Does having normal periods mean you are fertile? Will lying on your back with your legs in the air give sperm the best shot at reaching their target? If you are trying to conceive, well meaning friends and relatives may offer advice about fertility and the best ways to get pregnant. However what works for one couple may not lead to similar results in another. Moreover, not every nugget of information may be accurate, or even true. Dr Tan Tse Yeun, a Senior Consultant at the Department of Reproductive Medicine, KK Women’s and Children’s Hospital, was a speaker at the annual Know Your Fertility Wellness Campaign by I Love Children (ILC). We get her help to sort out the myths from the facts.
(See also: 7 Common Fertility Problems that Couples in Singapore Face)
❌ Lie on your back with your hips elevated for 20 minutes after sex to ensure that sperm travels in the right direction.
Sperm can be found in the cervical canal seconds after ejaculation, regardless of position. There is no evidence that sexual position, orgasm, or prolonged rest after intercourse increases the chance of conception.
✅ The more, the merrier. Having more sex means more chances to conceive.
Yes, having regular sex will increase your chances of conception. The highest pregnancy rates are seen when a couple has intercourse every one to two days during the fertile window.
❌ You should have less sex so as to ‘save sperm’.
This is false. Having regular sex increases chances of conception. In fact, long periods of abstinence (not having intercourse) can lead to a decrease in sperm quality.
❌ ✅ Apparently, orgasms can help with conception?
There is no known relationship between orgasm and fertility. However, the female orgasm may promote sperm transport (and make her feel good on top of that), so why not?
❌ Oral sex will ‘kill’ sperm and affect chances for conception.
Some vaginal lubricants and saliva may decrease sperm motility (movement) or survival. However if there are no severe sperm problems, it should be fine to engage in sexual practices as desired, as oral sex has not directly been shown to reduce pregnancy chances. Hydroxyethylcellulose-based lubricants, mineral oil, or canola oil can be used if preferred as these have not been demonstrated to have any adverse impact on semen factors.
❌ “My periods are regular, so I am fine”.
Having regular menses is a positive sign. However, bodily health may not equal fertility health.
(See also: When Should You Consider IVF, if you are Trying to Conceive?)
❌ “It’s the woman’s fault.”
This is a misconception. Worldwide, approximately one-third of subfertile couples have significantly abnormal sperm counts. Furthermore, around 20% of subfertile couples have more than one factor that contributes to their infertility (https://connect.asrm.org/srs/about/new-item9?ssopc=1).
To find the cause of infertility, the couple has to seek a medical consultation together. If the husband does not go for a semen analysis as deemed necessary by the doctor, it will be challenging to arrive at a comprehensive conclusion about the cause(s) of infertility.
✅ Stress makes it can be harder to make babies.
Yes, trying to start a family can lead to stress for couples, and have a negative impact on sex. In addition, scheduling sex to happen during the woman’s fertile period or when she is ovulating can ironically lead to sexual issues over time.
Share openly with each other when either one of you is not keen to have sex that day. Be it due to physical fatigue or mental exhaustion, forcing yourself to have sex when you are not in the mood can result in a less than stellar experience for both. For instance, a lack of foreplay and reduced arousal can lead to discomfort for women, and difficulty in maintaining an erection for men. Over time, this may affect your sex drive, and lead to chronic sexual problems.
❌ Being on contraceptive pills will make it harder to conceive later.
The contraceptive pill has no impact on fertility. They are also used to regulate menstruation and to manage gynaecological conditions such as endometriosis.
✅ Couples should go for a fertility check before trying to conceive.
In general, couples should seek specialised medical attention if they do not conceive after one year of regular intercourse without the use of contraceptives. Couples above 35 years of age who have not been able to conceive after six months, even though they have been having regular intercourse without the use of contraceptives, can seek fertility assessment earlier.
Women with the following risk factors should seek medical attention earlier:
- Menstrual problems (no periods, or very irregular periods)
- Gynaecological conditions such as endometriosis
- History of: (i) sexually transmitted infections, past cancer, and cancer treatments especially those involving the gynaecological organs (ii) suffering from multiple miscarriages (iii) female sexual dysfunction
Men with the following risk factors should also seek medical attention earlier:
- Known problems with the genitals (e.g. mumps orchitis, testicular surgery)
- Sexually transmitted infections
- Male sexual dysfunction (e.g. with erection and/or ejaculation)
- Past cancer treatments especially those involving the testicles
Early evaluation and optimisation of female sexual function through physical activity and mental wellness promotion in family planning interventions or preconception care can be a pivotal strategy to improve pregnancy chances.
Dr Tan Tse Yeun is a Senior Consultant with the Department of Reproductive Medicine at KK Women’s and Children’s Hospital (KKH). An accredited in-vitro fertilisation (IVF) specialist and a Fellow of the European Committee of Sexual Medicine, Dr Tan subspecialises in assisted reproductive programmes, reproductive surgery, female sexual health conditions, and infertility. Dr Tan was also instrumental in the establishment of the Sexual Health Clinic in KKH.
Dr Tan was a speaker at the recent Know Your Fertility Wellness Campaign by I Love Children (ILC). The campaign aims to encourage more couples to be aware of their fertility health and go for fertility consultations together.
Sign-up for a fertility consultation from now till 10 April 2023 at ilovechildren.sg/know-your-fertility-wellness and visit www.ilovechildren.sg to learn more about fertility health all-year-round after 10 April.
Featured image: Dewey gallery