Myths, Misconceptions, and Optimal Practices to Enhance Natural Fertility (Smarty Sponsor: CMC Women’s Institute)

By Guest Blogger, Dr. Bradley Hurst (Carolinas Medical Center- Women’s Institute)

It shouldn’t be hard to conceive. After all, a lot of women delay pregnancy until finishing school, establishing a career, and finding the right guy. It is annoying when pregnancy doesn’t happen right away, so most women take active measures. By the time I see a couple in my practice, most have used ovulation tests, tried timed intercourse, and almost everybody has tried a pillow under hips to “save the boys.” New recommendations from the American Society for Reproductive Medicine (ASRM) provide practical advice for couples who are trying to conceive.

How often should you have intercourse to have the best chance to conceive? Perhaps the most common myth is that a man needs to recover between ejaculations to build up sperm. However, medical studies have come to a clear conclusion: more is better. Once (or more) daily provides the best pregnancy rate, 37 percent per month. Every two or three days is almost as good. Even couples who have intercourse once a week are still “in the game,” with a 15 percent pregnancy rate. The bottom line: there is no medical reason to recommend changing the timing for those who have intercourse at least twice weekly.

Do ovulation tests help? Ovulation tests and monitors are promoted to help couples know their “fertile times,” presumably to enhance fertility. But to my knowledge, ovulation predictors have never been proven to improve fertility in infertile couples. So I do not recommend these tests for my patients, with one exception: it may help those who have infrequent intercourse. Even so, timing intercourse based on cervical mucus (the clear, slippery or sticky discharge indicates the most fertile time) is a simple, “no cost” alternative for some; intercourse may be recommended once or twice during the 2 – 3 days when this clear mucus is identified.

As for post-coital routines, there is no scientific merit propping hips up on a pillow after intercourse. In fact, sperm may enter the uterus and the fallopian tubes within seconds or minutes after ejaculation, regardless of position. A woman’s orgasm may accelerate this sperm transport. Some vaginal lubricants may be harmful to sperm, but vegetable oil is an inexpensive safe option. If pregnancy doesn’t happen by 12 months (6 months for women over 35), it’s time to seek help from your physician.

Bradley S. Hurst, M.D.
Director of Assisted Reproduction
Department of Obstetrics and Gynecology
Carolinas Medical Center
1025 Morehead Medical Dr., Ste 500
Charlotte, NC 28204
(704) 355-3149 office
(704) 355-9322 fax