Timed intercourse. Programmed intercourse
A simple first option to achieve pregnancy through couple intimacy
How many couples want to seek help from a fertility specialist to become pregnant but fail to do it for fear of the complexity of assisted reproduction techniques? The truth is that, despite how complex it may seem, many couples, if properly selected, may actually benefit from this simple technique and achieve pregnancy in the most natural way possible thanks to so-called ‘timed intercourse’.
It is a simple, inexpensive, low-risk technique monitored by gynaecologists whereby sexual intercourse is timed to take place during the most fertile period of the woman’s menstrual cycle, that is, during ovulation.
Through this technique, a simple medication plan is implemented orally, or in some cases by low-dose hormone injections, in order to induce ovulation in women undergoing anovulation (lack of ovulation) or dysovulation (irregular or ineffective ovulation), or otherwise to “help” or control ovulation in women with regular menstrual cycles. This way, and sometimes with the use of ultrasound scans to monitor the response, your doctor will determine the best time for you and your partner to have intercourse, which must coincide with ovulation.
In normally-ovulating women (having 28-day menstrual cycles), this time coincides approximately with day 14 of their cycle.
When ultrasounds show one, two or three follicles longer than 18 millimetres, your doctor may suggest an injection to trigger the final maturation of the egg/s and having sexual intercourse before, during and after the expected ovulation (i.e. 24, 36 and 48 hours after the injection). It is recommended to avoid sexual intercourse from 3 to 5 days before ovulation.
In a large number of cases, especially when a doctor has monitored one cycle already, subsequent cycles do not need to be strictly monitored. This results in reducing the stress caused by continued appointments, simply informing you about the best time in each cycle for sexual intercourse.
If your doctor finds it appropriate, s/he might prescribe you medication to facilitate or help the latter phase of the menstrual cycle (the luteal phase) and prepare the endometrium (the inner layer of the uterus) for attachment.
After an initial medical assessment, your doctor will inform you whether you have good chances of becoming pregnant by using this technique. Generally, those who most benefit from it are:
- Patients with recent sterility (less than 2 years)
- Young couples (ideally, women younger than 35)
- Oligomenorrhoeic patients (with very long menstrual cycles)
- Patients with inadequate luteal phase (insufficient progesterone production during the latter phase of the menstrual cycle)
- Patients with mild endometriosis (with patent Fallopian tubes)
- Patients with no alterations in sperm
Sterile patients without apparent cause
On average, chances to conceive using this technique are approximately 15% for each cycle.
It is recommended to be used for a maximum of 6 cycles. Beyond this, it has been observed that the chances of becoming pregnant using this technique do not increase. For this reason, monitoring patients with risk factors is recommended, even if it is only done initially, to assess their response to medication.
If more than 3 follicles are seen by ultrasound, it is recommended to avoid sexual intercourse or use a different technique, such as In Vitro fertilization if the response is too strong. Ovarian hyperstimulation after taking medication is very rare, the most susceptible patients being those with polycystic ovaries.