Patient: Dr. Malpani, my husband and I have been trying to conceive for over a year now. I’ve read a lot about timing intercourse during ovulation, but we haven’t had any luck. I track my ovulation meticulously and we try to have sex exactly during that window. Am I missing something?
Dr. Malpani: I understand why you’d think that way. It’s a very common approach, and it seems logical at first glance—have sex during ovulation because that’s when you’re most fertile, right? Unfortunately, this kind of strict timing can actually reduce your chances of getting pregnant.
Patient: Reduce our chances? But I thought ovulation was the most fertile time?
Dr. Malpani: It’s a bit counterintuitive, but let me explain. Ovulation is when the egg is released from the ovary, but by the time you ovulate, the ideal window for fertilization may have already passed. You see, the egg only survives for about 12 to 24 hours after ovulation. But sperm can live inside your reproductive tract for up to 5 days if the environment is right. That means your most fertile period is actually the 2 to 3 days before ovulation, not after.
Patient: Oh, I didn’t realize that. But if we wait until I ovulate, isn’t the egg still there for some time?
Dr. Malpani: Yes, but here’s the catch. After ovulation, your cervical mucus dries up. This mucus is crucial because it nourishes the sperm and helps them swim through the cervix and into the uterus. Without it, sperm have a much harder time reaching the egg. By the time you ovulate, the environment is far less sperm-friendly.
Patient: So, we’ve been focusing on the wrong days?
Dr. Malpani: It’s possible. Many couples are told to have sex frequently between Day 10 and Day 20 of the cycle, which sounds like a reasonable window, but this approach often lacks precision. Each woman’s cycle is unique, and ovulation doesn’t follow a strict calendar. Also, waiting for ovulation can cause unnecessary stress—turning intimacy into a chore.
Patient: I’ve also heard that abstaining from sex for a few days before ovulation can improve sperm quality. Is that true?
Dr. Malpani: That’s another myth that leads many couples astray. The idea is that if you “save up” sperm, the semen volume will be higher and increase your chances. But here’s the problem—sperm quality actually declines with abstinence.
Patient: How so?
Dr. Malpani: When sperm are stored for too long, more of them die or become sluggish. Frequent ejaculation, on the other hand, ensures that sperm are fresher and more motile—making them better equipped to swim toward the egg and fertilize it. In fact, we now advise IVF patients to have sex the night before sperm collection because fresher sperm give better results.
Patient: That makes sense. But what if my husband has a low sperm count? Wouldn’t saving up sperm help in that case?
Dr. Malpani: Not really. Even for men with low sperm counts, regular ejaculation improves sperm quality. Abstinence for more than 3 to 5 days generally does more harm than good. The key is to ensure that you’re not overcomplicating things. Frequent, relaxed intercourse—two to three times a week—works better than strict scheduling.
Patient: I hadn’t thought about how much pressure this puts on both of us. Timing sex around ovulation sometimes feels mechanical and stressful.
Dr. Malpani: You’re not alone. Many couples feel the same way. Sex becomes goal-oriented, which can take the joy out of intimacy. This often leads to frustration and even relationship strain. Ironically, stress itself can negatively impact fertility.
Patient: So, you’re saying we should stop focusing so much on ovulation and just let things happen naturally?
Dr. Malpani: Exactly. Relax and aim for regular intercourse throughout your cycle, especially during the days leading up to ovulation. Think of it as covering your bases. This way, sperm are already present in the reproductive tract when ovulation occurs.
Patient: I see. But what about ovulation predictor kits? Should I stop using them?
Dr. Malpani: Ovulation kits can be helpful, but they shouldn’t dictate everything. Use them as a guide, not a rulebook. If they stress you out or lead to performance anxiety, it may be worth stepping away from them for a while. Listen to your body’s natural cues instead—such as changes in cervical mucus, mid-cycle cramps, or an increase in libido.
Patient: That’s reassuring. I guess I’ve been overcomplicating things.
Dr. Malpani: It happens more often than you’d think. Remember, conceiving is a journey, not a race. Be patient with yourselves. If you’ve been trying for over a year without success, that’s when it may be time to consider additional tests to rule out underlying fertility issues.
Patient: What kind of tests would you recommend if nothing happens naturally in the next few months?
Dr. Malpani: A simple set of tests for both partners can give us a lot of information. For you, a pelvic ultrasound and a few hormone tests like AMH (Anti-Müllerian Hormone) can help assess ovarian reserve and ovulation. For your husband, a semen analysis can provide insights into sperm health. These are basic but essential starting points.
Patient: Thank you, Dr. Malpani. This has been incredibly helpful. I feel like we’ve been unnecessarily complicating things.
Dr. Malpani: I’m glad to hear that. Remember, fertility is about working with your body, not against it. Enjoy the process and try not to let stress take over.
Dr. Malpani: If you’d like a second opinion, you can fill out the form on our website with your reports or you can get answers from my AI Twin instantly at https://www.drmalpani.com/chat-w-chatbot/index.html