11 Embarrassing Fertility Questions AnsweredBrette McWhorter Sember
1. Does having an orgasm help you to get pregnant?
In theory, an orgasm could help you get pregnant, but experts agree it’s definitely not necessary. During an orgasm, the uterus contracts, causing a vacuum effect which could theoretically move sperm up into the uterus. But Sandra Gahn, co-author of The Infertility Companion: Hope and Help for Couples Facing Infertility points out, “There’s a certain logic in this theory, yet while studies have shown such a vacuum effect exists, whether it actually brings about a higher pregnancy rate is unproven.”
The key to getting pregnant is not having an orgasm (although it sure makes trying more fun), but timing intercourse to correspond with your fertile period. Trying to force yourself to have an orgasm every time is a recipe for disaster since the stress will not put you in the mood. If you do want to have an orgasm during intercourse, many women are not able to have an orgasm from intercourse alone, so added manual stimulation may help.
2. Should I try to stop the sperm from leaking out after sex? For how long?
After ejaculation, the fluid that carries sperm liquefies and most of it runs out. Your body can’t use and doesn’t need that fluid, so it’s has to run out at some point. You may be worried that you’re losing valuable sperm, but according to Dr. Michael Bohrer, MD, endocrinologist with Reproductive Medical Associates of New Jersey and former director of the IVF program at the Robert Wood Johnson Medical Center, “The vagina naturally slopes backwards and the majority of ejaculate will be retained.”
Sperm are speedy and can make their way to the Fallopian tubes within five to 10 minutes of ejaculation. Many experts recommend lying on your back with a pillow under your hips for about 15 to 20 minutes after intercourse. The consensus is that it can’t hurt and may help. But forget standing on your head—that won’t do anything other than make you dizzy.
3. Are there any sexual practices we should avoid while trying to conceive? For example, is saliva harmful? Sex toys? Flavored lubricants?
Lubricants can make intercourse more comfortable and pleasurable, but they aren’t conducive to conception. Dr. Mark Leondires, MD, a reproductive endocrinologist with Reproductive Medicine Associates of Connecticut, says, “Oil-based lubricants or any product containing scents or inorganic materials are likely to kill sperm.” Lubricants also affect sperm motility, slowing down the swimmers. According to Dr. Leondires, studies have found that all lubricants on the market have some impact. A product called Pre-Seed is marketed as a lubricant for those trying to conceive, but there are no independent studies yet proving that it does not impact sperm.
Dr. Jay Schinfeld, MD, reproductive endocrinologist with Abington Reproductive Medicine in Abington, Pennsylvania, says, “The safest two lubricants are egg whites (to use, take a medium-to-large egg, separate the white, and let it come to room temperature) or olive oil.” He points out that salmonella is not a concern with egg whites unless they get in the mouth, so avoid oral sex after the application. Saliva is not harmful to sperm. And sex toys are not a problem, as long as you wash them carefully and avoid contamination from the rectum.
4. Is there a sex position that’s best for conceiving?
Good news here—whatever floats your boat works just fine. Most experts agree that any position that deposits sperm next to the cervix is effective. Some women worry that if they are on top, sperm will leak out immediately. Semen is very thick when it is ejaculated and liquefies with time. This keeps it next to the cervix long enough for the sperm to forge ahead. However, director of Georgetown University’s Institute for Reproductive Health, Dr. Victoria Jennings, MD, points out there is a common belief that missionary position is best. “There is not actual evidence for this, but it certainly can’t hurt.” Different positions do not influence the sex of the baby.
5. I think my husband masturbates sometimes. Should he stop while we’re trying to conceive?
Frequent masturbation can reduce your partner’s sperm count temporarily, but occasional masturbation is not a concern. Men have a 24/7 sperm factory at work; two days of ejaculation in a row have no effect on sperm, but more than that could decrease sperm count. If you’re concerned, suggest that he abstain during your fertile period when you will be having regular sex. But the rest of the month is not a problem, in fact, “Abstaining from ejaculation for too long is also detrimental to male fertility,” says Dr. Bohrer.
6. Do we have to have sex every day while I’m trying to get pregnant?
“Couples who have sex every one to two days conceive more quickly than those who have sex every three to four days,” reports Dr. Peter McGovern, MD, reproductive endocrinologist in the Department of Reproductive Science at Hackensack University Medical Center in Hackensack, New Jersey. The standard advice from fertility clinics is to have sex every other day during your fertile period (from five to six days before ovulation to one day after).
7. Is there a body type that’s best for conceiving? I’m flat-chested and thin-hipped … are women with more curves more fertile?
“Fertile women come in all sizes,” says Glahn, pointing out that women of all body types are able to get pregnant. However, Dr. Randy Morris, MD, associate clinical professor of Reproductive Endocrinology at the University of Illinois School of Medicine in Chicago, says a recent study has shown that women with larger breasts and slimmer waists have higher levels of estrogen and progesterone, the hormones associated with fertility. The study did not compare pregnancy rates though. Since you can’t control your basic body shape, focus instead on staying healthy and maximizing your fertile period.
8. Is it OK to diet while trying to get pregnant? Is it safe to cut out carbs?
Some dieting is OK. Dr. Bohrer says, “A well-balanced and healthy diet accompanied by light exercise is ideal.” He cautions that “extreme diets like South Beach and Atkins induce a starvation-type response, not good if you are trying to conceive.” Make sure you’re getting enough calcium, folic acid, and iron by taking a prenatal vitamin.
9. My period isn’t late yet, but I really feel like I’m pregnant. Am I crazy? How early can I do a home pregnancy test?
Early pregnancy often feels just like a period about to start, but some women notice the effects of the early rise in HCG levels, which can result in breast tenderness. Dr. Morris conducted an informal five-year survey at his infertility office and asked women about to take a pregnancy test if they believed they were pregnant. “Most pregnant patients did not think they were pregnant,” he discovered. A pregnancy test is the best way to determine if you are pregnant, and a blood test is the most accurate, particularly in early pregnancy. Home tests are accurate when used according to package instructions, usually not until the first day of your missed period, though some brands now offer results up to five days sooner, with decreased accuracy.
10. If I get my period regularly does that mean I’m ovulating and fertile?
Fortunately, for the vast majority of women, regular periods equal ovulation. Not getting a period is definitely a sign that you may not be ovulating, but it is possible to get a period in months in which you do not ovulate. “Even the fact that you’re ovulating doesn’t mean for sure that you’re able to get pregnant,” points out Dr. Jennings, because you could have tube blockage or low progesterone levels or other problems. If you’re concerned, chart your basal body temperature and use an ovulation prediction kit. If you ovulate in the month you test, then it is likely you are ovulating monthly.
11. My periods are usually very regular, but the last one was late. Could that mean I was pregnant and miscarried?
It is possible. Ten to 25 percent of all pregnancies end in miscarriage, including many pregnancies that women aren’t even aware of because they occur very early. “Early pregnancy losses are extremely common and not a cause for concern,” reassures Dr. McGovern. You would not experience more cramping with an early miscarriage, and the only way to know you that you were pregnant and miscarried would be with a blood test. Having a late period one or two times a year is in fact normal and often due to stress, travel, exercise, or illness.