When I first started treating infertility in my acupuncture practice 15 years ago, one of the first things I realized was that many of my patients felt uncomfortable or embarrassed to ask a really important question, a question that could determine whether or not they would get pregnant that cycle:
When should they be having sex?
Once I decided that this was one of the first conversations I needed to have with each and every fertility patient, I discovered that most of my patients were waiting until they knew they were about to ovulate to have sex. This is usually way too late!
It’s important to remember that while the egg is only viable for about twenty-four hours, the sperm actually live for five days. Imagine that your egg is a magical queen (because she is). Waiting until you’re about to ovulate to have sex is almost like Beyonce starting to perform while the audience is still trickling into the theater. Just as Beyonce should be arriving on-stage to a packed house, your egg should be bursting forth into a completely full house, with tons of sperm vying for her attention. Imagine her disappointment if she arrives to just a handful of sperm.
I have an easy formula to help ensure that you are ovulating to as many viable sperm as possible, to maximize your pregnancy success rate.
Beginning the day after your period ends, you should have sex every other day until you ovulate. Let’s say that you have your period for five days. You should then have sex on days 6, 8, 10 and 12. If you know you ovulate on day 14, for example, you’ll also have sex for 3 consecutive days surrounding the day that you ovulate. So for a day 14 ovulation, you’ll have sex days 13, 14 and 15. Then, you’ll skip a day, and have sex again on day 17. Any sex after day 17 is optional.
I’ll give you another example for a later ovulation. If you know that you tend to ovulate on day 16 and your period lasts for 6 days, you’ll have sex days 7,9,11,13,15,16,17 and 19.
Here’s one more example so that it’s really clear. If you have a 3 day period and tend to ovulate around day 12, you’ll have sex on days 4, 6, 8 and ten and then surrounding ovulation on days 11, 12 and 13.
My patients tend to ask me why they need to start having sex so early if the sperm only lives for five days. It’s true that day seven sperm is no longer viable by day sixteen, but it’s important to remember that sometimes we ovulate early. We don’t want to “waste” a whole cycle just because we ovulated early that month. If you happen to ovulate on day 12 that cycle instead of day 16, you will still be ovulating to a “packed house” of sperm. Your egg will still feel like the magical queen she is.
Now of course you can use this formula even if you aren’t sure exactly when you’re going to ovulate. You can just have sex every other day. But it is helpful to have a sense of when you ovulate to really take the most advantage of this formula. If you haven’t been tracking your basal body temperature with a basal thermometer, it’s incredibly helpful so that you know when you’ve ovulated. Usually, post-ovulation, the temperature elevates by at least a half of a degree, or .5 degrees. An ovulation predictor kit (OPK) can also be helpful.
Some other useful tips to increase your chances of conception:
- Avoid any store-bought lubricant that might contain ingredients that negatively impact sperm. Olive oil is a very safe and effective lubricant that everyone seems to have on-hand.
- Both partners should avoid recreational drugs or alcohol when you’re trying to conceive. They have a tendency to negatively impact the fertility level of both cervical mucus and sperm motility.
- Especially around ovulation, it’s important to reduce or even remove completely both sugar and dairy from your diet. Both sugar and dairy tend to stagnate our energy. It’s important to keep your energy moving as smoothly as possible so that the “bursting” of ovulation can occur. It’s great to get in a cardiovascular exercise right when you’re about to ovulate.
- This might be a "touchy" subject, but it's ideal for your partner to conserve his sperm so that he's only ejaculating during sex with you during this time period. The skipping of a day is actually for the purpose of sperm regeneration, so that there is as much sperm in each ejaculation as possible.
- My patients always ask me about eating pineapple. I’ll answer that question here: The core of the pineapple is very high in Bromelain, which can help with implantation. So, if you’d like to help promote implantation, you can buy a ripe, ideally organic pineapple and cut the core into 5 equal pieces. Please don’t eat the pineapple itself -- it has way too much sugar. Share it with your friends instead. Starting the day that you ovulate, eat one piece of the core for five consecutive days. Once you’re done and five days has passed, do not eat any more pineapple core. Too much bromelain can actually increase movement of the blood to the point that it can dislodge an implanted embryo, so just stick to the five days post ovulation.
- I know that “trying-to-get-pregnant-sex” has a tendency to lose all the fun, spontaneity and even enjoyment of good old sex. So as much as is possible, try not to stress about getting the schedule “perfect.” Stress pumps cortisol into our body, which throws all of our other reproductive hormones out of whack, which is a general bummer for fertility. While I know it might not be realistic for me to tell you to try to just have fun and have sex, I’m going to say it anyway. Just try to have fun with sex. Try as much as possible to avoid letting it become another thing about this whole process that stresses you out. I recognize that you might hate me for even suggesting it, but as much as you can will yourself to let sex be a time that you let go of all the stress and worry and concern about getting pregnant, the better.
I hope that I’ve given you some useful info about when to have sex to improve your chances of getting pregnant. If you do suffer from PCOS or another menstrual imbalance where you’re not ovulating regularly, I’ll address the best ways to improve your reproductive health in future blogs, so stay tuned.