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Bay IVF - Advanced Reproductive Care                                Palo Alto  650-322-0500

 

Coital Practices

Adapted from a report of Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society for Reproductive Endocrinology and Infertility.

Postcoital routines may become ritualized for couples trying to conceive. Although many women think that remaining supine for an interval after intercourse facilitates sperm transport and prevents leakage of semen from the vagina, the belief has no scientific foundation.

Studies in which labeled particles were placed in the posterior vaginal fornix (top of the vagina) at varying times of the cycle observed their transport into the Fallopian tubes within as little as two minutes during the follicular phase. It is interesting that the particles were observed only in the tube adjacent to the ovary containing the dominant follicle and not in the opposite tube. The number of transported particles increased with size of the dominant follicle and after administration of oxytocin, given to simulate the increase in oxytocin observed in women during intercourse and orgasm.

There is no evidence that coital position affects the probability of pregnancy. Sperm can be found in the cervical canal seconds after ejaculation, regardless of coital position. Although female orgasm may promote sperm transport, there is no known relationship between orgasm and fertility. There also is no convincing evidence to indicate any relationship between specific coital practices and infant gender.

Some vaginal lubricants may decrease fertility, based on their observed effects on sperm survival in vitro. Whereas commercially available water-based lubricants (e.g., Astroglide®, KY Jelly®, and KY Touch®) inhibit sperm motility in vitro by 60% to 100% within 60 minutes of incubation, canola oil has no similar detrimental effect. KY Jelly®, olive oil, and saliva diluted to concentrations even as low as 6.25% adversely affect sperm motility and velocity, but mineral oil has no such effect.

Hydroxyethylcellulose-based lubricants such as Pre-Seed® also have no demonstrable adverse impact on semen parameters. Although there is no evidence to indicate that use of any vaginal lubricant decreases fertility, it seems prudent to recommend mineral oil, canola oil, or hydroxyethylcellulose-based lubricants when they are needed.

Other Considerations:

A literature review concluded that sauna bathing does not decrease female fertility and is safe during uncomplicated pregnancy. In normal men, recommendations for behavioral modifications aimed at controlling or decreasing exposure of the testicles to sources of heat are unjustified.

October 2013

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