Maximizing Your Fertility

by Arthur L. Wisot, M. D. of Reproductive Partners Medical Group

A young couple with normal fertility who has intercourse at or around the time of ovulation has about a 20 to 25 percent chance that a pregnancy will result. In order for any couple to reach maximum efficiency of their reproductive systems, they need to be sure that:

  • Intercourse occurs as close to the time of ovulation as possible
  • The man’s sperm is at optimal levels
  • The environment is suitable

Intercourse can be timed to occur on the day of ovulation as determined by the calendar (least accurate), examination of the woman’s previous basal body temperature charts, the presence of maximum clear cervical mucus, or (for the more scientifically minded) the urinary LH home test (most accurate). Precise timing may be more scientific, but it does tend to add stress to the process and can even take the fun out of it. An alternative: be sure to have intercourse at least every other day before, during, and after the estimated ovulation day. Given the life of the sperm and the egg, this would tend to make sperm present during the “life” of the egg no matter when ovulation occurs.

Currently no evidence exists that more frequent intercourse than every other day impairs sperm quality in men with normal fertility. Generally a man will produce his best sperm specimen possible after one to two days of abstinence. Just don’t let more than two days pass without having sexual relations around your estimate of ovulation so there will always be sperm present. Motility (movement) of the sperm tends to decrease with longer periods between ejaculations. The best compromise appears to be a two-day interval to maximize the sperm quality.

By environment, I do not mean candlelight, music, and wine! I am talking about sexual position and the avoidance of practices that might be harmful to sperm. The man-above-woman-below position is best for most couples' fertility, with the woman staying on her back for about 20 minutes following ejaculation. The use of artificial lubricants and douching after intercourse should be avoided.

So far, what I have discussed pertains to normal reproduction and the couple who has no problem conceiving. Most people take their fertility for granted. They expect that when they want to start a family, they will be successful quickly, and most will.

So how do you know if you have an infertility problem? Infertility is usually defined as the inability to conceive a baby after one year of fairly regular unprotected intercourse. That’s not the same as trying to have a baby for a year. For example, I have seen couples come in with a history of unprotected intercourse for several years, but they didn’t think they had an infertility problem. (I don’t know where the notion that you have to be “trying” came from...) If the factors controlling your fertility are normal and you are having regular unprotected intercourse, you will get pregnant whether you are “trying” or not.