Sex Advice

Dear Dr. Locker: My husband and I are trying to conceive. I have waited 20 minutes on my back after sex with a pillow under my hips to help the sperm travel. Should I be concerned that the sperm sometimes comes back out? Sometimes it is even 3 hours later.

Answer from Dr. Locker

As long as you are staying on your back with your legs or hips up for at least 20 minutes then you are doing what most people recommend for conception.

Yes, most of the semen will come out at some point. For some women, if they stand up right after sex, the semen will spill out. For others, even if the woman stands up right after sex, the semen may stay inside her for a while, and then leak out or drip out minutes or hours later. So, yes, 3 hours later, as you mentioned, is totally normal. It will come out faster if you cough, sneeze, laugh, urinate, or do Kegel exercises. Just to be clear, though, you do not need to try to keep it in there for hours. As long as you are on your back with your legs or hips up for at least 20 minutes, you are doing fine for trying to conceive. (Many people do not even do that, and they can still get pregnant.)

Remember, one drop of semen contains millions of sperm, and usually some of the semen that is shot out during the ejaculation itself travels past the cervix at that time. Once there, sperm can stay alive for between 1 and 4 days (sometimes up to 7 days), so it can fertilize the egg days later. A few more notes...

In order to be most certain that you are having sex at the optimal time for conception, you can use Ovulation Predictor urine tests that you’d buy in a drug store, and/or you can chart your basal body temperature to be sure that you do not miss the day that you ovulate. For more information about this, you may enjoy the following book which goes into great detail about how to detect ovulation using the basal body temperature as well as cervical fluid. Plus, it explains more about when and how to have sex for conception. Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health, by Toni Weschler.

For more information about how to conceive, please talk to your gynecologist or primary care doctor. I recommend that all women who are trying to get pregnant see your doctor for an annual exam. Also, when you start trying to conceive, it is usually recommended to take a prenatal vitamin (either over the counter or prescription), so talk with your doctor about that, too.

If you have been trying to conceive for one year with no success (or 6 months if you are over age 35), then you should consult your OBGYN doctor and/or a fertility specialist to get more information and advice, or to get fertility testing.

Also, for more info, check out my answers to these questions:

*Are there sex positions that prevent getting pregnant, and what is the best position to conceive?

*My husband and I had sex on a Friday night, and two days later, I detected my LH surge using an ovulation predictor test stick. Is there a chance that I got pregnant even though we had sex before ovulation occurred? How long does sperm live inside a woman to fertilize an egg?

Good luck!!

Copyright © Dr. Sari Locker