Tuesday, March 8, 2016

Baby Maker's Take: Abstinence, Ovulation and Intercourse & Finding Your Fertile Days

Many couple attempting to get pregnant have no idea when to have sex.  Those who don't suffer from infertility offer their advice: "All of the time!" But this neophyte advice can be counter productive to achieving pregnancy for a couple who may have multiple factors inhibiting conception.  Even men with perfect semen analysis, may not fair well, once inside the woman's body. 

The Perfect Storm

  • Timing 
  • Environment
  • Sperm Quality
  • Egg Quality
  • Lubrication
In this Article our Fertility Expert, Kristen N. Burris, L.Ac., M.S.T.O.M., better known as the Baby Maker, will be reviewing Timing for getting pregnant.

The easiest way to predict your most fertile days is using an at home ovulation predictor kit. But not all tests and monitors are created equal and they affect the timing of intercourse so be informed on what type of monitor or test strips you are using.

 The one we suggest, is the most advanced, and the most expensive.  It's called: the Clear Blue Fertility Monitor and costs around $200.  We found it cheaper on Amazon.com.  Why it's more advanced?  It checks two hormones, Luteinizing Hormone (LH) and Estrogen (E3G),  to predict a woman's most fertile days. Most strips are only checking for an LH surge that often happens 24-36 hours BEFORE you ovulate, but those are averages.

This monitor also stores up to 6 cycles, giving you critical information about your cycle.  It's known that up to 40% of women have up to 7 days of varying fertile window days throughout their cycle.  Sadly, many couples are ill-advised that if they check one month of their cycle they can rely on that information for all other months.  This is incorrect and bad medical advice.  Check monthly for optimal results.

 When and How Often to Have Sex

Now that you have mastered which days are your peak fertility days, what does that mean and when do you actually have intercourse?

No two couples are the same, and individualizing this advice can be helpful depending on their personal circumstances including, sperm quality and quantity, impotency, cervical fluid or lack there of and regularity of ovulation including average fertile window days for each individual.

However, general recommendations can be followed improving your fertility.

If your peak days are 14 and 15 this is what you would do:
The week before you expect to ovulate (usually day 6-11) you will have your husband abstain from any ejaculation at all.  Day 12, when you monitor (the expensive and advanced one) most likely is showing a high fertile day, aka smiley face,  you would have intercourse.  Then abstain Day 13, then have intercourse Day 14 and either again on Day 16.  The rest of the month, freely be intimate as often as you want, however, once you hit Day 6 again, it's time for 5 days of abstinence.

Abstaining helps bolster sperm counts yet it becomes the quality of the sperm is stagnant and often clumping together inhibiting it's ability to move freely once released.  By allowing your husband to offer his first ejaculate on a day when you haven't peaked yet, gets rid of his least optimal sample.  Then, a day of rest, helps him re-build and then on your peak day, it's the most optimal day for intercourse for both you and him, that is if your monitor is checking BOTH LH surge and E3G.  More on that to follow.

Day 16 is more like an insurance policy, you will probably not need it, it may not be effective or cover what you actually want, but it's nice to have it there just in case.

When to have intercourse if you are using the suggested monitor Clear Blue Fertility Monitor that checks for both LH surge and E3G:

If your PEAK or SMILEY FACE Days are Day 14 and 15 This is what you would do:
Some couples opt to have intercourse back to back on their most fertile days
Abstain Day 7-11
Intercourse Day 12  (getting rid of stagnant semen)
Rest Day 13 (building back up)
Intercourse Day 14 (peak day for you, best sample for him)
Intercourse Day 15  again (second peak day)

Apply this formula around YOUR TWO most FERTILE DAYS

If your PEAK or SMILEY FACE Days are Day 11 and 12 This is what you would do:
Abstain Day 3-8
Intercourse Day 9
Rest Day 10
Intercourse Day 11
Intercourse Day 13
(OR some couples just can't resist a SMILEY face day and have Intercourse on Day 12 too like the example before this one)

Apply this formula around YOUR TWO most FERTILE DAYS

But My Ovulation Sticks Only Check for LH Surge

IF you are using cheaper monitors or sticks that JUST detect LH surge, intercourse days are different so pay attention.

On the first morning you detect an LH surge (usually start testing Day 10 and continue until you get an LH detection (pink line) and then stop checking every morning once you get a morning where there is no detection)

Day 5-10 Abstain
Day 10 Start Checking for LH surge
Day 11 Check again
Day 12 Check again
Day 13 FIRST Detectable surge so  have intercourse to rid stagnant sample
Day 14 Intercourse (optimal sample and optimal day for potential ovulation is today or tomorrow)
Day 15 Abstain then  Continue having intercourse every OTHER day until you no longer see evidence on your sticks that LH hormone is detected ie: Day 13, 14, 16, 18

Repeat this formula around your detectable LH surge days.  Those days vary considerably for some women.  

 If you are going through IUI (intra-uterine insemination)
After working along side with dozens of OBGYN's and Reproductive Endocrinologists (R.E.'s) I have observed many different styles and recommendations for when to have an IUI.  This is what I would advise.  Follow your doctor's recommendation for an un-medicated (all natural), or medicated IUI, and on the morning of your first PEAK fertility day go in for an IUI.  The next day follow up with a second IUI on your second PEAK day. If your doctor refuses to do back to back IUI days, then be sure to have intercourse on the second peak day.

  Do not wait an entire day after you ovulate, as some doctors suggest to their patients.  I suspect these doctors are going off of what they learn a decade or so ago.  The old ovulation monitors used to only show LH surge exclusively (not checking for E3G), therefore predicting you would most likely ovulate 24-36 hours AFTER the LH surge is detected.  But what happens when the first detectable amount was actually during your sleep, let's say 11pm that night before you check.  Then you waiting an entire day and a half to go in for you IUI, let's say 1pm.  Then it's too late and poor medical advise.
Newer monitors get you closer to your peak days, which means you need sperm to get pregnant to meet you egg.  When you see PEAK or SMILEY face, it's definitely go time, not wait another day and a 1/2.   A talented doctor will use ultrasound to confirm ovulation and monitor you throughout your fertile week to decide on the optimal day do the actual insemination.

Some other sweet suggestions to help those swimmers along and support conception as well as implantation:
After intercourse use a pillow to prop up your hips, allowing gravity to aid in the sperm motility
Try to do this for at least 1/2 an hour to 1 hour.  Some women just go to sleep for the evening and don't rise until morning

Eat pineapple (1 cup a day for a week).  One study showed that eating FRESH pineapple, especially as much of the core as possible, helped aid in implantation.  There are different theories including increased enzymes called bromelain as a nutrient that aids in implantation through slightly thinning the blood, increasing circulation and reducing inflammation.

Resume your normal activities the day after.  They used to be adamant about bed rest, and now new science is going back on that saying to return to your daily routine.  We do however, suggest keeping exercise to a moderate amount, not intensive, exhaustive levels.

Note: Medical Advice is not advisable over the internet.  It is always best to seek advice from experts in person for the variables can be confusing and need personalized attention.  Ask your natural fertility doctor for a personal recommendation.  Consultations are available throughout the US (208) 938-1277  
Baby Maker Infertility Consultations

1 comment:

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