face-to-face, and the word spread... As for dog-style, personally I've always preferred the Asian term: "jump of the tiger.")

The bottom line for sexual position is pretty simple: The best position is the one that gets the sperm closest to the cervix, and gets it to remain there instead of exiting the wrong way, back out the vagina. The first criterion basically means deepest penetration possible or comfortable; the second argues for keeping a "downhill" path for the sperm after ejaculation. The first criterion rules out some possibilities like the scissors position, in which only shallow penetration is possible, and the second argues against all the female-superior and standing positions.

There is debate about whether missionary or rear-entry offer the deepest penetration. The answer may be different from one couple to another, in light of the considerable differences in anatomy and in how they fit together. Probably this is one question that you will have to experiment and resolve in light of your own situation!

Even if you decide on an optimum position for you and your partner, there are a few other variables to consider: for example, should rear-entry be on hands and knees, or lying across a pile of pillows, or... ? Again the bottom line (it's hard to resist those puns, isn't it? :-)) is "whatever aids gravity and goes deepest." These points and some additional position-related issues are more fully discussed in Secs. 10.6 through 10.15 below.

For women who have a tipped (retrodisplaced) uterus, special considerations come into play; see Sec. 7.13 for discussion. - RAH

Positions: I've seen conflicting reports on this - some evidence says missionary position is best, others say rear-entry is okay too. I can tell you that at least two of our three children were conceived in the rear-entry position <*blush*. Anyone know more about this aspect?

My RE says missionary is the best. It allows for the sperm to travel downwards into the uterus easier. I hope this helps.

Two positions to try are missionary and rear-entry (doggy style). These positions allow deeper penetration and deposit semen closest to the cervix.

Positions to avoid include woman on top, standing, both partners sitting upright - mostly due to the effects of gravity on the semen.

A couple of other tricks to try - try to orgasm at about the same time (the cervix actually dips down a little to gather up sperm during orgasm), have your SO lie down for 30 minutes after sex, have her lie with legs or hips propped up on a couple of pillows (again, trying to use gravity to move the sperm to the cervix).

Can't guarantee any of these work, but it's something to try. Good luck!

My understanding is that missionary or rear-entry are the preferred positions (especially for subfertile couples), and that woman-superior or standing positions are less effective because of gravity -- hence, we should choose other positions ahead of those two.

I agree that any sex, in any position, gives you better odds than no sex!

As for positions, missionary is the best... if you work out the angles (look at the anatomy chart sometime) you'll see that, to some extent gravity will help the little guys get to their date. I would presume this would improve if the woman have her knees up to her chest... you know what I mean...

To my knowledge, the position in which you have intercourse should not effect the results of a post-coital test. We did both of our post-coitals in the missionary position and, although the results weren't exactly what we wanted, we do the feel the test gave accurate results. This test is to evaluate the condition of the females cervical [fluid] to see if it is a hostile environment for the sperm. It also gives the doctor an idea about how many sperm are present and their condition. My doctor told me that a good post-coital test should show 7-10 normal (no two heads, defective tail, etc...) sperm actively moving in the right direction per EACH field of view in the microscope as well as [cervical fluid] with an egg-white-like consistency.

I tried for three months ALL the different methods in each session, I am now 18 weeks pregnant with our first. The thing that worked for me was very little foreplay and surprise! The best position is DEFINATELY girl on top.

hey, worked for us. ;-)

For us, rear entry is the better position. I know that missionary is recommended as slightly better, but for us the rear-entry is more comfortable... don't forget that some women are too small or the man is too large to make missionary a confortable fit! Someone suggested the legs over his shoulders position, this is just about impossible if your SO is well-endowed - ouch!! Deep is in the eye of the beholder :-).

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10.6 Was there deep penetration into the vagina during ejaculation? In particular, at the beginning of ejaculation?

RAH - As seen in the section above on position, ejaculating the sperm right next to the cervix is the best possible "head-start in life" you can give them. This is good common sense as well, of course. Another aspect which may not be so obvious, however, has to do with the physiology of male orgasm. Specifically, the sperm aren't spead out evenly among the several pulses or "spurts" that make up the ejaculation; instead, the sperm cells themselves are concentrated in the first spurt or two, and the following spurts contain more fluid from the seminal vesicles and prostate -- the substances that nourish the sprm and give them their initial burst of energy to travel their long journey up the female tract.

Thus, it's particularly favorable if the beginning part of the ejaculation takes place as deep inside the vagina as possible or comfortable. Of course, if all the ejaculation is pooled together as deep as possible, that's even better, so the sperm aren't separated from their "life-support"! Ideally, the man's orgasm should ejaculate his semen right onto the cervical opening; try to get as close to this ideal as you can, without hurting your partner of course. - RAH

I just read this the other day --

The deeper the penetration by the penis into the vagina, the better. Especially right at the first part of the male's orgasm, because the majority of the sperm will be right at the beginning of his orgasm. And the closer he can get to the cervix, the better off the spermies will be in trying to get into the uterus to begin their journey to the f-tubes. And the most efficient position for this 'task' is the good old missionary position.

Maybe you already knew this... Good luck anyway!

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10.7 Did he continue thrusting movements during ejaculation, or stay still?

RAH - There's almost no data on this question, to my knowledge -- either on how many men keep going or freeze up; or on which method is better for conception. Intuitively, staying still seems more likely to result in depositing the semen closest to the cervix, as discussed above in Sec. 10.6. But the post below does raise the intriguing question of which method triggers the more forceful orgasm. I think this is one debate that won't be resolved soon. Fortunately, it seems to me to be one method that won't make a whole lot of difference either way. For the sake of completeness, though, it's worth considering a change in your usual practice to see if it makes a difference. - RAH

[An earlier response] attributed successful conception to the fact that her SO always kept moving throughout his ejaculation, instead of "freezing" like many men do. I haven't heard of this as a fertility method anywhere else, although I confess that I do this too <*blush* and we have conceived three times this way. Maybe some of the semen gets left farther up the vagina, but my orgasm is always more intense and there's more semen when I keep going.

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10.8 How soon did he withdraw after ejaculation?

RAH - It makes sense that after ejaculation, conception odds will be improved if the sperm have only one place to go -- through the cervix, into the uterus, and toward the tubes! Therefore, if at all possible, the man should try to keep his penis inside his partner for as long as possible (or feasible) after his orgasm. If used in conjunction with the female-orgasm-afterwards recommendation (see Sec. 10.11), this can be an excellent way to propel the sperm in the right direction. It may be difficult logistically, but the effort may pay off. - RAH

BTW, another intercourse fertility-hint: If you can manage it, try to have your partner stay inside for a while after orgasm, as deep as possible -- it makes a good barrier, and keeps the semen concentrated as close to the cervix as it can get. Some people recommend putting in a diaphragm or cervical cap after intercourse for the same reason, but I think this runs the risk of excluding some of the sperm, since those barriers fit very close to the cervical opening and not all of it will be inside the uterus at that point.

We have had the same problem - with excessive leakage that is. Our PCT [post-coital test -- a measure of sperm viability in the female tract] was still viable. The volume has been quite high in most of the tested samples and, while the doc has never flagged this as a problem, one of the infertility books I have did say that volume over a certain amount (I think 5 ml.?) could be a problem. My husband's counts have been low to borderline normal - per ml., but his total count has always been quite high. In your case, I don't know if high volume is an issue, but you might want to check it out if you haven't already.

A couple of things we have had some success with to decrease leakage have been: my husband doesn't withdraw, but waits until nature does the withdrawing (if you get my drift - I can't believe I'm broadcasting this delicate info to the world!! :) ). Secondly, we sometimes have sex from behind. The books say not to, but, if I hunch the top of my torso down on the bed, with my rear end in the air (a very attractive sight! hee hee), I have been able to manage no leakage on several occasions.

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10.9 Did intercourse take place on a hard or soft surface? (e.g., waterbed versus floor)

RAH - As with staying-still versus keep-moving, there doesn't seem to be much evidence concerning the relative merits of different surfaces for intercourse. I'm including it because of our own experience (see below), which is the only fertility-related information I've seen on the subject. Intuitively, firmer surfaces should be better, in that they can allow for carefully-positioned deep penetration at the moment of male orgasm (which might be tricky if the surface is too soft.) Of course, this has to be balanced against other factors, including comfort -- not everyone enjoys intercourse on the floor, at least not every day!

As far as specific surfaces are concerned, I think a reasonably-firm mattress will be just about as good as the floor. Very soft surfaces probably are the ones to avoid, such as old-style waterbeds (the kind with waves :-)). Overall, I don't think this is a major variable, but it might give a small fertility boost, physically and psychologically.

As with every other aspect of this FAQ, I'm open to discussion about this idea! - RAH

My experience has been that it's hard to get positioned just right at the moment of my orgasm unless we're on a firm surface, like a firm mattress or the floor. In trying to go deep (but not TOO deep, which can hurt your partner), the firm surface gives me "fine-tuning" control. Intercourse on a yielding surface makes it hard to do this. My experience with that has been on an old- fashioned waterbed (not the new waveless kind), and intercourse was fun but not very controlled :-). I confess I don't have any idea how the newer waveless waterbeds compare.

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10.10 Was intercourse occasionally or typically painful to her?

RAH - There are a number of possible fertility problems that can be signalled by pain during intercourse. Commonly, a woman will find that intercourse hurts her at certain times of the cycle, but the same activity during a different cycle-stage will be pain-free. Less typically, she might feel pain during any act of intercourse. These two examples are signs of different phenomena, and call for different solutions.

The first type, pain in a certain part of the cycle, often is caused by changes in cervical position, as discussed in Sec. 9.6. During the least fertile parts of the cycle, the cervix is "low", i.e., closer to the vaginal opening; during these phases, the penis may be touching the cervix during intercourse, and this contact can be painful (as nearly all women undergoing internal exams or Pap smears will testify!) At the peak of fertility, on the other hand, the cervix is high, and sex that might be painful at other times becomes pleasureable instead. (Fortunately for those trying to conceive, nature designed things so that the most fertile part of the cycle is also the time that painful intercourse is least likely, other things being equal!) The solution to this difficulty is for the male partner to take it easy and let his mate tell him if things are getting too rough. Sexual positions can make a difference, too -- the most common position that causes pain seems to be female- superior (which ought to be avoided by those trying to conceive anyway; see Sec. 10.5). I would suggest that you try both of the recommended positions, missionary and rear-entry, to see which is less likely to be painful. This can be one of the deciding factors in which position to use regularly. If you are prone to experiencing this pain, you and your partner will learn each other's limits, and the problem should be manageable if you're careful.

Incidentally, sometimes the penis can tap the cervix in such a way as to cause minor bleeding or spotting along with the pain. This is not cause for alarm, as long as the bleeding is not heavy or prolonged. The reason it happens is that the cervix has many blood vessels close to the surface, and it doesn't take much to break the skin. Again, caution, and learning each others' limits, is the best way around this problem.

Pain throughout the cycle is a different matter. There are a number of possible causes of chronic pain during sex, and virtually all of them are serious conditions warranting medical treatment. Two of the most common causes are endometriosis (a condition in which tissue similar to the uterine lining grows outside the uterus) and pelvic infections. Both of these conditions should be treated in their own right, aside for their effects on fertility. Usually these conditions are painful even when you aren't having intercourse, so pay attention to your body's warning signs. - RAH

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10.11 Did she reach orgasm? Was it before / during / after his orgasm?

RAH - I like to think of this as proof that Mother Nature knew what she was doing, when she combined our reproductive lives with our pleasure centers :-). There is clinical and anecotal evidence that female orgasm is beneficial to those trying to conceive, as long as it happens during or after the male orgasm. It happens that when you (female) have an orgasm, your cervix can dip or move into close contact with the pool of semen, and "suck" or propel it into the uterus. The mechanism by which this is accomplished isn't fully understood (not be me, at least :-)), but the results indicate that it does happen. At least one report (see below) suggests that the same effect can take place even if female orgasm is slightly earlier than male orgasm.

Also as noted below, the female orgasm doesn't necessarily have to be brought on by intercourse itself -- something to keep in mind if you, or he, find that the rockets don't go off on schedule, so to speak.

Finally, be cautious about female orgasm outside this time frame -- it's possible this may hinder the odds of conceiving (see Sec. 10.15). - RAH

: One topic of discussion [on the ONNA list] is "who should orgasm first?", to maximise chances of : conception. (I told you we'd gotten chummy) :-)

Baker and Bellis (1993 Animal Behavior 46:887-909) studied "flowback" in human females (the semen that leaks out after copulation) and found evidence for the "upsuck" hypothesis (Fox et al. 1970 J. Reprod. Fert. 22:243-251). Thus, female orgasm after male orgasm might function to bring the semen up through the cervix. They also suggest that orgasms *between* copulations might hinder future sperm retention by sucking up vaginal fluid into the cervical [fluid] making it more acidic and thus more hostile to sperm.

I honestly can't tell you whether this worked to get me pregnant, as the week I conceived was a busy, traumatic one and my notes are probably not accurate. If they are, I didn't orgasm at all on the crucial days that month, and didn't conceive the months I did. It did happen to be the first month we "tried" every other day rather than every day, and the first month we were too stressed by other family crises to stress out about conceiving (and to keep track of all these details, which I'm probably a weird scientist for keeping track of anyway).

I watched a medical documentary [Desmond Morris' "The Human Animal"] which included this... they used a miscroscopic camera inside the vagina during ejaculation and orgasm... it showed the semen being ejaculated onto the cervical area, and then when the woman had the orgasm it produced spasams around the cervix that created a sucking effect, thus drawing the semen into the uterine cavity. The program didn't specify if it was necessary for this to happen for conception (we all know it doesn't... some women seem to get pregnant just looking at a picture of a baby) but it did say that it helped to get the sperm where it needed to go... in addition, the womans own secretions help to suspend and carry the semen as well. It only takes "one" to do the job. It really is a miracle isn't it?

There was an interesting show on sex by David Suzuki on the CBC recently (Nature of Things) that stated that if a man and woman orgasm simultaneously the woman retains a much higher percentage of sperm than if she orgasms first. I think the % were something like 70 to 30 . Making pregnancy more likely in the first instance ..I suppose.

I saw the same show... you are correct. Apparently the female orgasm creates a "sucking" effect around the cervix which can help to draw sperm inside, not to mention the female lubrication which is compatible with sperm and can help it remain suspended while it is transferred into the uterus. No, it isn't "necessary" for conception to occur, but it doesn't hurt your chances! It was a good show.

I read that at orgasm, the female uterus actually dips into the vagina picking up sperm with each flexing or dipping when having an orgasam. This possibly would increase fertillity chances. I don't know if it is really true but it made for interresting reading.

As mentioned in other articles, if the female will lie with her head down and her hips slightly elevated, this too will help..

There was just an article in the LA Times about this, and it said that female orgasm sometime between one minute before ejaculation and 45 minutes after will have the upsuck effect. And the woman is ideally supposed to lie on her back for 20 minutes after sex, so there's some latitude there, if you time it right. Besides, I don't think you have to lie absolutely still -- as long as you don't stand up...

He had the orgasm first. It seemed to do the trick as I conceived about 6 weeks after going off the pill, which I had been on for 8 years.

I had a lot of problems getting pregnant and did all sorts of things. I do know that I climaxed a GREAT climax each time I got pregnant. I told the physician. he said he had read something like that too. Another friend trying to get pregnant was talking to me. I told her to make sure she had an orgasm. I think she may have had it after he climaxed and went off for a shower while she helped herself along to a climax.

What I am saying, it does not have to be a naturally occurring climax. The woman can move it along and the results are teh same. She got pregant. She and I are not going to claim that is the only reason we got pregnant, but I believe there is something to the climax and fertilization.

Concerning medical findings... the Shettles method for choosing your baby's sex before conception ... overlaps heavily with fertility and conception methods as a whole. Shettles confirms that female orgasm does cause the semen to get into the uterus more quickly, and in fact it plays a part in his recommendations -- orgasm for a boy, no orgasm for a girl.

The vagina contracts rhythmically during orgasm. This helps bring the semen closer to the cervix. Although we can't be sure, we're pretty sure our first was conceived during some very good, perfectly timed sex :)

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10.12 Was she able to lie down for some time after intercourse? For how long?

RAH - There is a lot of conventional wisdom to the effect that lying down and remaining still for XX minutes after intercourse will give the sperm a better chance at reaching their destination quickly. Firm clinical evidence to back up this belief is scarce. However, it's another recommendation that fits the "can't hurt, might help" category. Typically the advice is to stay horizontal for 20 minutes to + hour, and to remain in the same position in which you had intercourse. The majority of women who linger lying down also elevate their legs and/or pelvises after sex; see Sec. 10.13 immediately following. - RAH

I've found that less sperm gets out right away if I lay on my stomach after sex.

The cervix is on the front side, so it seems OK because the sperm will fall toward the cervix.

This works for some women, but not all -- you're right, the cervix IS on the anterior or "front" side, but for some women the vagina will be "uphill" to the cervix, if you're on your stomach. However, this is one *very* low-tech method -- all you have to do is try it both ways, and see which causes more sperm to leak out. (Hopefully, semen volume won't vary much in the two trials :-) ).

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10.13 Did she elevate her legs and/or pelvis after intercourse? For how long?

RAH - This is one of the most frequently-recommended methods on the newsgroups, and in folk wisdom generally, for speeding the lucky sperm on its way toward union with the egg. There is a certain intuitive logic to the idea, for two reasons: first, sperm ought to travel faster in the right direction if they are swimming with gravity and not against it. Second, there is a reduced chance that semen will leak out of the vagina after intercourse.

Typical advice if you're having intercourse in the missionary position, is to place one or two pillows under your buttocks to raise them above horizontal, and/or to put your feet on an elevated surface, such as resting them on the bed's headboard or against the wall. For rear-entry intercourse, the usual suggestion is to place a couple of pillows under your pelvis and upper thighs, while lying on your stomach. (This is not as awkward as it sounds, according to one practitioner with whom I'm on familiar terms :-)). The customary time frame is 20 minutes to + hour (see Sec. 10.12). As in that discussion on lying down and remaining still, there's no harm in following this advice (unless you count boredom). Of course, many women conceive without the aid of pillows and the like (the majority of the world's people don't even have pillows, for that matter). On the other hand, assuming you DO have pillows, this method seems to offer a low-cost way to improve the odds, so it's likely worth doing. - RAH

I once heard that if you put your legs up after making love (rest them against the wall or your headboard) and place a pillow under your butt for about 20 minutes, it helps the sperm travel through your cervix. I don't know, but it can't hurt.

Funny story here... When we began trying to get pregnant my husband's friend told him to have me lay on my back and put legs over my head (afterward.....) We had a good laugh trying to picture his friend and his wife getting into this position. Just for kicks... after sex one night I put my legs up over my head and stayed that way until I couldn't stand it any longer... and darn it if that wasn't the month we got pregnant. Whether it was contributed from that position or not I don't know... but it is interesting to wonder.

a friend of mine was saying that on a re-run of 'thirty something', when a couple was trying to get pregnant, the wife stayed in bed for a half hour with her pelvis elevated by a pillow following intercourse...anyone ever heard of this?

This is one of those "can't hurt - might help" recommendations. Staying still with a pillow under your hips gives the best chance for the most sperm to swim into the uterus.

If there are no fertility problems, a few million will make it in without help. If there are significant fertility problems, this won't make much difference.

As for staying still... I don't know... One of my husband's friends was joking about how hard he and his wife were trying to get pregnant - finally after intercourse she laid on the bed, with her legs and butt up as high and level as she could get it... for as long as she could stand it (about half hour)... well, it may have worked because they got pregnant... who knows if it was from "that" time. Just for kicks we tried it too and we also got pregnant (but we had not been "trying" for as long as they had)... I don't know... whatever works I guess.

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10.14 Was any other method used to prevent semen from spilling out afterwards (e.g., keeping legs crossed)?

RAH - Along the same lines as the two previous sections, this suggestion is designed to get as much sperm as close to the egg as possible. Of the two mentioned below, I would suggest the crossed-legs as preferable over the diaphragm; it seems to me that you might run the risk of trapping some of the sperm on the "wrong" side of the barrier. On the other hand, the diaphragm (or a cervical cap) might be a good idea, if you need to get up immediately to run a 10K race :-). - RAH

This might sound crazy, but after my husband and I have sex I take a paper towel and fold one labia over the other and then cross my legs. 9 times out of ten when I have gotten up several hours later there was no leakage at all.

This may sound a little off the wall, but even some doctors reccommend it. If you have a diaphram put it in after sex. It will act as a cervical cap. If you do not have one they are pretty inexpensive if you have you doctor [write a prescription]. I have not bought one for years, but if I remember correctly It was only about 20 dollars. Good luck and hang in there.

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10.15 Did she ordinarily have orgasms in-between acts of intercourse (i.e, without semen present in the vagina)?

RAH - As mentioned in Sec. 10.11, it's optimal if the female orgasm follows or is simultaneous with the male orgasm, due to the climax's drawing fluids into the uterus. By the same token, if you (female) have an orgasm outside this time frame, as in oral sex preceding intercourse for example, it seems possible that the same activity can draw normally-acidic vaginal fluids into the uterus. Since sperm require an alkaline environment to survive, this could pose a potential problem. The evidence is far from conclusive on this point, but once again, for those who want to gain every "conceivable" advantage :-), it wouldn't be a bad idea to save the fireworks for the main event. - RAH

I do remember reading somewhere that a woman's orgasm can change acidity and create problems, too. Don't you wish this could be simpler?!?! I sure do!

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10.16 Can other sexual practices have some effect on conception?

RAH - The primary reason I'm including this section is because of a debate that took place on the three newsgroups in early 1996 about the wisdom of oral sex (fellatio) and subsequent swallowing of semen. The arguments are, on the one hand, swallowing sperm can build up antibodies to her partner's sperm in the woman's immune system, and these antibodies can attak the sperm entering via the vagina, thus making conception difficult. The counter-argument is that there's no known process by which antibodies can be formed through swallowing sperm, since the stomach would quickly digest them as it would any other protein. Some of the groups' medical professionals weighed in on one side of this debate, and some on the other. I am not expert enough to make any conclusive judgments here, so I will reproduce the debate in its entirety and let you draw your own conclusions.

One other note: Anal sex is one practice that IS likely to produce sperm antibodies, since there are no digestive substances in the lower intestine, and since minute abrasions or tears in the anus and rectum can accompany this activity, thus putting sperm and bloodstream in direct contact. If you engage in anal sex, it's wisest (for many reasons, not just fertility reasons) to use a condom. - RAH

..Yes I definitely think the "newness" of a relationship has something to do with it. Maybe we build up immunity to our husbands sperm or something? It would be interesting to know. One thing I have heard - Don't, under any cirmstances, swallow or ingest sperm. That causes the body to build up immunities against it.

The sperm definitely have to get into the blood stream to cause antibody formation, which may happen if there was a little excited back and forth resulting in some bleeding from the cervix or something.

One thing I have heard - Don't, under any cirmstances, swallow or ingest sperm. That causes the body to build up immunities against it.

This sounds possible, but I personally think it's absurd. What about the couple who has an astounding number of children over a 20 year period? I lost track of how many my great grandmother had. My own mother had 8 pregnancies in 16 years. Some people I've heard of have had 19 children, all with the same man.

As mentioned, the sperm have to directly enter the bloodstream in order to produce antibodies -- this may happen in some cases, but I don't think it's especially common during intercourse. Same thing with oral sex -- unless you have an open sore or abrasion in your mouth, esophagus or stomach, I don't see how it's going to produce this reaction. Sperm don't survive long in an acid environment, so they aren't likely to be a problem once they get into the digestive tract. Anal sex may be a different matter -- this is the riskiest behavior for AIDS transmission, due in large part to the fact that it often causes small abrasions in the rectum; so the same might be true for sperm entering the bloodstream.

I think most of us can relax :-) .

: Sorry to burst your bubble but in "Missed Conceptions, Overcoming : Infertility" by Anne Mullens, McGraw-Hill Ryerson, copyright 1990 she : states, on page 62 "The evidence is not yet firm, but an increasing number : of doctors working in immunologic infertility are concerned that women : taking semen into their digestive tract may form antibodies to their : parters' sperm. The antibodies may later attack and kill sperm when they : are in the cervical canal. Dr Richard Bronson, of New York, a leading : expert in immunological infertility says, "We don't know yet whether this : is a real concern, but to be prudent it is wise to say avoid ingesting : sperm." Men should avoid ingesting sperm as well as in oral-genital sex : after intercourse because he can make antibodies to his own sperm causing : them to coat or even kill them before they leave his body." :

: In "The Infertility Book, A Comprehensive, Medical and Emotional Guide" by : Carla Harkness, Celestial Arts Publishing, copyright 1987, 1992 she : states, on page 164, that sperm antibodies can exist in the reproductive : tract and in the blood. This doesn't necessarily mean they will be in : both. It seems the antibodies in the reproductive tract are more likely : to cause infertility by affecting the sperms' movement. This is a highly : controversial discussion with doctors and they disagree on the effect of : antibodies effect on infertility. : : This doesn't mean you can't have oral sex, I understand. Anyways, you'll : have a hard time getting anyone pregnant if this is how you are putting : your semen into her :-) Ladies: I think, as a precautionary measure, it : would be wise not to have a guy come in your mouth. This might seem a tad : prudish but anyways you're not going to get pregnant this way!!!!

: This allergic reaction probably exists toward all sperm rather than just: those of one partner. Based on this, I am going to be prudent. i wasn't : trying to lecture anyone, just to let people know what I read. BTW they also : mention anal sex as a real danger too as well as males taking semen in thru oral-genital sex after intercourse. Not a nice thing to think about but hey, : what's nice about infertility????????

: Just found another reference: In "making Babies" by Heather Pullen and : Jocelyn Smith RN, Randon House/Lorraine Greey Book, copyright 1990, they : state, on page 98, that swallowing semen can cause the production of : antibodies. Also men who have had vasectomies develop these antibodies : because the severed end of the vas deferens has leaked sperm into the : surrounding tissue, triggering the immune system to attack the "invaders" : with antibodies. They can also be generated by frequent genital infections.

What kind of craziness are people spreading? Don't ingest sperm? Oral sex is such a joy for men...and women...why scare people away from such pleasures without proven data? Come on.

"doctors...are concerned that women .. may form antibodies to their partners sperm" sounds to me like some doctor is GUESSING that maybe this is a problem. Sounds like bullshit to me. Normally when substances are ingested by mouth there is an immunosuppresive effect, not the development of antibodies, otherwise we would all end up becoming allergic to bread, milk, bananas, apples or anything else we ate. FOOD is made up of substances that are foreign to the body by definition. More recent research in the immunology of the digestive tract shows that there can be a strongly positive suppressive effect, such that if you are allergic to some kind of medication and ingest some if it, the allergic reaction is suppressed. That would imply that if you have anti-sperm antibodies, oral sex might have a positive effect ! ;-)

Until somebody comes up with a study or some other research that there is some real problem I would just chalk this up to some doctor's imagination. As many of us have found out, doctors are only human and are perfectly capable of coming up with ridiculous hypotheses.

Some patients with multiple sclerosis are being treated with oral doses of myelin. (Myelin is the covering of the nerve ends and is what the immune system of ms patients view as "the enemy".) The theory is that if they ingest it, their body will begin to no longer view it as "the enemy".

My husband has pointed out (in fun) that this can be extrapolated to apply to a woman who has developed antibodies to her husband's sperm.

I don't understand how antibodies could develop from swallowing sperm. I would have thought that the acid level and enzymes in the stomach would quickly kill and breakdown the sperm. After all aren't they mostly proteins? Once they've been digested, wouldn't they enter the bloodstream through the villi in the small intestine as glucose and amino acids, just like food? It is very important to understand that anti-sperm antibodies DO NOT develop from swallowing sperm. I was quite surprised and a bit shocked to read the post that stated this. This is totally false information. You are quite right in how things are digested in the stomach.

Hi-- I hate to get into this because I've never heard of antibodies to sperm (which doesn't mean a whole lot --there are lots of things I've never heard of) but I do know it is possible to develop antibodies to things which are ingested and as a result have some severe allergic reactions. Examples which come to mind are peanuts, eggs, drugs, strawberries, wheat, etc. There is even an oral polio vaccine The exact mechainsm is what I am not exactly sure of but I would propose it is similiar to other allergen-antibody reactions where for whatever reasons when the allergen ( the offending substance) is introduced the body sees it as a foreign substance (for whatever reason) and makes antibodies to attack it. Even though the stomach is an acid environment and digestive enzymes break substances down to aid in absorption, the original substance still retains some specific properties which the body may later recognize and "attack" causing an allergic reaction. I hope this makes sense. I don't know if sperm allergy exists but it wouldn't surprise me.

I know of women who's antibodies are hostile to sperm. They are usually advised to use condoms for 6-12 months, then try. This works often. I hadn't heard the oral sex theory of antibody build-up, but do know its more likely to happen in women who have used IUDs for birth control.

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