Sexual relation is an integral aspect of any healthy marriage. It is important that both partners are comfortable and enjoy the intimacy.
However, patients often ask, “Doc, what is the best sexual position to adopt for conception?”

Let us examine the different sexual positions and determine their varying degrees of effectiveness. 

Missionary position 

Many experts believe that the missionary position (man on top) affords the best opportunity for baby-making. This position allows for the deepest penetration and as a result, places the sperms closer to the cervix. 
For additional effectiveness, the woman can try elevating her hips with a pillow so that her cervix is exposed to the maximum amount of semen.

​Rear entry

Rear entry, when the man enters the woman from behind, either lying down or kneeling, can also deposit the sperms close to the cervix to aid conception.​ 


Side entry

Lying side-by-side can be a relaxing position and easier on a partner who is overweight or has chronic back problems.​ 


​​Effective manoeuvres 

A woman can further increase the likelihood of conception by remaining in bed for up to half an hour following intercourse, preferably on her back and with a pillow under her pelvic region. In theory, this provides the sperms with additional travel time up to the fallopian tube with the aid of gravity. 

The contractions that accompany a female’s orgasm may help carry the sperms further into the cervix.

​​​Sexual positions that are not recommended for conception 

Avoid having sex while sitting, standing or with female partner on top. These positions defy gravity and may discourage the upward mobility of the sperms. 

Predicting your timing of ovulation 

You can increase your chances of getting pregnant by timing your sexual intercourse close to your time of ovulation (releasing of your egg). 

However, keep in mind that every woman’s menstrual cycle is different. Normal cycles can vary from 21 days to 35 days. We use the 28-day cycle as an average. There are several ways to predict ovulation.​

1. Basal body temperature

You will experience a slight increase in your body temperature just after ovulation.

Measure your body temperature every morning after waking up and keep a record of your body temperature every day. After a few cycles, a pattern should emerge (Figure 3.1).






2. Changes in your body

Be vigilant of changes in your body. The cervical mucus is noted to be thinner and clearer during ovulation. Another indication of ovulation is mild lower​ tummy pain during mid-cycle when the egg is released from the follicle in the ovary. This is called mittelschmerz, and is sometimes accompanied by midcycle spotting or mild bleeding.​ 


3. Ovulation test kits 

There are test kits to predict ovulation which are easy to use. The test strip is placed under a stream of urine when the woman first wakes up in the morning. The strip changes color to indicate hormonal changes related to ovulation. These kits are fairly accurate. 

However, the most important factor is to have regular sexual intercourse. We suggest having sex at least three times a week if you are trying to conceive. 

For women with regular 28-day menstrual cycles, your most fertile period is between Day 11 to Day 18 of your last menstrual period. And, remember, the ovulated egg only lives from 24–48 hours, sperms live for 72 hours! 

Acknowledgement

Source: Dr TAN Thiam Chye, Dr TAN Kim Teng, Dr TAN Heng Hao, Dr TEE Chee Seng John, The New Art and Science of Pregnancy and Childbirth, World Scientific 2008.

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