Moment 187: The Pregnancy Doctor REVEALS 3 Ways To INCREASE Your Chances Of Pregnancy NATURALLY

[0] What the fertile window is, is going to be the five days before and then the day you ovulate.

[1] So an egg lives for 24 hours.

[2] The five days before you ovulate, okay.

[3] So the five days before you ovulate and then the day that you ovulate.

[4] The egg lives for 24 hours.

[5] It has to be fertilized while it is in the fallopian tube in those first 24 hours.

[6] Sperm can live in the female reproductive tract for five days.

[7] So that is why we will tell people to have sex before and then during ovulation.

[8] Put some of that sperm from the locker there a little bit earlier and then get some there right at the time when you're ovulating to see if you can fertilize that egg.

[9] If we think about...

[10] Understanding when your fertile window is based on your cycle length.

[11] So if we say your cycle is the entire process and then your period is just the bleeding days.

[12] The entire process, if your cycles are on average 28 days, the corpus luteum lives 14 days.

[13] So 28 minus 14, you on average would ovulate on day 14.

[14] So the five days before and then day 14 are going to be your most fertile days to try to target intercourse or avoid if you don't want to be pregnant.

[15] And if your cycles are 35 days, though, it's very different, right?

[16] Because now 35 days minus 14 is going to be...

[17] 21.

[18] There you go, 21.

[19] So your fertile window for that person is going to be cycle day 21.

[20] So now the five days before and day 21.

[21] So those are very different fertile windows, days they should be having sex.

[22] It's a lot, isn't it?

[23] Do we just have sex every day if we can?

[24] So absolutely.

[25] If you can have sex every day or every other day and you don't have to track your cycles, if they are coming regularly and you're putting sperm in the presence of the egg by every day or every other day sex, absolutely.

[26] And that's one of the things that I see people do wrong the most is have less sex in the idea that they should save it up to put more sperm present when the egg is arriving.

[27] I have to say, I mean, there's a few things I wanted to say about this.

[28] So I think, what's the first thing I wanted to say?

[29] First thing I wanted to ask is how long on average do different age groups need to try before they hit the bullseye?

[30] If you're age 30 and you're trying to get pregnant, you have a 20 % chance of pregnancy per month.

[31] Okay.

[32] This means that the majority of people should be pregnant within six months.

[33] Infertility is defined as trying for a year and not getting pregnant within that year.

[34] It's kind of going off the curve of that standard deviation.

[35] Importantly.

[36] Trying to get pregnant means that you're having intercourse, you're ejaculating inside, and you're having regular periods.

[37] If you're not able to complete the act of intercourse and you're not having regular periods, people should not wait X amount of time to come see a doctor.

[38] You should go be seen right away.

[39] When my friends tell me that they've started trying, I always think, God, doesn't that just ruin the fun?

[40] You know what I mean?

[41] Because I have this one friend who was telling me that because they're trying now.

[42] Sex has become such a...

[43] Like a chore.

[44] Like a chore.

[45] And if he's away when she's most fertile, then she gets annoyed at him.

[46] And I just think, God, it's so crazy what's happening with sex in that regard.

[47] That it's, we're now, because we're having kids later and later and we're leaving things a little bit later than ever before, we're now having to...

[48] treat making kids almost like, as you say, like a chore.

[49] It's becoming like, I don't know, there's something about that that I'm like, oh gosh, like.

[50] Well, it's a good point because if you're waiting later and you still want to have more than one child, there's a lot of pressure on it.

[51] If you're starting at 35 and you have that 10 to 15 % chance per month, if you're starting at 38 and now it's 5 to 8 % per month, if you're 40, it's 3 to 5%.

[52] Isn't pressure like the opposite of sex?

[53] Right, it doesn't sound very fun.

[54] I think that one, Having realistic goals is helpful because if you're trying to start your family at 37 and you want four kids, it is very unlikely to happen without intervention like IVF saving embryos for the future, which we can absolutely do.

[55] And we do that for people sometimes so that they can go have fun with their sex life again.

[56] Two, you feel like you have to track your cycles and time intercourse appropriately when you're older because there's so much that you...

[57] can't do, right?

[58] You only have so many eggs, you only have so much time and you're trying to do what you can.

[59] Understanding your cycle tracking for a woman is a reflection of her full health.

[60] How's your brain interpreting your entire body?

[61] So it is helpful because if you have irregularity, it is a sign that things are not working normally.

[62] That being said, regular sex is good for so many reasons and in a relationship.

[63] that if you can establish sex more frequently as just part of your relationship, it becomes less burdensome that you're here recording a podcast at this time or somebody's out of town this one given month.

[64] If we remember that sperm live in the female reproductive tract for up to five days, most of the sperm is going to live there for two to three days.

[65] So five is kind of like the longest it can.

[66] What we have is that...

[67] Okay, have sex two or three times a week.

[68] What about couples that can't?

[69] Because I've sat here and interviewed so many sex therapists and sexologists, if that's even a thing.

[70] And we often speak about sexlessness, people having sex less and less than ever before because they're so busy and they're so stressed in their lives.

[71] And you must meet so many couples in your practice that, you know, you look at them and go, well, really the problem here is you're just not having sex with each other.

[72] A hundred percent.

[73] And sometimes it's situational.

[74] Truck drivers, pilots, there's just a job where it is too hard to have that intercourse during the fertile window.

[75] But then also, yeah, high performing people or who just don't prioritize or don't enjoy that part of the relationship.

[76] We certainly do what we call IUI or intrauterine insemination.

[77] And this is where you take the sperm and you're putting it inside the uterus.

[78] So instead of intercourse, we are taking an ejaculated sample and then processing it and putting it in the uterus.

[79] Wait, so I could just...

[80] ejaculate in a petri dish get a little pipette and I mean, you can't do it yourself, but...

[81] Why?

[82] Well, because most of the ejaculate of your sperm is actually meant to protect the sperm from the acidity of the vagina.

[83] So most of that is not ever going to see the inside of a uterus.

[84] And if we put the whole sample up in the uterus, it would cause a huge inflammatory or infectious process.

[85] But if we clean that sample and we pellet out, centrifuge it, and get just the sperm, we can then put the sperm...

[86] into the uterus and avoid having all that protective ejaculate sample with it.

[87] If we talk about doing it the old -fashioned way, you know, sex, there's a lot of misconceptions around how to increase our odds of getting pregnant.

[88] You hear about women putting their legs in the air after sex or things like people think if you go for a wee, then you're going to wee out all the sperm and that's not going to make you pregnant.

[89] Are any of these things true?

[90] There's so many myths when it comes to trying to get pregnant the good old -fashioned way with intercourse.

[91] So certainly we can go through a few of them.

[92] One of them we already touched on, which is, oh, you should save up sperm for when you're ovulating.

[93] So we see that sometimes men will ejaculate less or couples will actually not have sex trying to save up for that exact day of ovulation.

[94] But there's no need to do that.

[95] As we know, we want to clear the pipes to keep the sperm coming out healthy and alive and not have dead sperm and that you can have sperm survive in the reproductive tract for up to five days.

[96] So you want to be having intercourse.

[97] up until that ovulatory day.

[98] So every other day sex, every day sex, every three -day sex, those are all fine.

[99] Nobody ever needs to have less sex.

[100] So if you and your partner have sex every day, please don't have less sex because you're trying to get pregnant.

[101] Number two, the sperm are inside the fallopian tubes within minutes.

[102] They have gone from the vagina, gotten through that seminal fluid in the ejaculate, through the cervix, through the uterus, and into the fallopian tube.

[103] within minutes, under five minutes.

[104] So there's no need to prop your hips up on a pillow for 30 minutes or put your feet in the air.

[105] Truly the sperm are into the cervix within two minutes.

[106] And the cervix is where they then sit for up to the five days.

[107] So the two minutes time that it's going to take you to withdraw.

[108] Get up, go to the bathroom.

[109] The sperm are fine.

[110] You're not going to pee out any sperm.

[111] You don't need to put any device in to keep sperm in place.

[112] Keep your feet up, lay in bed.

[113] You can go and do whatever you want to do.

[114] And in fact, we know that urinating after intercourse for women decreases the risk of a urinary tract infection.

[115] So we try to encourage people to get up and be normal.

[116] I also tell people all the time, embryos implant, eggs fertilize when you are up and living your life.

[117] So you don't need to just...

[118] be horizontal to have fertilization occur.

[119] So what about sex positions?

[120] Are there any sex positions that are more conducive with?

[121] Yeah, whatever position allows for ejaculation.

[122] So this is where variety is the spice of life, because as you alluded to earlier, sex can feel a little bit more of a chore when you're trying to get pregnant or you're struggling.

[123] So making sure that ejaculation can happen.

[124] There's not any position that is going to be better or worse or going to have higher chance of a boy or a girl.

[125] or any of that kind of knowledge.

[126] If the female orgasms, does that increase the chance of fertility?

[127] We do know that orgasm does help, uterine contractions help get the sperm to the eggs faster.

[128] So we do know that.

[129] How do we know that?

[130] How do we know that?

[131] There have been studies looking at orgasm and then the speed of which sperm gets to the fallopian tubes.

[132] We'll just say that.

[133] I was thinking of all the causal factors.

[134] I was like, maybe it's just bigger and that's just...

[135] No, so yeah, just that those contractions are helping kind of propel the sperm up there.

[136] What about penis size?

[137] So penis size really doesn't matter.

[138] What's interesting is that penis size does tend to correlate with different race and ethnicity, also with vaginal length.

[139] So we tend to see different vaginal lengths in correlation with what tends to be a similar penis length based on that ethnicity or where that...

[140] person originated from which is super interesting but you don't need to you don't need a smaller penis or a bigger penis as long the sperm doesn't need to get closer to the cervix a lot of people obviously think that when you ejaculate it goes it gets right where it needs to go okay crazy it's super interesting i've learned so much about um all of this stuff today