How to arrange the number of intercourse during pregnancy preparation? Many women who are planning to get pregnant don’t know exactly how to arrange it, so they consult many forums, but they don’t get scientifically correct guidance. In fact, to be honest, the meeting of sperm and egg cannot be completely programmed, there are very, very many uncertainties in it. So, here I can only give you some advice, or to put it more bluntly, what I know so far about ovulation – fertilization – implantation – embryo development I hope this will help you to understand the process and to organize your intercourse. Here are a few of your inquiries: 1. How to arrange intercourse for follicle monitoring? I had an ultrasound today and I have two follicles on my right side: 24x13mm and 21x12mm. Are they considered mature follicles? I don’t know if they will ovulate? Should I continue to monitor? What is the best way to arrange intercourse in the next few days? My doctor told me to have intercourse after ovulation, but I’ve been on some forums and some of them said to let the sperm wait for the egg, so I’m confused! Please guide me. 2. How to arrange intercourse with ovulation test paper monitoring method? I have been using ovulation test paper, and this month I used one test an semi-quantitative ovulation test, the peak appeared at 15:30 on the 31st, still peak at 18:30 in the evening, then intercourse, the value still peak at 24 in the evening, tested at 7 in the morning on the 1st, the value dropped a bit, then intercourse, please tell me, is the chance of winning big? The 2nd and husband quarrel very aggressively, will it be affected. 3. How to arrange intercourse with the method of basal body temperature monitoring? I’ve been using test strips for a few months but I’m not pregnant, so I’m using my basal body temperature this month, but I don’t know if I should have intercourse on the day my temperature is the lowest or the day it rises. I have been told that it should be once in the morning and once in the evening on the day of the lowest temperature, while others say it should be once in the evening on the day of the lowest temperature and once in the morning on the following day, but some people on the internet say it should be within 24 hours after the temperature rises. What is the best time? Can anyone tell me? Before I answer these questions, I would like to talk to you about pregnancy. If we want to fully understand the matter of “pregnancy”, several monographs may not be comprehensive. Here, I would like to try to talk about it in my own words, and if there is something unclear, please feel free to leave me a message on Sina Weibo @LuNan. Let’s start with the anatomy of the female reproductive organs: we start from the outside in, first the vulva, then the vagina, then the uterus, and the portal between the uterus and the vagina is the cervix. The uterus is actually already located in the pelvic cavity, which is commonly known as the belly. Further in the uterus are the bilateral fallopian tubes and ovaries. If you think of the uterus as a little girl’s head, the bilateral fallopian tubes are like the two ponytails of the girl’s head, while the bilateral ovaries are the two orbs of alabaster at the end of the two braids. The uterus is shaped like an inverted pear, but the part of the pear nucleus is empty, which is the uterine cavity. The uterine cavity is connected outward to the vaginal cavity through the cervical canal and inward to the pelvic cavity where the ovaries are located through the fallopian tube cavity. The ovaries of women of childbearing age are filled with many tiny follicles, known as “primordial follicles”. During each menstrual cycle, one of these primordial follicles will gradually grow and when it reaches about 20mm, it is called a “mature follicle”. When the mature follicle reaches a certain level of growth, it will rupture spontaneously like a balloon, and the egg contained in the follicle will be expelled from the ovary, which is also called “ovulation”. Most women have a menstrual cycle of 28-30 days and are expected to ovulate 14 days before their next period, which is around day 16 if you count the first day from the start of vaginal bleeding. After ovulation, the egg, if she is lucky, will be “picked up” by the end of one of the two braids of the uterus, known scientifically as the “umbilical end of the fallopian tube”. The length of this “braid” of the fallopian tube is about 8-14 cm, and once the egg is caught by the end of the braid, it enters the lumen of the fallopian tube and swims in the direction of the uterine cavity. On both sides of the coin, semen is ejected into the vaginal cavity after the couple has intercourse. The semen contains uncountable tiny sperm (at least 40 x 106). The sperm scrambles from the vaginal cavity through the cervical canal and into the uterine cavity. From the uterine cavity, they then move into the lumen of the fallopian tubes. If egg collection in the fallopian tube depends on luck, then the meeting of sperm and egg in the lumen of the fallopian tube should be considered even luckier. This is because from the moment the sperm and egg meet to form a fertilized egg, the birth of a new life is confirmed. If everything is coincidental, the process from ejaculation to fertilization can be completed in 10 or so hours if it is fast. This new life, 11-12 days after fertilization, will return from the fallopian tube lumen to the uterine cavity again if the lumen is wide enough and open. At this time, the uterine cavity is covered with a thick endometrium, like fertile black soil, and the fertilized egg, like a seed, will be lucky enough to implant into the endometrium and complete the so-called “fertilized egg implantation”. If the fallopian tubes are narrowed due to previous inflammation, if the endometrium is thin due to multiple abortions, if endometritis is caused by intercourse during menstruation or when the menstrual period is not completely cleared, which leads to adhesions in the uterine cavity, etc., then unfortunately, the process of fertilization may not happen. Moreover, even if the fertilized egg does come to term, there is a risk of embryonic arrest or even fetal malformation that we cannot anticipate. Since these are no longer part of our discussion in this issue, we will not talk about them for now. Let’s talk about the “pregnancy”. There are several concepts of timing here. The egg survives 1-2 days after ovulation, and fertilization is strongest 24 hours after ovulation; sperm can survive 3-5 days after entering the female reproductive tract. Therefore, the period before and after ovulation is 4-5 days, and the rest of the time is considered safe for conception. In other words, the day of ovulation and the time outside the 5 days before and after it are considered safe. Since ovulation can be delayed or advanced due to factors such as life, emotions, sexual life, health condition and external environment, and additional ovulation may occur, the “arrangement of intercourse” mentioned above can only be described as a suggestion, which is not absolute and not infallible, and we cannot precisely determine which moment ovulation occurs. It is impossible to predict whether ovulation will occur or not, and whether fertilization will be successful after ovulation. Nowadays, the main methods of monitoring ovulation during pregnancy preparation are “vaginal ultrasound monitoring”, “ovulation test paper monitoring” and “basal body temperature monitoring” as we mentioned earlier. We will explain each of these methods in the following paragraphs. Vaginal ultrasound monitoring, as the name implies, is the process of observing and monitoring the growth of the primordial ovaries into mature follicles in the pelvic cavity during each menstrual cycle by using the vaginal probe of an ultrasound device to enter the vaginal cavity of a woman. This is also the most accurate way to monitor follicle development and even ovulation. However, the disadvantage is that it is too costly. A trip to the hospital for a vaginal ultrasound is required in the first 16 days of the menstrual cycle, about 2-3 days. Not to mention the cost of transportation, each vaginal ultrasound will cost$150. A mature follicle occurs when the maximum diameter of the follicle reaches or exceeds 20mm and ovulation often occurs within 24-48 hours. Some people may have polycystic ovary syndrome, where the ovarian surface is thicker and harder, and when spontaneous ovulation is difficult, some medications can also be used to induce and help ovulation. In normal women, when the ultrasound indicates mature follicles, intercourse can be arranged, preferably every other day, for a total of 2-3 times (2-3 nights), i.e. once on the day of ovulation, once on the second day after ovulation and once on the fourth day after ovulation. When converted to a menstrual cycle, this means once on the 16th day of menstruation, once on the 18th day, and once on the 20th day (provided that the menstrual cycle is 28-30 days and regular). Mature follicles usually ovulate on the 16th day of menstruation. If ultrasound monitoring indicates delayed ovulation, you may have polycystic ovary syndrome or you may be too nervous, so nervous that even ovulation is out of order, so for all women who are preparing to get pregnant, please remember: “calm” is important, very important. As for whether the egg is waiting for the sperm or the sperm is waiting for the egg, I think both are possible. I suggest that you wait for the egg, from the day the ultrasound indicates that the follicle has become a “mature follicle”, until the 4th day after ovulation, which is every other day. The actual fact is that if you are always late to ovulate, then you are not going to exhaust the other party, besides, from the point of view of semen quality, too frequent intercourse is also not recommended. The actual fact is that you will be able to get a good deal on your own. Ovulation test paper and basal body temperature monitoring ovulation are not very accurate, there is a big error, not what I recommend. Here I will briefly explain to you. The principle of basal body temperature monitoring method is: when there is no ovulation, the body temperature is located in the low phase, once ovulation and formation of the corpus luteum, due to the involvement of progesterone, the basal body temperature will rise on average 0.5 degrees Celsius compared to the low phase. Figuratively speaking, it is a low phase temperature (e.g. 36.5 degrees Celsius) for 16 consecutive days, followed by a slight increase and this increase lasts for 5-6 days without dropping (e.g. 37.0 degrees Celsius). The basal body temperature has very strict requirements and needs to be taken early each morning, first thing upon awakening, preferably with a mouth gauge. The daily basal body temperature is depicted and the fluctuation of temperature is used to determine if ovulation is occurring. Given that the lowest phase of temperature is not easy to determine, and the jump from low phase to high phase is easier to determine, I suggest that it is better to schedule intercourse from the time the temperature fluctuates from low to high, also once every other day, 2-3 times in total (2-3 nights). The principle of ovulation monitoring with ovulation test is based on the change of hormone level during menstrual cycle to determine whether ovulation is occurring. Since the technology is still not very mature, the reliability of using ovulation test strips to determine whether ovulation is occurring is much worse than that of ultrasound monitoring. The details of how to arrange intercourse when monitoring with ovulation test paper are similar to those described above, so I won’t repeat them here.