The Big 10. We Answer Your Most Commonly Asked Questions When TTC.
How many times have you laid in bed, struggling to fall asleep, wishing you could find an answer to that question that’s been plaguing you for days? You search Google and Wikipedia and even enter a few chat rooms, but no dice. While you see several answers, you question the reliability, the validity, and the medical science behind the response. As fertility specialists and women, we have been asked almost every question in the book (and actually several out of the book) about the dos and don’ts, the yeses and nos, and the cans and cannots when it comes to getting pregnant. There is actually almost nothing that is too taboo, nothing too risqué, and (almost) nothing that we haven’t heard before. Many of our patients have called us their “pen pals,” their “professional girlfriends,” and their “guardian angels.” And while you may not be able to ask us directly, we thought we would share with you our “big 10” when trying to conceive.
1. Does position matter?
So in case you didn’t get it…news flash, we are talking about sex (not yoga!). The short answer is “no.” Do what you want and what you like. Being on top versus on the bottom will not improve or worsen your chances; sperm can swim in pretty much any direction. Up down, back and forth, they are pretty good navigators (even without stopping to ask for directions!).
2. Do you need to lie still after sex? That is, does standing, moving, or peeing interfere with the sperm’s ability to get to the egg?
Again, the answer is no. Sperm is pretty fast and pretty sly. Seconds after ejaculation, sperm can be found in the cervix, and about two minutes after ejaculation, they have found their way into the fallopian tubes. While intuitively it makes sense that lying flat with your feet in the air would shorten the course, reduce traffic, and ensure a smoother, faster transition to the egg, scientifically, it doesn’t seem to matter. Do what you need to do when you need to do it, especially if you are prone to UTIs and need to urinate after sex to prevent one.
3. When is the best day to have sex?
This is probably one of our most popular questions, and for all you busy ladies trying to plan your schedule, it’s a very important one. Studies show that having sex the day before ovulation yields the highest chance for pregnancy. Although two days before ovulation is also pretty fruitful, the nearer you are to, ovulation the better. If time is of the essence and you have to pick (pre- or post-ovulation), go for pre-. Sperm can survive longer than the ovulated egg, and by having sex before, your chances are increased.
4. How many times must you have sex around when your ovaries are doing their thing?
Sorry to burst your bubble, but you actually don’t need to have that much sex when trying. People drive themselves crazy during the peak days of fertility, and it can lead to undue anxiety and stress (both for you and your significant other). Sperm lives for about 72 hours (and in some instances up to 96 hours). Pregnancy rates per cycle are comparable when sex is had every day versus every other day (37% versus 33%). So if you miss a day or two due to work, travel, or fatigue (trying to have a baby can be hard work), don’t worry. You’re covered! Become familiar with your cycle (even before you start trying). This will help when you’re trying to pick the best days to try. Remember, even couples who have sex once a week will still get pregnant at a fairly good rate (about 15% per cycle compared to 37% per cycle with daily intercourse). Trying to follow a strict schedule can definitely lead to undue pressure and anxiety; remember, sperm will survive!
5. Is lubricant okay?
The answer here is somewhat slippery…while some lubricants contain a substance that can inhibit sperm survival, many couples that use lubricants conceive without a problem. Additionally, lubricants (with the exception of spermicides containing Nonoxynol-9) are not contraception and cannot reliably prevent pregnancy. However, when a couple is actively trying to conceive, we do recommend that they trade in their KY Jelly or Astroglide for something more sperm friendly. Astroglide TTC, Pre-Seed, Yes Baby, Conceive mineral oil, and canola oil are good alternatives that do the trick without stopping his swimmers.
6. Masturbation…must I make him stop?
Let’s squash this one quickly—absolutely not. (Can you imagine the mutiny we would have on our hands if we said yes?) While it’s not the act of masturbation that has been questioned, it is the frequent ejaculations. Men who ejaculate on a daily basis were traditionally thought to have decreased fertility. Although men are constantly regenerating new sperm (unlike their female counterparts), limited bench time between ejaculations was thought to lower the count and the motility of the sperm as well as the volume of the ejaculate. Therefore, ideally before a sperm test or a fertility procedure (such as IVF or an insemination), two to five days of abstinence are recommended. However, more recent data show that, for most guys, daily ejaculation has no impact on their sperm; in fact, more frequent ejaculations are far better than less frequent (guys who went for more than 10 days without ejaculating had much poorer sperm quality when compared to those who ejaculated daily). If it’s been some time and pregnancy has not occurred, you should speak with your OB/GYN. They will likely order some tests, including a sperm check (semen analysis). This will reveal if there is a problem with the sperm and if further treatment is required.
7. Should I replace his briefs with boxers?
Boxers versus briefs: the age old debate. Now, to make it more complicated, we’ve added a third option—the boxer briefs! And while traditionally it had to do with a guy’s comfort and preference (and maybe ours too), now it has also come to include sperm health. But breathe a sigh of relief; we are here to tell you there is no need to throw out those tightie whities. Unless they are skin-tight (imagine Spanx for men!), his undergarments are likely not the problem. If fertility issues arise, he will need an evaluation; if this reveals a problem with sperm, consider a change. But until then, loosen up, and let him wear what makes him feel good.
8. Saunas, Steam, and Sweaty Cycling Classes
How hot is too hot? Is turning up the heat turning down his sperm quality? Frequent sauna/steam use and long bike rides have long been on the no-fly-zone for guys whose partners are trying to get pregnant. When temperatures heat up, so do the testicles, and therefore, so does the sperm. This can lead to a decrease in sperm count and morphology (shape) and possibly hinder a sperm’s ability to fertilize an egg. However, despite lots of speculation, the data remains unclear; in many ways the negative impact of heat is more speculative than scientifically proven. But anything in moderation is more than acceptable and need not be modified. Guys like to sauna, steam, and ride; it’s where they chat, they catch up, and they relax. As long as he is not doing it on a daily basis, let him chill out (or heat up). It will not burn his sperm or your chances to get pregnant and might even help relax him.
9. Is it okay to bare all?
What you can wax, when you can wax, and how much you can wax is another question on many of our minds. Simply stated, bearing it all versus Brazilian versus just cleaning it up is up to you. What you do with your “business” is your business. One is not safer or more dangerous than another. Just a couple words of advice here—make sure the facility you use is clean (no double dipping), the equipment is sterile, and your technician wears gloves. Keeping that clean will keep you clean from infection!
10. Orgasms
And last but clearly not least, the big O. The number of times we have been asked can I, should I, or do I need to definitely tops the triple digits. It’s usually done in a hush hush voice; we all want to know about it but can be ashamed to ask. While orgasms have been shown to assist in sperm transport (the uterus contracts and can help sperm pass from the vagina to the cervix and into the tubes), they are not mandatory (at least medically speaking!). Many women get pregnant all the time without having one; so if it doesn’t happen, don’t stress out. It won’t hurt your chances. Quick sidebar while we’re on the subject…if you happen to already be pregnant, having an orgasm won’t hurt your embryo or fetus. They are pretty much glued into that uterus. You can’t cough them out, laugh them out, sneeze them out, or orgasm them out (no matter how many times you do it!).
We all wonder the same things, ask the same questions, and internally debate what’s the right next play to call. Should you pass, or should you run? Should you blitz, or should you play deep? When you are several quarters into the game, it can be hard to see the next move clearly. Take a time out, and ask for help. Your doctor is there to guide you. We have played this game before and know how to lead you to a win. Game on!