How often should you have sex to get pregnant?

When you are trying to get pregnant, there are many questions about the fertile window, timing of intercourse, and intercourse frequency.

A few Fertility myths you may have heard.

  • Myth 1. Having more sex decreases sperm concentration and thereby decreases pregnancy rates.
  • Myth 2. Having sex further away from ovulation can lead to decreased sperm quality (older sperm) and thus increases miscarriage.
  • Myth 3. The timing of sex (further or closer to ovulation) will impact the sex of the baby.
Pregnant Woman

Sexual health & Fertility Research Findings

Findings from Wilcox, Timing of Sexual Intercourse in Relation to Ovulation — Effects on the Probability of Conception, Survival of the Pregnancy, and Sex of the Baby, a 1995 study-
Although there may be some degree of variability it’s largely agreed upon that women have a six-day fertile window. The six days include the five days leading up to ovulation and the day of ovulation.
There are variable pregnancy rates on each of the six days of the fertile window. More frequent intercourse provides improved pregnancy rates, while less sex is associated with lower pregnancy rates.
  • Day 5 = 8%,
  • Day 4= 17%,
  • Day 3= 8%,
  • Day 2= 36%,
  • Day 1= 34%,
  • Day of ovulation= 36%
Interestingly, the study found that when couples have untimed intercourse averaging once per week, conception rates fell to a 15% chance of conception per cycle. This study found that increased frequency of intercourse did not decrease rates of conception. Basically, we’re not seeing more frequent ejaculation reduce the chances of pregnancy (win!). Fertility rapidly drops after ovulation, which may be due to decreased egg quality or changes in cervical mucous. (i.e. don’t wait to ovulate to have sex) Sperm and Egg illustration A study out of Japan (Coital Frequency and the Probability of Pregnancy in Couples Trying to Conceive Their First Child: A Prospective Cohort Study in Japan) found that intercourse was the only variable the impacted the rates of pregnancy. The study found conception probability was not significantly associated with age, BMI, or AMH, a measure of reproductive age and ovarian reserve. Another finding from this study was that pregnancy rates were lower than previous studies and when compared to other countries. This was consistent with the low rates of intercourse found in the couples. It may be surprising that couples trying to conceive would have lower rates, but sex was on average three times per cycle in this study. US couples trying to conceive average 4-9 times per cycle. Unhappy man on edge of bed Sexual frequency rates have been decreasing in several higher-income countries. One study out of Great Britain found that over half of the men and women aged 16-44 have sex once per week. Scientists aren’t exactly sure what’s behind these reduce rates. The same study reported that both men and women would prefer to have more frequent sex. (Wellings, 2019). Couple's legs in bed
The National Institute for Clinical Excellence guidelines- recommends that the optimal rate of sexual intercourse for couples trying to get pregnant is 10-15 times per month
And yet, the average rate of couples in the US is 6-7 times per month and decreases drastically with age. (ACWG, 2019) A study of out Singapore looked at how a couple’s sexual frequency changed in response to perceived stress and fatigue levels and weekends and holidays. As guessed, women’s increased perceived stress and fatigue were associated with lower rates of intercourse. There were higher rates of intercourse on the weekends and weekdays that were lower in perceived stress. (Tan, 2021)

How to support a healthy sex life?

With the demands of modern life, work, and other stressors, sex can take a back seat. It is also true that couples who report the greatest health also have improved sex lives. Healthy Sex Life

Here are a few steps you can try out to see if you find more balance, improve energy and libido.

  1. If you’re able to adjust your work schedule around your fertile window, take advantage of extra time. Perhaps that means using vacation time to leave work a bit early to have time to relax and unwind. Aim to avoid overworking. We all do it sometimes. Are there areas where you’re over-extending unnecessarily? Evaluate what you need to do to achieve your goals and modify them.
  2. Get a massage during the fertile window and/or go on a date and try to increase the fun factor even if you don’t feel like it at the moment. More fun leads to connections and feelings of spontaneity.
  3. Commit to having regular intercourse. You know what they say if you don’t use it, well, it is true. Often, libido will increase if there’s effort. Give yourself time for intimacy regularly, perhaps every 2-3 days or daily if you’re up for the challenge. You may be surprised at all the benefits that come with regular intercourse.
  4. Schedule sex- yes, if it is not scheduled, it just might not happen. We make time for most other things in our life and plan, and sex should be one of those things too!
  5. Get great sleep; fatigue is a huge libido killer.
  6. Exercise- movement, endorphins, and circulation are all wonderful for supporting your libido. Exercising together even better if you can.
  7. Use botanicals to enhance energy and libido; Shatavari, Ginseng, and Maca are a few to try. Ashwagandha can also be a great nourishing herb that builds and strengthens over time.
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Citations

Wilcox, Allen. 1995.Timing of Sexual Intercourse in Relation to Ovulation — Effects on the Probability of Conception, Survival of the Pregnancy, and Sex of the Baby. N Engl J Med 1995; 333:1517-1521

Konishi, Shoko. 2020. Coital Frequency and the Probability of Pregnancy in Couples Trying to Conceive Their First Child: A Prospective Cohort Study in Japan. nt. J. Environ. Res. Public Health

Wellings, Kaye. 2019. Changes in, and factors associated with, frequency of sex in Britain: evidence from three National Surveys of Sexual Attitudes and Lifestyles (Natsal). CCBY Open access. BMJ 2019; 365

Annual Capri Workshop Group (ACWG). 2019. Towards a more pragmatic and wiser approach to infertility care. Human Reproduction, Volume 34, Issue 7, July 2019, Pages 1165–1172,

Tan PL. 2021. Stress, Fatigue, and Sexual Spontaneity Among Married Couples in a High-Stress Society: Evidence from Sex Diary Data from Singapore. Arch Sex Behav. Jan 13. doi: 10.1007/s10508-020-01848-y. Epub ahead of print. PMID: 33439407.

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