Sept. 5, 2000 -- There's good news from Canada for millions of couples trying to have a baby. For the first time -- as suspected by many women and doctors -- evidence shows that a short period of rest after artificial insemination has been shown to increase the chance of pregnancy, according to a report in the September issue of the journal Fertility and Sterility. The technique was so successful that the authors recommend it as a standard practice.
"We don't know how much bed rest is optimal, but ... 10 minutes seems to be sufficient," says co-author Togas Tulandi, MD, professor of obstetrics and gynecology at McGill University and director of reproductive endocrinology at Royal Victoria Hospital, both in Montreal. "It's possible that bed rest may even enhance conception after sexual intercourse," he tells WebMD.
Affecting at least one out of every five couples in North America, infertility is technically defined as the inability to conceive after a year of unprotected sex. The condition is increasing in incidence, in part as the result of women postponing pregnancy until they're older and less likely to conceive. There are other possible causes, but unexplained infertility still accounts for up to 10% of all cases.
Artificial insemination is often used to treat unexplained infertility. The process involves depositing sperm directly into the uterus, or womb. Depending on the treatment and the risk factors, many couples get pregnant by the sixth attempt, but the emotional and financial stakes get higher every month.
Fortunately, you can improve your odds without treatment, Tulandi tells WebMD. "Basically, it's a matter of adopting a healthy lifestyle and timing intercourse carefully, but there's a few things to keep in mind," he advises.
- Don't rely on temperature as an indicator of ovulation; use a predictor kit from the drugstore.
- Have sex during or just before ovulation, lying on your back for 10 minutes afterward.
- Both partners should stop smoking immediately, and ideally avoid alcohol or limit alcohol to one drink a day.
- Women should take folic acid and prenatal vitamins in preparation for pregnancy.
- Men should avoid anabolic steroids, as well as saunas.
Although the man's wearing tight underwear has been thought to lower the sperm count, recent studies have shed some doubt on that.
After a year, couples who do not conceive are usually referred to a fertility specialist. "But if you're over the age of 36, you may not want to wait that long," says Aida Shanti, MD, an assistant professor of obstetrics and gynecology at Atlanta's Emory University and medical director of in vitro fertilization at the Emory Clinic. Shanti adds that bed rest after insemination has always been standard practice at Emory.
To test the effectiveness of this longstanding method, Tulandi and colleagues studied 95 couples with unexplained fertility. Following insemination, about half of the female participants rested on their back for 10 minutes and the other half did not.
Sixteen out of 55 women got pregnant after resting, compared to only four out of 40 in the comparison group. The reason is unclear, but Tulandi suggests that lying flat may hold the sperm close to the fallopian tubes, where fertilization occurs.