Knocked Up Podcast - Having sex to get pregnant; try Ellechemy’s Protectility Lubricant
Thinking about having sex to get pregnant, what do we need to know?
You know us as the hosts of Knocked Up, some of you may know Raelia as your Doctor. We are also the founders of Ellechemy, an intimate wellness company – we make very clever lubricants.
Ellechemy’s collection of medically-backed, customisable intimate skincare and pleasure products that provide effective solutions for complex concerns.
One of our products, Protectility, was designed to aid natural conception, by allowing for more comfortable, and pleasurable, sex.
On Knocked Up we talk so often about Assisted Reproductive Technology incl IVF, sometimes we forget the basics when it comes to getting pregnant. Thinking about having sex to get pregnant, what do we need to know?
Hosted by Dr Raelia Lew and Jordi Morrison
Dr Raelia Lew is a RANZCOG Board Certified CREI Fertility specialist, Gynaecologist and the Director of Women’s Health Melbourne.
Find us on Instagram - @knockeduppodcast
Have a question about women's health? Is there a specific topic you'd like us to cover? Email podcast@womenshealthmelbourne.com.au. We keep all requests anonymous.
TRANSCRIPT
Intro
Women's Health Melbourne is an innovative, holistic fertility and women's health practice.
We are world leaders in IVF and egg freezing and provide our patients with every opportunity to achieve their goals.
Jordi Morrison:
Our handpicked expert team provides the ultimate care experience for our patients.
Reach us at womenshealthmelbourne.com.au and follow us at Women's Health Melbourne and @drraelialew.
Hello, and welcome to Knocked Up, the podcast about fertility and women's health.
You are joined as always by me, Jordi Morrison, and Dr. Raelia Lew, CREI fertility specialist.
Welcome, Raelia.
Dr. Raelia Lew:
Hi, Jordi.
How are you today?
Jordi Morrison:
I'm great. Loving the sun out in Melbourne, finally.
Our topic today is having sex to get pregnant — try Alchemy's Protectility lubricant.
To our listeners, you know us as the hosts of Knocked Up, and some of you may know Raelia as your doctor.
We are also the founders of Alchemy, an intimate wellness company, and we make very clever lubricants.
Alchemy’s collection of medically backed, customizable intimate skin care and pleasure products provide effective solutions for complex concerns.
Raelia, why was the creation of Protectility so important to you?
Dr. Raelia Lew:
As a fertility subspecialist and CREI-qualified doctor, when we designed our range of lubricants, we were really inspired to meet the clinical and pleasure needs of women.
It was really important to me to design a lubricant that was sperm-friendly and conception-friendly because during my day job as an IVF specialist and reproductive medicine specialist, what I do is I help people get pregnant.
And on Knocked Up, we talk a lot about assisted reproductive technology.
We talk a lot about IVF and interventions to help people get pregnant.
Almost everyone who wants to get pregnant will try the old-fashioned way first and try and have sex to get pregnant.
And even though IVF is much more common than it used to be due to multifactorial reasons, most people who have a baby will actually get pregnant more naturally.
Doesn't always happen straight away though, and it often does take a concerted effort to get pregnant.
And what people find, particularly when they're trying and it's taking a little bit longer—but really anybody who's trying to have sex on demand during a fertile window as opposed to when they're in the mood—can benefit from the use of a beautiful lubricant.
What we've done with Protectility is design an intimate skin care solution that is a beautiful moisturizer that you can apply on a daily basis if you want to, if you find that the vulva skin is a little more dry or needs a little bit of natural protection.
But it's also a lubricant.
And to my knowledge, it's the only lubricant that has been designed by a fertility specialist to help people actually get pregnant.
Now we don't claim that the lubricant enhances a sperm's ability to reach an egg — I don't think that's true at all.
But what we do claim with our lubricant is to have thoroughly researched all the principles and all of the literature in its design to include elements in its fabrication — and importantly to exclude many elements — to make it sperm-friendly and not sperm-toxic.
Jordi Morrison:
What does sperm-toxic mean?
Dr. Raelia Lew:
What that means is that it won't reduce the chance of getting pregnant by using lube, which has always been a concern with the use of standard lubricant.
So Protectility is something that I can definitely testify as a fertility specialist is safe to use when you're trying to get pregnant.
So when people are trying to get pregnant, having sex often is one of the things you need to do.
And when you do have sex every couple of days—and some people who are really enthusiastic have sex every day—a really common concern that people face when they're trying to get pregnant is they get vaginal irritation or vulva irritation from too much of a good thing.
Jordi Morrison:
I'm gonna interrupt you there, Raelia, because you've started to talk about the vulva, and I think it might be a good idea to understand a little bit about anatomy and where lubricant fits in when trying to conceive or just having better sex.
Dr. Raelia Lew:
Female anatomy — some people just use the word “vagina,” but you can break it down into the vulva, which is the external part of the female genital tract, the lips and the labia.
And then you also have the vagina, which is the mucosa-lined tunnel, which is the way that the sperm finds its way to the internal aspects of the female genital tract.
And at the roof of the vagina is the cervix, which is the neck of the womb.
And the cervix itself has special functions to create special sperm-friendly mucus that allows a column for sperm to travel upwards into the womb itself and into the fallopian tubes, which are the two little tubes at the top of the womb that connect the inner uterine cavity to where the egg is released at the ovary.
So the fallopian tubes enter the pelvic space.
And it’s really in the fallopian tubes that fertilization and early embryo formation occurs.
What happens is that when we ovulate in the middle of our cycle, the egg is released freely into the pelvic fluid, and the end of the fallopian tube — known as the fimbria — has to pick up the egg and direct it down the fallopian tube in the direction of the uterus.
Sperm released in the vagina needs to travel up through the cervix, through the uterus itself, traversing the cavity of the uterus and up into the fallopian tube looking for an egg.
Jordi Morrison:
So given that a sperm is microscopic, that's quite a big journey?
Dr. Raelia Lew:
That's right.
If a sperm was a human, it would be like walking across Australia to find an egg.
So from the sperm's perspective, it is a really long way.
Not every sperm's going to make it.
So a huge number of sperm are deposited in the vagina, and the concentration that actually reaches the egg is much, much less in a funneled gradient.
What that means is it's really important when you're using products like lubricants that they don't affect the sperm adversely, that they don't knock off a certain number of the sperm because that would reduce your chance of getting pregnant.
And their ingredients are really important, and their effects on sperm are really important.
And a lot of clinical thought really should go into the construction of lubricants, and that hasn't classically been the case.
Jordi Morrison:
So you also mentioned about ovulation. That's key when conceiving.
So the sperm also needs to reach the egg at the right time of the month.
When do we ovulate?
In a conventional scenario, if we were all the same, when would we ovulate?
Dr. Raelia Lew:
So I guess a really important thing to say is we're not all the same and not everybody ovulates by the clock.
And even in a woman’s own lifetime, she won't ovulate at the same time in cycles later in life as she does earlier in life because our cycle does shorten as our ovarian reserve diminishes with age.
The important thing to say is women who are young, fit, healthy with a regular menstrual period will ovulate roughly on day fourteen of the cycle.
But it's actually a misunderstanding to say that we need to have sex exactly at the time that we release an egg to get pregnant.
Actually, sperm sticks around in the female genital tract for up to seven days — on average, five to seven days.
So making sure that sperm is there waiting is a much better strategy than trying to have sex exactly when you're ovulating.
Dr. Raelia Lew:
And that's why when I advise couples to plan a pregnancy naturally, with a bit of guidance as to when to have sex to get pregnant, I explain that we need to have sex regularly to get overall a larger concentration of sperm waiting for the egg — and that we should be having sex every couple of days from well before we ovulate. Usually around day ten of our cycle, if we have a regular cycle, is a good time to start trying.
And a rule of thumb that we use is twice during the week and once on the weekend — so that can say that every couple of days we're having sex to try and improve our chance of achieving a pregnancy that month.
Jordi Morrison:
And what are the signs that we should watch out for that might indicate that we're ovulating?
Dr. Raelia Lew:
I think a lot of the way that this is explained on the internet when people research is fundamentally wrong.
And a lot of women get very confused about certain signs that they're looking for.
For example, we expect that the cervix will make more mucus as our estrogen reaches to be close to its peak, and that does occur before ovulation.
It doesn't mean you're ovulating.
It just means that you're getting ready to ovulate.
I know a lot of patients who are going through IVF treatment — because of what they've read online — going up to an IVF egg collection, the estrogen levels are high because multiple follicles are ripening, and they're making a lot of mucus.
They're worried that they're ovulating because that's what it says on the internet to explain a lot of mucus.
Actually, it doesn't mean you're ovulating, but it does mean that your estrogen's rising and you're coming into your fertile period.
Another sign that you may be coming into your fertile period is increased sex drive.
And again, that's not because you're ovulating. It's because of the effects of the hormone estrogen that rises around the time that you are about to ovulate.
These signs are really indicative of a fertile zone, and that's a good time to have sex to try and get pregnant.
Other signs that you may notice is a temperature rise.
Now that happens — instead of a prelude to ovulation — after the ovulation has already happened.
When we're ovulating and afterwards, more importantly, progesterone starts to rise, made by the corpus luteum, which is the follicle that turns into a progesterone-making factory after it releases an egg.
And it's that progesterone hormone rise that happens after we've ovulated that causes a temperature rise.
So people can use devices to monitor their temperature and use that to track cycle — and very useful in non-conception cycling, for example, for cycle syncing of exercise routines.
So they know they're in their luteal phase when their temperature has gone up and their progesterone has risen.
That in itself is not a useful sign when you're seeking to conceive, to know when to have sex.
Because by the time your progesterone has risen and your temperature has risen, you've already ovulated and it's a little too late to try.
Now, a lot of health professionals include when they teach women to track their cycles, will quote, you know, noting temperature and charting temperature, and it is useful to have that idea retrospectively of when you ovulated in that particular cycle — and we can kinda work it out.
But it's not useful prospectively to know when to have sex to get pregnant.
Jordi Morrison:
Which is why you're recommending every other day sex?
Dr. Raelia Lew:
That's right.
Imagine you're a plane and you need to take off.
What we need to be doing is actually timing intercourse to conceive while the plane is running down the runway as opposed to when it's already taking off.
Think of it like that.
The other analogy I've used in our past episode is — at that point of time —
Jordi Morrison:
Beyoncé?
Dr. Raelia Lew:
Yeah.
Jordi Morrison:
Beyoncé on the left side.
Dr. Raelia Lew:
That's right.
It might be someone else on the red carpet these days.
Maybe it’s Tay Tay.
Look.
On the analogy that we use there is that, you know, you gotta get there first.
You gotta be prepared.
Jordi Morrison:
So the—yeah. The paparazzi don't turn up the same time as Tay Tay.
They turn up hours in advance to get the right spot.
Dr. Raelia Lew:
Exactly.
Those analogies are just really to illustrate that you've gotta have sex before you ovulate if you want to get pregnant.
Having sex exactly while you're ovulating is okay, but maybe the sperm won't make it to the egg in that amount of time. Who knows?
It's better to be a premeditating person when you're planning sex to conceive — and frequent sex is good because the more sperm, the better. Not all the sperm are going to make it to meet the egg.
A lot of them are going to go backwards out of the vagina and never meet an egg.
And look, people ask me sometimes, do I have to have sex every day, or is every second day okay?
That's when we draw back to the fact that not every sperm that ejaculates is gonna frizzle up and die in thirty seconds.
They've got a long life.
They've been actually made over a seventy-day period leading up to the time that sperm is ejaculated, and they've got a little bit more in them.
So you don't have to have sex every day.
In fact, there's not a benefit — from a point of view of the number of pregnancies conceived — by having sex every day over having sex every couple of days, and those studies have been done.
And we know that clinically there's no benefit.
So that's important when people are taking a little bit longer because sex every day is not what the vagina is really designed for, and it can become uncomfortable.
You can get skin abrasions and fissures and things like that, especially also because when you have sex every day in a heterosexual situation, from the male side of things, it might take a little longer to ejaculate, and that together with the fact that—
Jordi Morrison:
More friction.
Dr. Raelia Lew:
Yeah. There's just more friction, more potential for friction, irritation, and it becomes really something very beneficial to use a fertility-friendly lube like Protectility.
Jordi Morrison:
So at the very top of the episode, you started talking about kind of, hey, if you're not using lubricants, some of the damage that can be done to the vulva.
And so going back to that, can you talk us through a little bit about why lubrication is important when having this regular sex? You sort of just touched on it, but explicitly—
Dr. Raelia Lew:
Look.
A lot of us are trying to have babies a little bit later in life than we were biologically created to do in terms of optimal fertility rate.
It's important to realize that if you channel your inner cavewoman, your ancestor would have been trying to have a baby — or maybe not even aware of it — but having sex for the first time without contraception at a much younger age than the average age of first motherhood in modern society.
One of the unfortunate consequences of that is that egg quality at the time that we're trying to have a baby may not be ideal.
And so it's not abnormal that it can take six to twelve months to get pregnant even if there's nothing wrong with a female or a male in a heterosexual relationship having regular sex.
So from that point of view, having more sex per baby is something that happens now because not every egg is of high enough quality to make an embryo that can go in and make a pregnancy. And so it can take longer.
The other thing is that as a generation, this is the generation of permanent hair removal.
A lot of people in the generation of women who are seeking to become mothers were also the generation who first made famous the Brazilian wax and then the laser hair removal movement.
And so we actually are more vulnerable to friction injury than generations past, and so it's a problem that when we do have sex really frequently, we are more subject to minor skin injury that can make things uncomfortable.
And then that also can have a bit of a vicious cycle because skin fissuring and irritation can make us more vulnerable to conditions like thrush.
It's really helpful to have a fertility-friendly lubricant solution.
Lubrication is something that does happen naturally.
This is not to replace that.
It is to enhance it.
When we do lubricate, what happens is the vagina is able to distend, and it's also an important point that the secretions in the vagina have to maintain a balanced pH.
And the vagina is meant to have a negative pH.
Sperm is more of an alkaline pH to help the sperm survive the acid environment of the vagina, but the pH balance is important.
So a lot of lubricants that are not fertility-friendly may contain high amounts of sugars and may have a suboptimally alkaline pH, and that can cause vaginal irritation.
It can also cause bacterial imbalance, and it can cause detrimental effects to the microbiome of the female genital tract — and that can potentially have adverse consequences for your chance of getting pregnant.
So all of these things happen together, and lubrication is an important part of the experience of enjoyable sex for females to make sure sex is not painful.
And, obviously, sex is for pleasure as well as for conception, and we want to make sure that both of those things are possible.
Jordi Morrison:
And there are some great ingredients in the Protectility formulation, like shea butter, vitamin E, jojoba oil.
These all work, as you were saying, to provide a really good environment for the vulva in terms of skin care.
For people who are not looking to get pregnant, some of these ingredients — I think we would read and think, “Oh, can’t use those with condoms,” but we can in this case?
Dr. Raelia Lew:
Yeah. Protectility — and actually all of the Alchemy formulations — are condom-safe for those who are not trying to get pregnant.
Now that can be important for people who are even trying to get pregnant through other means like IVF.
So we do ask people in some circumstances in IVF during certain periods of their treatment not to have unprotected sex.
For example, when we're trying to avoid multiple pregnancy or when we're trying to avoid the risk of hyperstimulation syndrome during an IVF stimulated cycle, we'll ask patients for that particular time frame not to have sex.
And so you can use your same Protectility lubricant when trying to have sex because it's sperm-friendly — when trying to conceive — and you can use it even in other contexts when you are actively trying not to conceive, and the lube is condom-safe.
Jordi Morrison:
Thank you, Raelia.
Great episode.
Always interesting.
There’s a few things in the show notes — there’s a great blog on the Women's Health Melbourne website about exactly this with some more resources.
And, also, we’ve got a discount code for our listeners that’s in the show notes.
Alchemy can be found at alchemy.com.au.
Thank you so much.
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Join us on Instagram at @knockeduppodcast, and join Raelia at@drraelialew, and email us your questions to podcast@womenshealthmelbourne.com.au.