Thursday, 3 April 2008

Becoming a father Chapter 5 - Sex: timing, effectiveness and gender

This chapter is going to cover the mechanics of sex and fertility as well as how they affect both the chances of conception and the potential gender of the baby. Clearly if the act of sex affects both of these things then there is going to be overlap if I try to separate them completely. This means that while there are bits specific to how effective at producing conception sex is and specific bits on gender selection there are also bits such as the female orgasm that affect both. Because it is not clear until you have read them what the subtle effects are I would suggest reading through the whole chapter before going back and looking properly at the bits that interest you.

Effective Sex
The first thing to be said on this is that if you turned here first you are already in trouble. Stress is very counter-productive, and if you are too hung up about the effectiveness of your sex you will be stressed, which is not good.

Having said that, there are things related to sex that can stop it resulting in conception. You should know about these things as this can stop you consistently falling into unexpected traps.

The most important thing to ensure your sex is effective is timing. Unlike a man, a woman is only fertile for part of her monthly cycle; this limits when sex can cause conception. Sperm can survive for up to 7 days in perfect conditions. In practice most sperm die within 24-48 hours. The timing section below will explain how long either side of ovulation is practical for conception. There are ovulation tests available to check that ovulation is occurring when you think it is. Conveniently enough a woman experiences a large surge of hormones just before ovulation. These hormones show up in the urine so, just like the pregnancy test, peeing on a stick is the way these tests work. This is hormonal rush provides a heads up that it is time to start having sex. There are many kits and books that will tell you the exact time of ovulation, but in my opinion the stress of trying to work to a strict timetable is sufficiently counter-productive to make a rough knowledge of the day preferable.
Remember, the rhythm method is a form of contraception based on timing your sex to avoid fertile periods. It is not 100 % effective, but it has worked for millions of people for hundreds of years, so the time of the month when you have sex is probably the most significant factor over which you have control.

Just as conception is unlikely to occur unless you ejaculate it is less likely if the woman does not orgasm than if she does. This is because the muscular contractions that take place during orgasm help move the sperm towards the egg.

As female orgasms are a factor in effective sex it is important that the sex is enjoyable. One problem often encountered by couples trying for a child is that they become too obsessed with timing, fertile periods, nutrition and all the other things which can effect conception and become stressed. This stress in itself will affect a woman’s ability to conceive, but worse than that it can effect the enjoyment of sex. Couples report it becoming “automatic”, “clinical” or “just not sexy”, and unsurprisingly the female partner is less likely to orgasm under these circumstances.
Different positions can also affect the chances of conception. The further into the vagina the sperm are deposited the less distance they have to swim. Not only that, the vagina is the least friendly environment that the sperm will have to swim through, so minimizing that part of the swimming distance can have a disproportionate effect on the chances of success. Similar effects can be produced by the position assumed after sex, as this can allow gravity to work in favour of the swimming sperm. This is why some films have women posed on their backs with their legs in the air after sex when trying to conceive.

The sperm count of a man can be affected by the frequency with which you have sex. Abstention for a set time before the fertile period can alter the chances of conception, as can changing the frequency with which you have sex during the fertile part of your partner’s cycle. It used to be that they reccomended abstinence for ten days before ovulation. This is not longer considered to have a significantly different effect to two days of abstinence.

Sperm levels are highest in the morning. This may be related to an some men’s desire being heightened in the mornings. The sperm levels, to some extent, drop off throughout the day. If you want to take advantage of this then have sex as soon after waking as you feel comfortable with, so mornings or early afternoons might be good.

As was made apparent in the previous section there is only an egg available for a few days each month. Ovulation is generally about two weeks before the first day of her next period. This means that if she has regular cycles you can assume ovulation will be about 14 days before that. If her cycle is not regular (and one in five are not) then start by guessing and if things are taking a while (a few months) check your guess by persuading her to use a test (clearblue?). If her cycles are particularly irregular it is worth using some sort of check on a regular basis to ensure you do not miss the window.

It is worth noting at this point that ovulation test kits do not test for ovulation. They test for the rush of hormones preceding ovulation. This rush can occur even if ovulation does not. In the event of a significant amount of time with no success at conception it is worth having a check that she is ovulating. This is usually done through your medical practitioner. The good news is that if this is the problem then in many cases there is a simple injection that can fix things by jumpstarting ovulation. This is particularly frequently the case for second or later pregnancies.
It is also possible to check for ovulation using the temperature profile of the woman. {more on how this is done, the timing of ovulation and different techniques for estimating and checking}

Once you know when ovulation is occurring you need to work out when her fertile period is. This is generally from 4-5 days before ovulation through to 1-2 days after. Male sperm survive longer than female sperm once they are out of the acid environment of the vagina so having sex at the start of this period creates a slight bias towards male children; the day either side of ovulation creates a slight bias towards female children. You can buy programs to tell you that her most fertile period is the days mentioned above, but as you have now read this it is probably not worth the bother.

The rhythm method of contraception:{To be completed}

Further background Information
The menstrual cycle of a woman determines when she is fertile. Cycles vary in length from around 20 days to over 35 days. Changes in the cycle of up to around a week are fairly common. Unless a woman is on the pill her cycle is not likely to be completely regular.
Signs that she is entering her fertile period can include:
• The cervix becomes higher and softer and open (you can feel this with your fingers)
• Cervical mucus produced in the cervix changes to an environment that is better for the sperm. This can be observed in the texture and taste.
• Increased fluid ; up to 10x increase in mucus volume can be seen.
• Highly-fertile mucus is nearly all water – This gives a transparent, glistening, slippery, stretchy - spinnbarkeit effect.
• The structure of fertile mucus includes a particularly loose network to help the sperm get though. Again can be discerned through the texture.
• Increased salts, sugar and amino-acids to nourish sperm, again noticeable as it affects the taste.

The female orgasm
One thing that is often important is lack of stress. Many couples become pregnant shortly after they give up and stop trying. When applying for IVF the time while you wait for treatment is one of the most likely times for conception.
You are more likely to cause conception if your partner has an orgasm after you have ejaculated. This is because the vaginal contractions that take place during the female orgasm act as a pump to move sperm from the acid vagina to the relative safety of the uterus. More female orgasms mean more pumping of sperm, mean more chance of conception.

There is a theory to suggest that that multiple groups of multiple orgasms throughout the days following the fertilisation of the egg by a sperm can cause sufficient movement within the uterus as to lower the chances of successful embedding by the fertilised egg. I have been able to find no research to either confirm or deny this.

Some women come more violently on their second or third orgasms than on their first, others find each orgasm weaker than the preceding one. For those in the latter category the effect on the chances of conception will be lowered if her first orgasm is before yours. If she is likely to feel like stopping after she has had an orgasm, then make sure you save her orgasm until after yours.

As well as affecting the probability of conception the female orgasm, or lack of female orgasm will affect the gender distribution. For more details see ‘gender selection’ below.

Given the advantage if your partner orgasms after you have, it is worth talking briefly about some ways to achieve this. There are suggestions that men have a tendency to roll over and go to sleep after they have ejaculated. In terms of conception this is not optimal. While we all know that in actual fact there are really only about 10 men who ever did that, and they are reformed characters now, it is still interesting to find out how other people have sex, so below are a few suggestions. Another thought you might want to consider is that what you do and how you do it will be more restricted during pregnancy, so taking advantage of your relative freedom at this point may be a good idea.

It is also worth noting that your ejaculate (the combination of sperm and seminal fluid you produce) will change consistency a short while after you ejaculate. This is useful in adding to the motility of the sperm. It is best if you have a rough idea how quickly this will take place. This varies from man to man, and also depends to some extent on your diet and how hydrated you are. In practice we are going to have to assume your diet and level of hydration are pretty much constant, so that we can gauge how long it is in your case. You will then want to see if you can induce an orgasm just after the sperm has de-jelled.

To test this you want to ejaculate onto a non porous surface of about body temperature. A hot water bottle or a plastic sheet you have been lying on would be perfect. If your sperm takes longer than 15-30 minutes to liquefy then do not worry about trying to time things to match, as it will just detract from the sex and add to stress. If your sperm takes more than 120 minutes then you have an agglutination problem and may need to look to your diet or consult a qualified doctor. Anything up to 60 minutes is considered normal. Most common times are on the order of five minute, but the spread is really quite large which is why this is actually worth checking. On the subject of which you might as well do this when it is not going to affect fertility, so a week or more from ovulation. This could be viewed as a good excuse to persuade her to make you come.

One of the more sort after sexual acts amongst women is, apparently, for the man to go down on her. How much women actually want this is culturally biased as well as varying significantly on an individual basis. Like everything else in this section it is worth discussing with your partner to see what she would enjoy most. If she does enjoy it then it is worth bearing in mind as an eminently practical way of allowing her to orgasm after you have.

It may seem obvious, but you both have fingers and they are one of the most sensitive and agile parts of your bodies. Her using her fingers to ensure she has an orgasm just after yours is a very satisfying way to achieve good timing. You doing the same for her after you have come can provide her with some excitement and variety and is another worthwhile alternative to relying on friction and motion from the penis.

Contrary to popular myth a vibrator is not just a dildo that makes a funny noise. In pornography you will generally find that the purpose of a vibrator is to be inserted into the vagina and there to be used as a penis replacement; that is to say they are used as a dildo. In practice this is not how vibrators are used except by the very inexperienced. Certainly some people will use a vibrator as a dildo when they do not have a dildo and something else is doing the job of the vibrator. Also this use does look sexy (that being why it appears so frequently in pornography) so using it this way for you watch is quite reasonable.

In general use however the vibrator is there to apply vibrations to the clitoris where all the nerve endings are and not to the vagina where they are not. A vibrator can be used, by either of you, while you are making love. If the purpose is to ensure the female orgasm then it would be applied to her and the position that you used would need to take account of this. Best access is generally provided either during sex where you are behind her or where you are kneeling up between her legs as she lies down. Either of these positions provides fairly deep penetration, though the rear entry has the edge. That said you have more control over depth of entry when you can see what is going on so either of these is preferable to the missionary position in terms of gender selection. If you are trying for girl you might want to delay her orgasm for a while after you come, so a vibrator is good for her to make herself come while you watch after a pause.

Fantasy is strong element in all sex, whether through investing significance in what is going on or through imagining something else entirely is happening. As a couple it is worth talking through what your sexual fantasies are and what you would enjoy most. This will give you a whole range of things to play with, metaphorically speaking. If you can fulfil a few fantasies then you will probably create that much stronger orgasms. Some couples even find fantasising about the fact that they are creating a baby and bringing into existence new life a trun on.

Caressing, stroking, kissing and other ‘foreplay’.
{to be completed}

Other toys:
Benoit balls (not a good idea?), Penis rings, tens devices, S/D, textured gloves, etc.
{insert notes on foreplay, after-play and producing orgasms after the so called main events.}
Foreplay: Kissing, stroking, cuddling, setting the mood, oral sex, role playing and fantasy fulfilment, talking dirty.
Pornography, a personal taste.
After-play: Vibrators, oral sex, manual stimulation by him, manual stimulation by her, breasts, maintaining the mood, cuddling, kissing.
Vibrators: The different types, how to use, when to use, why to use, a toy for both of you. Worth noting that mains powered ones can bring about male orgasm as well as female orgasm. Mention of the rabbit vibrator and it’s plus and minus points fro conception. Also mention hygene.

Effects of frequency on sperm count and on probabilities of different genders.

Sexual positions
Affects on probability of conception and on gender distribution.

As described above, sperm swim at only 3mm an hour and cannot survive long in the acid conditions of the vagina. Girl sperm can survive for significantly longer in this environment than boy sperm.

Gender Selection
Warning Words
Selecting for gender often lowers the chance of conception
There are differences between boy sperm and girl sperm, and these allow us to change the chances each have of surviving. Outside of a medical procedure pretty much all the things we can do to alter the chances of a particular gender involve making the other gender less likely to survive. This means that many of the ways of trying to produce a particular gender reduce your overall chances of conception. Ther are exceptions, and in fact many of the things you can do to increase your chances of conception will, in themselves bias the gender distribution at least a bit.

Beware of anecdotal evidence
The fact that we start with around a 50/50 chance of either sex has led to a wonderful confidence trick:

• Offer a 100% money back guarantee.
• Provide none some or all of the suggestions below as being proprietary.
• Do no work and keep about 50% of the money you are given.

The original version of this used a “potion” made simply of water. The later more sophisticated version used injections of saline solution. Clearly neither had any effect on the gender of the child, but it did not matter.

Clinics using the salt water injection had a whole set of satisfied customers willing to testify to how well it had worked for them. The ones who did not get what they want were given their money back and so kept quiet as they did not feel they had a cause for complaint.

Some of the confidence tricksters out there now get a better than 50% chance of keeping the money they are paid as they get you to do the things below to lower your chances of conceiving the unwanted gender. Some of them even believe in their proprietary products. So far I have not found any that can offer an independent study that shows a better success rate than someone using the tricks below. If you do, please feel free to get in touch with me and let me know. If on the other hand you use one and it works do not bother to let me know, as at least half of their customers will be in the same boat as you.

Gender Selection Overview
Back to the factors that really have an effect on the gender of the child. There are a lot of old wives tales about selecting the sex of your child by how and when you have sex. Interestingly many of these tales turn out to have some basis in fact.
It is easy to dismiss all of them by bringing up counter examples, where people followed all the advice to select a child’s sex and it did not work. This is because we are dealing with millions of sperm which means that no matter what you do there is a chance that an unexpected sperm can sneak around and surprise you. In effect we are dealing with probabilities, and while we can stack the odds by being careful with our sex we cannot fix the race.

If you absolutely have to select the sex of your child, for reasons related to genetic diseases for instance, the only way to do it is through artificial insemination where they can select individual sperm and individual eggs. Doing this because of simple preference is not a good idea as cultures tend to have a gender bias.

An example of this took place in Asia, where most couples wanted boys. Through a variety of means from abandonment and infanticide through to genetic selections, people managed to select for male children. Suddenly there was a shift in the population bias so that hundreds of thousands of male children had no realistic potential partners as there were not enough girl children to go around. That said in some parts of Asia the government is making progress at rectifying the situation.
In China's Huaiyuan County, a pilot program gives parents of girls tax breaks and $240 in cash. As their local official says, after two years of this campaign, they have achieved remarkable results. The sex ratio in Huaiyuan has changed from 160 boys for every 100 girls to 120 boys for every 100 girls born there.

The 1990 Human Fertilisation & Embryology Act allows sex selection only for couples carrying a genetic disease which would be passed on to their children, and not for social reasons. None the less I am going to detail the things that can affect the gender of the child. This is not illegal as the act is referring to the medical arena, not to things you do as part of your sex lives at home. You can use the following tips to try to stack the odds a bit if you want, or equally you can look back at what happened and try to guess the sex of the child before the scan makes it possible to tell, or the birth shows you the reality.

In all of the following when I refer to “boy sperm” I mean sperm, which if they successfully fertilise an egg will probably produce a male child, and when I refer to “girl sperm” I mean ones which will produce a female child.

Keep an eye on the weather and wait for a cold snap. Research found that more boys are conceived after heatwaves and more girls after cold snaps. Sex ratio seemed to correlate with temperature about one month before conception. Hot summers or unseasonably warm patches were followed by the birth of more boys, while unusually cold weather favoured girls. This may be because of the effect of temperature on maturing sperm in the testes, with sperm carrying a female X chromosome more sensitive to heat. Equally there could be some non-causal link.

Missionary for a girl, doggy style for a boy due to the acid swimming distance.
Finally, in trying for a boy, ‘How to Choose the Sex of Your Baby_, by Dr. Landrum B. Shettles, MD, and David M. Rorvik. Published by Doubleday & Co.; copyright 1984.’ recommends a nice cup of caffeinated coffee for the man, right before sex -- he isn't clear on how or why this works, but apparently it gives the Y-sperms a jolt!
Scuba diving biases towards girls has a whole lot of myths, most with no validity at all, but I found it funny.

Old wives tale: In a couple if the woman comes first a girl child is more likely, if the man comes first a male child is more likely.

It looks ridiculous at first glance, but there is a basis in fact here. If the woman does not come with or after the man then no pumping of sperm will take place. As well as lowering the overall chances of conception this will bias things against the boy sperm because they are less likely to survive a swim though an acid vagina.

Extreme measures for gender selection
Some American books and articles I have come across recommend using douches to select gender. Acid douches make girls more likely; alkali douches make boys more probable. So a lemon juice and water mix would kill a load of the boy sperm giving the girl sperm a competitive advantage.

Bicarbonate douches (alkali) can help to improve the chance of conceiving for a few people with unexplained infertility. But there's no evidence that it affects the sex of the baby, and douching may also be harmful.

A pure lemon juice douche would cause pain and kill off any chance of actually having sex that night, so be aware extreme measures are not necessarily a good idea. I have to say that the idea of douching with water and bicarbonate of soda for a boy also seems a bit too far to me anyway, and I am not really in favour. That said it is as well to know what could be done, even if you are too sensible to actually do it.

Inertial separation of sperm into dizzy girl sperm and dizzy boy sperm through size (girl sperm are bigger). This is a recognised successful mehod but is usually only available through expensive clinics.

Anal sex
As I mentioned under Nutrition above, around 8% of couples of who use anal sex as a method of birth control have pregnancies each year. It used to be said that sperm can sometimes penetrate the membrane between the anus and the vagina after being deposited during anal sex. The current theory is that these are “splash conceptions” where the sperm actually find their way around to the vaginal opening from the anus.
A pregnancy conceived by anal sex carries a significant risk of the bacteria associated with feces being sealed in with the developing embryo. During the first months a foetus does not have an immune system and bacteria can cause severe disabilities. Even apart from the odds against conception, the risks mean this is not a good way to conceive. If you are trying to conceive I would suggest avoiding anal sex for the duration.

If you do practice anal sex whilst trying for a baby at the very least wash the penis after engaging in anal sex and before inserting into the vagina, otherwise, the risk of bacterial transmission from anus to vagina is extremely high.

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