Timed intercourse linked to higher rates of pregnancy

Reviewed by Emily Henderson, B.Sc.Jul 5 2022

Women who time intercourse may be able to increase their chance of conceiving, according to an updated Cochrane analysis. The review found that couples who pinpoint their 'fertile window' using urine-testing monitors specifically may improve their pregnancy odds.

However, first investigator Dr Tatjana Gibbons, who will present the findings today at the 38th Annual Meeting of ESHRE, said definitive conclusions could not be reached on other home-based or clinic-based ovulation detection methods because of insufficient evidence.

These include fertility awareness-based methods (FABM) which are used in the majority of menstrual cycle apps for women trying to conceive. FABM include using calendar predictions, identifying changes in cervical mucus or even changes in body temperature with body-worn devices fitted with biosensors to detect when ovulation is most likely.

This update suggests a benefit of timed intercourse using urinary ovulation detection. However, more evidence is needed on the adverse effects of timed intercourse and its effectiveness in different groups - such as those with unexplained infertility – before clinicians are able to promote this practice. Future studies should also assess the use of FABM for couples trying to conceive."

Dr Tatjana Gibbons, Nuffield Department of Women's and Reproductive Health, University of Oxford

Timed intercourse may be more widely practiced because of a surge in the availability of health apps, including ovulation detection methods. These predict the days in a woman's menstrual cycle when the ovary is most likely to release an egg.

For this Cochrane analysis the researchers assessed the effectiveness of timed intercourse assisted by ovulation detection methods such as digital apps linked to urine monitors, urine ovulation tests which measure fertility hormones, and FABM.

The attempted aim was also to look at the impact of timed intercourse on live birth rates, pregnancy rates, time to pregnancy and quality of life. The purpose was also to investigate any links between timed intercourse and adverse events, including stress which may be caused by the lack of spontaneity and pressure of sexual performance.

Data were used from six studies involving 2,374 women in total who were attempting to conceive naturally.

Overall, results showed that timed intercourse using urinary ovulation detection was associated with higher rates of pregnancy than in couples who were not timing intercourse specifically around the fertile window.

The authors assessed the chance of pregnancy via timed intercourse as between 20% to 28% compared with 18% for spontaneous intercourse.

However, the findings were inconclusive as to whether timed intercourse using FABM resulted in a difference in live birth or pregnancy rates. Data were only available from two studies involving a total of 160 women and the evidence was low grade.

For couples using ovulation detection, a benefit was demonstrated in couples who had been trying to conceive for less than 12 months but there was insufficient evidence to detect a difference in subfertile couples (over 12 months).

Limitations of the research included insufficient studies reporting clinically important outcomes such as live birth, time to pregnancy, quality of life and adverse events such as stress.