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    Sex on a Schedule

    It may help infertile couples, but who can stick to it?

    How Women and Men Respond

    First, a couple should understand that each of them tends to react a bit differently, experts say. "A woman in this situation may feel alienated from her body, so it may be hard for her to feel sexual," says Andrea Braverman, PhD, director of psychological services at the Women's Institute for Fertility, Endocrinology, and Menopause in Philadelphia. "She may feel like little more than a set of ovaries and even begin asking herself, 'What's the point of having sex if I'm not getting pregnant?' "

    Lack of desire, in turn, can decrease natural lubrication, making sex painful, Braverman says, and resulting in even less sex.

    In addition, "A man may feel like nothing more than a sperm donor and become so distanced that he has difficulty achieving erection or orgasm," says Anthony Thomas, MD, a urologist at The Cleveland Clinic Foundation in Ohio and co-author of Overcoming Male Infertility . "Some men even fake orgasm to get sex over with."

    Relieving the Pressure

    Both partners should avoid getting into "performance" mode. It can help to realize that the window of opportunity for conception stays open longer than what is suggested in movies and television shows, where characters often engage in lunch-hour sex in order to conceive while the woman is fertile. Sperm can live in the cervical mucus for about five days before ovulation, according to Thomas.

    In general, infertile couples are advised to have intercourse every other day around the time of ovulation, usually around day 14 of the woman's menstrual cycle. Women can detect ovulation in a number of ways, such as by using a urine test or monitoring changes in vaginal secretions.

    However, sex shouldn't be confined to the time of ovulation. Unless instructed otherwise by their doctor, couples should make love throughout the month, not just when they think they might conceive, says Leslie Schover, PhD, a clinical psychologist who has counseled many infertile couples and is co-author of Overcoming Male Infertility. That might help them separate sex from conception -- and sex will become a natural part of life again.

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