There Is No Wealth But Life

As expected for someone whose life is made up of clichés, I learn something new everyday. Knowledge is a beautiful (terrible) thing and I should certainly rejoice at any chance to learn. But in reality my response to new knowledge is often irritation that I did not already know it. And that irritation turns to anger when it is information which I think that others need, but do not have.

Did you know that, for women with a history of miscarriage, timing of intercourse for conception is important for reducing the rate of repeated miscarriage?

Conception which results from intercourse which occurs less than 48 hours prior to ovulation is considered “optimal” timing. Conception resulting from intercourse which occurs either before or after the optimal time is considered “non-optimal.” This seems rather obvious, but I had never considered the implications.

For average women with good fertility, optimal timing of intercourse is not important in predicting whether they will miscarry. And since most women seeking pregnancy simply want to get pregnant, it is good for them to engage in intercourse on all fertile days¹ possible without concern for optimal timing. Otherwise they may miss a chance to conceive.

But for those women who have previously suffered miscarriage and care as much about avoiding the tragedy and trauma of another as they do becoming pregnant at all, it may be well worth the effort to try for optimal timing of intercourse.

This is a simple step for those who are already using fertility awareness based methods of natural family planning.

The goal is to have intercourse on the last day of peak cervical fluid. Many women can make an educated guess at which day will be the last day of peak fertility based upon at least six previous cycles. One woman may know that her last peak day has been either day 16 or 17 for the past year, and thus reasonably assume that it will be for the next cycle. Others may have a greater range in cycle days on which they tend to ovulate, but still have a typical number of high fertility days preceding ovulation. If a woman sometimes ovulates on day 10 and other times on day 25, but always has 4 days of peak cervical fluid preceding ovulation, she can simply count the days of cervical fluid rather than paying attention to the cycle day. Fertility monitors/OPKs may also be most useful.

I suspect that fertility experts do not talk about this because achieving pregnancy is their greatest goal, and seeking optimal timing of intercourse is likely to extend the time required to achieve pregnancy since waiting for peak fertility requires one to risk missing it entirely. But if I had suffered a previous miscarriage, I would be quite happy to wait longer for conception in order to cut my chance of a repeated miscarriage in half.² Using fertility awareness to avoid miscarriage makes perfect sense to me since I am already accustomed to thinking of it to achieve or avoid pregnancy. It seems to me that every couple should have this information in order to make an informed choice.

What about you? Do you think that you would be willing to risk waiting longer to conceive in order to reduce the risk of a repeated miscarriage? Do you think that it is good for doctors to not mention this, so that women do not feel as though they have yet anther thing to worry about, or even to feel unnecessarily guilty about after a repeated miscarriage?

Did you already know all of this and wonder why it was news to me?

1. Yeah, the “every other day so that sperm can build up” is a bit out of date. Please don’t comment correcting me unless you’re linking to recent studies!

2. “The adjusted relative risk of spontaneous abortion among women with non-optimally timed conceptions and a history of pregnancy loss was 2.35 (95% confidence intervals 1.42 to 3.89).” Source

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