Ready, set, go! Let’s have a baby!
We all think starting a family is a natural process. Nobody dreams of having a fertility issue, and for some, the journey to creating a family can be more difficult or require outside intervention. This can cause increased stress and make something that seems like it should be fun and natural feel like work or a chore.
When sex goes from being about recreation to procreation, many couples stress out that they are somehow doing it “wrong.” First off — relax! Trying to get pregnant shouldn’t be stressful. Neither partner should feel time-pressured or worried about getting the deed done at the exact time. But the reality is we all feel nervous, and everyone is on a schedule about when they would like to have a baby.
Most women who are trying will conceive in the first year of trying, and for those who don’t, many will conceive in the following year of trying.
We often worry, “When should we do it?” “How many times?” “What position is best?” “What happens if the sperm falls out afterwards?!” Trust us, everyone has these questions.
What time and how much is best?
Nowadays there are plenty of smartphone apps (check out Trymester), menstrual calendars and ovulation predictor kits out there to time the “fertile window,” down to the best two days. The apps are great but are not necessary if you understand your biology.
A common belief is that you should try exactly when ovulation occurs, but the truth is it’s better to try before the egg is released.
In fact, pregnancy rates are highest two days prior to ovulation and drop significantly after ovulation. Because sperm live for up to five days, it is best to have sperm in the system waiting for the eggs when they ovulate.
Our recommendation is to start tracking your menstrual cycle a few months before you start trying to get a good idea of your cycle length (for most women, 28 to 35 days). For example, if you have a 28-day cycle, you should have sex every other day starting on days 10 to 15 — day 1 of your cycle being the first day of red flow.
It’s important to remember that you want to keep the sperm volume up, so this is why we recommend sex every other day, as opposed to daily. Having sex every day not only can become exhausting, but also depletes sperm reserves.
For those on a tight schedule — and we all are, balancing work, home, social life (no one wants to skip that coveted gym class or girls night out!) and just the general busyness of life — using a home ovulation prediction kit, available in most drug stores, will time the best window to try, down to two days.
Similar to a home pregnancy test, when the kit turns positive with two lines or a smiley face (usually in the day 10 to 14 window), it’s time! We recommend testing urine ovulation (LH) kits in the morning, when hormonal concentrations are highest. This also allows for the whole day to schedule in time to try!
Kamasutra: Does position matter?
The truth is there is no one best position. Do what’s comfortable. Have fun. Enjoy. Many couples think the missionary position is the best to conceive or that you should lie flat with your legs up after sex to increase your chances. Not true!
Whether you are on top, stand on your head afterwards or try a crazy new position, the results are the same! We hear many couples worry that the sperm “falls out” after sex. While some semen can remain in the vagina after intercourse, sperm itself has entered the reproductive tract and made its way up towards the egg within minutes of intercourse. And remember, sperm can stay alive in a woman’s body up to five days after intercourse.
When will I know?
By one week after trying, most women have already made a few trips to the drugstore and checked a dozen or so pregnancy tests in anticipation of positive results. The truth is, you can check a pregnancy test as early as within a few days of your expected period. Home pregnancy tests are extremely sensitive and can detect a positive test within five to seven days of conception. Certainly, if you miss your menses, it’s time to check a pregnancy test!
Once you have a positive test, it’s best to contact your family doctor or OB/GYN to discuss next steps.
It’s not working!
If you have been trying for six months to one year and still haven’t conceived, do not despair! Help is available, and your pregnancy quest is far from over!
At this point, it is reasonable to see a fertility specialist to make sure everything is normal. For women under the age of 35, trying for one year before seeking assistance is reasonable, while for women over 35, we recommend six months of trying on their own. Of course, if you have any medical or gynecologic conditions that are known to affect fertility, seeing a specialist sooner is reasonable.