Should I lie down for an hour after intercourse? Most of the semen flows out – is it ok?

Should I lie down for an hour after intercourse? Most of the semen flows out – is it ok?

This is the one of the most common query I have answered and it is a genuine worry for most couples.

It is usual for me to elicit coital history for every couple. It is an important part of the history taking. The usual questions asked include the number of times of intercourse per week or month and if there is any pain or itching during the process or after the process.

After answering these questions, the usual query would be about post intercourse rest. Generally in fear of the semen flowing out, most women would lie down for a period of time which might range from half hour to one hour.

The semen consists of many things including sperms from the testes, which constitute only 5% of the semen. The other constituents are secretions from seminal vesicles and prostate which make up for the major portion of semen.  When semen is deposited, the sperms have been found in cervix (mouth of the uterus) within minutes.  And what flows out are the seminal vesicle and prostate secretions – which are not needed for the pregnancy to happen.

So there is no need to worry about semen flowing out after intercourse and  five minutes of lying down would suffice.

What is Ovulation Calendar?


Ovulation Calendar

 ovulation 

1) What is ovulation?

The egg or oocyte is formed in the ovary of the female. It is housed in a follicle in the ovary. The egg matures through the menstrual cycle. When the egg is mature enough, it is ready for the next process of reproduction – fertilisation. For this the egg has to come out of the follicle and meet the sperm in fallopian tube. The process of release of the egg from the follicle is called ovulation. Once the egg ovulates, it is taken up by the fallopian tube.

 2) What is the length of a menstrual cycle?

The normal duration of a menstrual cycle is between 22-35 days. The average menstrual cycle is about 28 days. 

The first half is called the follicular phase. This is when the egg grows and ovulates. The cervical mucus starts to thin around the time of ovulation. After ovulation occurs, it is the second half of the cycle and is called the luteal phase. 

The second half of the cycle is a constant 14 days. The variation in the menstrual cycle is attributable to the differences in the number of days of the follicular phase.

 3) When does ovulation occur?

In a woman with a 28 day cycle, the ovulation is expected to happen any day between day 10 – day 18. This is called the fertile period. This period may vary depending on the length of the menstrual cycle but it is easy to calculate. 

4) How to calculate ovulation time or fertile period? 

The starting day of period is called day 1. All the calculations are from this day. The fertile period depends on the length of the menstrual cycle. If is a 28 day cycle, it is between 11-18 days. If it is a 30 day cycle, it could be between days 13- 20 of menstrual cycle. 

As a rule of thumb, if you subtract 20 days from the menstrual cycle length that would approximately be the start of the fertile period. And usually the fertile period extends to about 7-10 days. As most women would have a cycle length of 28-30 days, the easiest way would be to consider day 8 – day 18 of the menstrual cycle as the fertile period. Ovulation usually happens during this time. 

5) How to make use of the fertile period?

 The fertile period as the name suggests is the period in which a woman has the best possibility of getting pregnant. Hence it is advisable to have intercourse daily or at least on alternate days during this period.

6) How effective is the use of ovulation calendar?

The possibility of a pregnancy is about 33% in each cycle in humans. This is called fecundity. Following the ovulation calendar and using the fertile period maximises the chances of conception in a couple but is by no means a fool proof method. Try an online Ovulaton calculator here.

 Practical tips

Ovulation calendar and fertile period is something I always suggest to my patients on a regular basis. As in most fertility clinics I would ask patients to use LH kits to check for ovulation and have timed intercourse. But over a period of time I observed that there were quite a number of couples who came back and said that they were unable to have intercourse around the time of LH detection in urine using the LH kits. One of the most common reasons was that the male partner was stressed and hence could not perform on that particular day. There was another difficulty couples faced. When asked to have intercourse on a daily basis, the male partner again had difficulty in performing. The moment this situation arises, the couple feel upset for two reasons – 1) They could not use that particular cycle optimally 2) They are afraid that a new problem has risen.

The first thing that I do when couples come in this situation is to reassure them that this is quite normal for any person and that there is no need to be alarmed.  Counselling is the key. And it has always helped the couple to regain confidence in them

 With due course of time, I changed my protocol. I suggested to couples to have intercourse daily or at least alternate days from day 8 – 18, without bothering about any LH kits or ovulation. This has hugely helped my patients and needless to say that many couples have achieved their dream of a family with this small step. 

Why you should consider India – the best place to do IVF

Why IVF in India?

1. World Class Clinical Expertise
 
IVF is a highly technical procedure that requires state of art technology and high level expertise both on the clinical side and in the IVF lab. 
 
The clinical side is manned by Gynecologists trained in Reproductive Medicine. In India, there are many qualified Reproductive Medicine specialists with extensive experience. The sheer number of cases that clinicians in India handle gives them the advantage of varied and vast experience. Some Reproductive Medicine specialists in India have also had work experience in very reputed IVF programs outside India. 
 
2. Experienced Embryologists
 
Embryologist are specialists who take care of the eggs, sperms and embryos in the IVF lab. They are also responsible for optimising and maintaining the culture systems in which the embryos are housed and nurtured during their stay outside the body. 
 
India is home to many qualified embryologists with many years of experience. Many have been trained in prestigious Clinical Embryology programs outside India and have had many years of work experience abroad. 
 
3. State of art Technology
 
IVF depends on technology. The embryo culture system is a culmination of high quality equipments, consumables and a fine clinical embryologist. IVF labs in India have the best of equipments from reputed international companies. The IVF labs in India are always eager to update themselves with the latest technology that can help patient conceive in the shortest period of treatment time. 
 
4. Success rate 
 
With the backing of an experienced team of clinicians and embryologists combined with world class technology, the pregnancy rate with IVF in India is on par with success rates reported internationally. 
 
5. Cost of IVF
 
It is a very well known fact that the cost of an IVF cycle in India is one third the cost in the western world. An IVF cycle could cost about $10,000-12,000 in U.S. Or Singapore. While the cost  in India is about $ 3000-4000 per cycle. 
 
Availability of world class expertise, state of art technology at the reduced cost combined with very good pregnancy rates is a very valid and important reason why a couple should opt for India as the destination for fertility treatment, especially IVF.  The low cost gives the major advantage that even if a couple is not successful in their first attempt, they can go for multiple cycles of IVF. 
 
The most important reason why IVF is available in India at such low cost is because the doctors in India charge much less than their counterparts abroad, which keeping all other parameters comparable to the IVF programs abroad.