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Timing of sexual intercourse (TSI) or follicle tracking with ovulation induction (OI) can significantly increase your chances of conception as long as you have no problems with your fallopian tubes and womb and your partner is not dealing with any male infertility issues.
Timing sex within the fertile window is relatively simple and less expensive than other treatment options for infertility, like IVF fertilization, intrauterine insemination (IUI), etc. Hence, it will be good to complete a timed intercourse cycle before proceeding to these costlier options.
One of the best things you can do to improve your fertility chances is to track your period and time sex around ovulation. After all, you have no chances of conceiving if you are not having intercourse during your fertile period. Since the probability of getting pregnant is higher in the five days prior to ovulation and highest on the day preceding ovulation, you need to be having sexual intercourse within this period if you are trying to become pregnant. Below are some data on the chances of getting pregnant:
Although some sources recommend having sex every other day within the fertility window, there are no empirical studies indicating the optimal frequency for sexual intercourse. But it seems the more frequently you have sex, the better.
A lot of women find it difficult to know when they are in their fertility period. According to fertility experts, it’s best to start having sex on day 10 of your menstrual cycle and doing it every other day until ovulation and a day following ovulation. Day 10 is a good point to start because estrogen levels are usually high on this day, and the womb lining (endometrium) should be growing very thick.
Tracking your ovulation gives a clear picture of your fertile window. Fortunately, there are ovulation predictor kits that can be used to check for an increase in luteinizing hormone (LH) in the urine. The levels of this hormone usually increase 24 to 48 hours prior to ovulation.
It is recommended that you do the tests in the morning and continue doing them for a day or two after you have gotten a positive result to ensure whether the positive disappears or turns negative again in order to know that the tests are really capturing your luteinizing hormone levels.
At times, it is good to have progesterone tests performed on day 21 to be sure that ovulation has actually taken place. If the levels of progesterone are found to be low, it suggests that did not occur.
Another method that can be used to track ovulation is through your basal body temperature. The belief is that the resting body temperature increases shortly after ovulation. You have the best chances of conceiving 2-3 days before this little increase in temperature. However, it is often used in conjunction with other tracking methods, such as monitoring changes in the cervical mucus) since it is impossible to know you are ovulating until that increase in temperature happens.
This is why reproductive experts do not recommend relying on the basal body temperature ( BBT) method alone for tracking ovulation.
But note that all ovulation tests are not the same. While some will show two blue lines or a smiley face when your luteinizing hormone (LH) peaks, others may provide a numerical value of your LH level. This allows you to know whether this hormone is low, high, or at its peak as you approach your LH surge and the two days when you are most fertile.
Important note: ovulation tests that provide a positive or negative result do not work for 10% of people whose ovaries have abnormal levels of luteinizing hormone.
Before commencing any treatment, your doctor will carry out several tests to evaluate your fertility. For women, this may include several blood tests and an ultrasound to check ovarian function, egg supply, and the shape of the female reproductive organs.
The male partner will have to undergo the analysis of the semen for sperm count, motility, concentration, and shape (morphology) to check for male infertility conditions.
The following steps will inform you of what you can expect to take on a timed intercourse cycle. Since treatment is customized for each patient, not all patients will follow these exact steps. We recommend consulting your healthcare providers as they will help make unique decisions to raise your own chances of having a successful cycle.
Once your menses start and you have bleeding (not spotting), note down the date and inform your doctor. But if you are one of those women who don’t menstruate, there are progesterone medications like Provera that you can take to induce a period.
When using ovarian stimulation medication like Clomid, it is important to write down the first day you experience a full flow because this date will be used to determine when you are to take your medication
After this, your doctor will do a transvaginal ultrasound to assess your ovaries. If there are huge cysts in the ovaries, the cycle will most likely be cancelled. However, your cycle won’t be cancelled if you only have small cysts like those in women with PCOS (polycystic ovary syndrome).
Medication is taken to improve hormone production, and it encourages the ovaries to develop mature eggs that will be released at ovulation. This can be in the form of a pill (like Clomid) or an injection.
Typically, oral medication is used for a period of 5 days, whereas injectable medication is normally taken for around 8 to 12 days, depending on how your ovaries respond. Your physician will design a personalized medication schedule just for you. While some women like to take oral medication in the morning, others prefer to take it at bedtime to sleep through the possible side effects.
To ensure correct timing of each step of the cycle, blood tests and ultrasounds will be carried out every 2-3 days to evaluate follicle growth and make sure everything is going well. This will enable the doctor to know the number of eggs that are developing.
If there is a chance of releasing an excess number of eggs, the cycle may be ended. This is done to prevent a pregnancy with multiples, which has a high risk for compilation and achieve a singleton pregnancy.
Depending on your egg development, your doctor also monitors the ovaries to determine the best time to give you a trigger shot.
A trigger injection or shot is given when the egg reaches optimal development, inducing ovulation within 36 to 42 hours. It contains human chorionic gonadotropin (HCG), a fertility hormone that causes the follicles to burst and release an egg or eggs.
After the trigger shot has been administered, the couples are advised to have sex every day or every other day for 3 days in the comfort of their home.
Approximately a week after timed intercourse, a blood test will be done to check progesterone levels to know if the trigger shot induced ovulation. If your progesterone levels are very low, your physician will recommend daily supplemental progesterone, which may be taken orally or through the vagina. Progesterone helps the womb lining grow thicker and promotes the implantation of the embryo in the womb.
Exactly 2 weeks after ovulation, a blood test is performed to know if the woman is pregnant. Remember that pregnancy tests that are done earlier than two weeks may produce a false positive because of the hormone administered via the trigger shot.
It will be good to consult your obstetrician/gynecologist or fertility expert if you are:
Midlands Fertility Centre help countless couples struggling with infertility as well as secondary infertility to conceive and have babies of their own. If you have more questions about pregnancy, simply note them down and ask our fertility specialists during your consultation.
It is estimated that in about a third of cases there can be an issue with the male however it is well documented that male factor infertility is on the increase worldwide. Female issues are diagnosed also in a third of cases, with a third combined factor, both male and female. 10% of cases are of unknown origin.
Many things can change a woman’s ability to have a baby. These include:
– Age
– Smoking
– Excess alcohol use
– Stress
– Poor diet
– Athletic training
– Being overweight or underweight
– Sexually transmitted infections (STIs)
– Health problems that cause hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency
Many women are waiting until their 30s and 40s to have children. Age is a growing cause of fertility problems. About one-third of couples in which the woman is over 35 have fertility problems.
Aging decreases a woman’s chances of having a baby in the following ways:
– Her ovaries become less able to release eggs.
– She has a smaller number of eggs left.
– Her eggs are not as healthy.
– She is more likely to have health conditions that can cause fertility problems.
– She is more likely to have a miscarriage.
Most experts suggest at least one year. Women 35 or older should see their doctors after six months of trying. A woman’s chances of having a baby decrease rapidly every year after the age of 30.
Some health problems also increase the risk of infertility. So, women should talk to their doctors if they have:
– Irregular periods or no menstrual periods
– Very painful periods
– Endometriosis
– Pelvic inflammatory disease
– More than one miscarriage
It is a good idea for any woman to talk to a doctor before trying to get
pregnant. Doctors can help you get your body ready for a healthy baby. They
can also answer questions on fertility and give tips on conceiving.
Painful periods do not necessarily mean infertility. Regular painful periods are an indication of ovulatory cycles. However progressive pain before the menses or during the sexual act may signify endometriosis. Irregular menses should be investigated especially if you are obese.
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