After ovulation: Immediately following ovulation your mucus will turn sticky, much like the consistency of rubber cement. After two or three days, it will become dry, until the cycle starts again.
Take Your Temperature
You can learn a lot about your body by using a thermometer. By keeping track of your basal body temperature—your temperature in the morning before you get out of bed—you can learn to approximate the time of ovulation and when in your cycle you will be most fertile. (Unfortunately, when monitoring the ever-changing cycle of fertility, we deal with approximations, not predictions.)
First, get a thermometer, a piece of paper, and a pen or pencil to record your temperature; keep these items by the side of the bed. To get an accurate reading, you’re going to need to take your temperature first thing in the morning—meaning before you sit up in bed, before you go to the bathroom, before you say good morning to your spouse, before you talk to anyone on the phone.
Some women take their temperature rectally for a more accurate reading, but an oral thermometer should be sufficient in most cases. You may want to buy a basal body temperature thermometer, designed to make it easier to read the temperature to the tenth of a degree. These thermometers usually come with a preprinted chart and directions for monitoring your temperature. They are available in most drugstores and usually cost less than $10.
Try to take your temperature after at least three hours of consecutive sleep and at the same time each day, plus or minus an hour or so. Keep in mind that every extra half-hour you snooze your body temperature will rise by about one-tenth of a degree.
Most women report a slight drop in their temperature just before ovulation (when the levels of estrogen increase to release the egg during the next few days). A day or two later, they note a sharp rise of 0.5 to 1 point when the egg is released (when the levels of heat-producing progesterone increase). By the time the temperature spikes—usually to over 98 degrees, though it may go to 99 degrees or higher in some women—ovulation has already occurred.
This temperature shift—and ovulation—usually occur at fourteen days into your menstrual cycle, or about day fourteen of a twenty-eight-day cycle. The morning temperature then should remain elevated for the second half of the menstrual cycle (the luteal phase), dropping slightly just before menstruation when the cycle starts over again.
To maximize your chances of conception, have intercourse every other day for two to four days before you anticipate the shift in temperature (and ovulation), as well as two to four days after your temperature rises. (If you chart your temperature for several months, you will recognize your personal ovulation pattern and become more adept at detecting when ovulation should occur.)
Normal body temperatures vary from person to person, but it is the change in temperature, not the temperature itself, that is important in measuring fertility. You may have a hormonal imbalance and should consult a doctor if your temperature remains the same throughout your cycle (you may not be releasing an egg) or if your temperature tapers off during the second half of your cycle (you may not have sufficient hormonal support to produce a mature egg). If your temperature remains elevated for more than two weeks after ovulation, you may be pregnant!
Note Changes in Your Cervix
You can learn to recognize the approach of ovulation by learning to recognize the changes in your cervix as ovulation approaches. If you want additional information on how to detect ovulation, take time to feel your cervix throughout the month so that you can learn to appreciate the subtle but important changes that occur during your menstrual cycle:
During your menstrual period, your cervix should be easy to touch with the tip of a finger inserted into the vagina. The area at the opening of the cervix should feel soft and opened wide to allow the uterine lining to escape.
After the bleeding stops, your cervix should feel firm and tightly closed; some say it feels like the tip of a nose. If you have not delivered a child vaginally, the opening of the cervix may feel like a dimple or pointed impression. If you have had a child vaginally, the opening may feel wider.
As the body prepares for ovulation, the cervix will rise or move away from the vaginal opening. (You will have to insert your finger deeper into your vagina to feel it.) The cervical opening should feel softer and wider, to allow the sperm to enter the uterus and fertilize the ripened egg.
After ovulation, the cervix lowers and grows firmer, and the opening closes tightly to prevent sperm from entering the uterus since conception can no longer occur.
Try an Ovulation Predictor Test
If you don’t trust yourself to read your body’s ovulation warning signs, you can pick up an ovulation predictor test kit at almost any pharmacy or grocery store for about $20. This test looks for the surge in luteinizing hormone (LH) that occurs just before ovulation. (The rise in LH actually triggers the release of the egg from the ovary.) Ovulation should take place twelve to thirty-six hours after the test is positive.
The kits are relatively easy to use and tend to be quite accurate—as long as you follow the directions. However, keep in mind that the test does not guarantee that ovulation has taken place. Some women, especially those with premature ovarian failure or those over age forty or approaching menopause, sometimes have LH surges that are not followed by the release of an egg. If you want some assurance that you are identifying your time of ovulation accurately, give an ovulation predictor kit a try for a month or two, but don’t rely on this test if your infertility continues for several months longer.
Stay on Your Back for Twenty to Thirty Minutes After Intercourse
It takes about twenty minutes or so for the sperm to work their way through the cervical mucus and up to the Fallopian tubes in search of the prized egg. Staying horizontal won’t guarantee success, but it can help minimize the risk of sperm leakage from the vagina—and it certainly can’t hurt. Plan ahead and have a book, music, or the television remote nearby to help pass the time, or close your eyes and take a nap.
Don’t Douche
Your vagina can keep itself clean, so there is no medical or hygienic reason to douche. Douching with commercial products can disrupt the natural pH of the vagina, possibly damaging or destroying sperm.
Even douching with plain water isn’t good for you: It has been linked to an increased incidence of ectopic pregnancy and pelvic inflammatory disease. A recent study conducted by researchers from Emory University in Atlanta and the Federal Centers for Disease Control and Prevention found that women who douched were almost four times as likely as those who had not to develop an ectopic pregnancy. The longer a woman douched regularly, the greater her risk. After fifteen years of regularly douching, the risk of an ectopic pregnancy was seven to eight and a half times that of a woman who had never douched. An estimated 37 percent of American women douche; if you are among them, discontinue the practice, at least until you have finished having children.
Take Cough Syrup
Guaifenesin, the active ingredient in Robitussin and several other cough syrups, works by thinning the mucus in the lungs. As an added benefit, it also thins the cervical mucus, making it better suited for moving sperm through the reproductive organs. Take one to two teaspoons a day, starting three or four days before ovulation.
HIS
Ejaculate Every Two or Three Days
You’re going to have to pace yourself: Ejaculating too much—or too little—can lower your sperm count. Don’t believe the old wives’ tale about “storing up” sperm to promote conception.
Most infertile couples focus on the timing of intercourse near the anticipated time of ovulation, but it is helpful to enjoy your sex life all month long. While absence may make the heart grow fonder, studies have found that abstinence makes the sperm grow weaker. Researchers have found that waiting more than two or three days between ejaculations (whether through intercourse or masturbation) can lead to a diminished number of active sperm and inferior sperm quality. Regular sexual activity increases testosterone le
vels, which stimulates sperm production and maturation. So to maximize your sperm count, enjoy a rewarding sex life all month long, not just around the time of ovulation.
Take a Cold Bath—Before Sex, Not Instead of It
“Go take a cold shower” may be one way of turning down the heat when someone’s amorous ambitions cannot be acted on, but evidence suggests that a cold bath or shower thirty minutes before intercourse can actually improve fertility. Evidence indicates that a cold bath increases the flow of oxygen in the body and the level of testosterone in the blood. So you might as well try a five-minute soak to cool things off—then enjoy yourself as things heat up.
Consult a Doctor if You Have Very Little Seminal Fluid
In some cases, a physical problem can cause a man to ejaculate into his bladder, rather than out through the end of the penis. He enjoys the pleasurable sensations associated with an orgasm, but no fluid is released. Then, the next time he urinates, a milky white fluid—semen—is excreted along with the urine.
In many cases, this problem, known as retrograde ejaculation, stems from a neurological disorder that causes a lack of control of the muscles at the base of the bladder that normally close off just before ejaculation. (The nerve damage can be a complication of diabetes.) Retrograde ejaculation can also be a side effect of certain medications, including those used to treat depression and hypertension. A change in medications or, in some cases, surgery can be effective in treating the problem.
Keep in mind that the volume of ejaculate is not a reflection of the number of sperm a man is producing. A man can be sterile and produce a tablespoon of semen, while potent men can release just a drop or two. As for average, most men release between one-half and one teaspoon of ejaculate.
A SEASON FOR LOVE
If your sperm count is low, check the calendar. According to researchers at the University of Texas Health Center in Houston, sperm counts fluctuate throughout the year, peaking between February and March, and falling to the lowest levels in September. No wonder Valentine’s Day is February 14.
Treat Impotence
Don’t be embarrassed: Sooner or later, most men experience occasional episodes of impotence. However, an ongoing problem with impotence—the inability to achieve and maintain a successful erection—can obviously interfere with fertility. Fortunately, impotence and problems of sexual dysfunction affect only about 5 percent of infertile men.
Many erection problems have at least some physical cause. To achieve an erection there must be cooperation of blood vessels, nerves, and tissues. Impotence can be caused by a number of health problems, including diabetes, heart and circulation problems, stroke, epilepsy, Alzheimer’s disease, neurological disorders, alcohol and drug abuse, Parkinson’s disease, and liver and kidney disease. Impotence can also be caused by certain mediations, such as tranquilizers, diuretics, and anti-ulcer, anti-psychotic, anti-depressant, and anti-hypertensive drugs. Some over-the-counter antihistamines and decongestants can cause temporary impotence as well.
The other cases of impotence stem from psychological factors, such as relationship problems, stress, anxiety, grief, depression, fatigue, boredom, and guilt. Sexual intimacy can make some people feel very vulnerable, causing a number of stresses and uncomfortable feelings.
With patience and treatment, most cases of impotence can be managed and overcome, but you must be willing to ask for help. The prescription drug Viagra, approved by the FDA last year, has been shown to help 70 percent of men with impotence. For more information on impotence, talk to your doctor or contact:
Potency Restored
8630 Fenton Street, Suite 218
Silver Spring, MD 20910
(301) 588-5777
Impotence Institute of America
10400 Little Patuxent Parkway, Suite 485
Columbia, MD 21044
(410) 715-9605
Impotence Information Center
American Medical Systems
Minneapolis, MN 55440
(800) 543-9632
COUPLES
Be Conventional: Stick to the Missionary Position
The so-called missionary sexual position—man on top, woman on the bottom—reduces the risk of sperm leaking from the vagina and increases contact of the semen with the cervix. If you are a woman, after intercourse you might want to tip your hips back, slip a pillow or two under your hips, and gently press the labia (lips) of your vagina together to give the sperm every chance possible to work their way north to the Fallopian tubes.
Another option is rear entry or “doggie style.” This position allows for the deposit of sperm close to the cervix. When you’re trying to conceive, don’t make love sitting, standing, or with the woman on top.
Make Love Before You Make Breakfast
Making love is a nice way to say good morning. There are no studies to show that morning intercourse improves the odds of conception, but experts do know that sperm counts are higher in the morning (provided you haven’t had intercourse the night before). In addition, male hormones peak in the morning, which may help explain why many men feel passionate first thing in the morning.
Have Sex Every Other Day
Some infertile couples assume that conception can most easily be achieved by having intercourse as often as possible near the time of ovulation. However, too much of a good thing can compromise sperm count.
Your goal, of course, is to fertilize a mature egg as soon as possible after it is released from the ovary. Since this window of opportunity can be just six or eight hours for some women, intercourse must occur in a timely fashion. Mother Nature makes this task somewhat easier because sperm can survive inside the vagina for up to five days. (Actually, the length of time the sperm remain alive depends on where a woman is in her menstrual cycle: If she is in an infertile phase, the sperm will die within hours; if she is approaching ovulation, the sperm can survive for days in the more hospitable wet cervical mucus.)
Waiting two days between lovemaking sessions is ideal for most couples. Having intercourse daily will reduce sperm count somewhat, which can make a difference in cases where the man has low or borderline sperm count. One exception: Men who have excessively high sperm counts (as determined by a sperm analysis conducted by a doctor) may find that daily intercourse helps lower the sperm count to a more normal level, which can prevent the sperm from fighting one another.
Don’t try to “save up” sperm by avoiding intercourse for a week or more before ovulation. This period of abstinence will lower sperm production, and it will result in the release of a large number of old sperm cells, which are less likely to achieve fertilization.
Also, keep in mind that the slippery, clear fluid or gel that is released prior to ejaculation contains live sperm. This pre-ejaculate is designed to protect the sperm by neutralizing acids in the urethra and vagina. Don’t confuse the release of this fluid with premature ejaculation; when ejaculation occurs, the prostate will release a greater supply of fluid that will allow the sperm to travel in the vaginal canal.
CHOOSING THE SEX OF YOUR BABY
If you’re having trouble getting pregnant, you probably don’t care about the sex of your child—you just want to have a healthy baby. But, to the degree that you can choose, some people like to try to tip the scales in favor of one sex or the other.
It’s the sperm that determine the sex of the baby. The male sperm (with Y chromosomes) tend to be smaller, lighter, faster, and more fragile than the female sperm (with X chromosomes), which tend to be bigger, heavier, slower, and longer-lived. While these methods are far from foolproof, evidence does suggest that the timing of intercourse can influence the sex of the baby. Consider the fact that fraternal twins (which come from two separate eggs) tend to be the same sex, and they would have been fertilized at the same time.
FOR A GIRL
Make love using shallow penetration in the missionary position; this will deposit the sperm at the mouth of the cervix and favor the slower-swimming female sperm.
Th
e woman should avoid orgasm; this will keep the vaginal canal relatively acidic, which will tend to kill off male sperm in favor of female sperm.
Make love on the second or third day before you anticipate ovulation. This will allow the longer-lasting female sperm to be present in the Fallopian tube at the time the egg is released from the ovary.
FOR A BOY
Make love using deep penetration (perhaps in the rear-entry position), which will deposit the sperm at the neck of the cervix, where they can sprint inside the uterus and speed their way up to the Fallopian tubes. In addition, the area deep inside the vagina tends to be more alkaline and more hospitable to male sperm.
The woman should have an orgasm; this will create a more male-sperm-friendly alkaline environment.
Make love as close to the time of ovulation as possible; this will allow the energetic, fast-swimming male sperm to reach the egg first. Also have intercourse on the day following your perceived peak day, just in case you miscalculated.
Skip Oral Sex
The bacteria found in saliva can degrade semen and reduce the chances of conception. Studies have found that saliva significantly decreases sperm motility and progression, causing many sperm to shake and vibrate without moving forward. Both partners should avoid giving or receiving oral sex during those lovemaking sessions in which you are trying to get pregnant.
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