Sexual Intercourse During IVF Treatment
Sexual intercourse is not only safe but may actually improve pregnancy outcomes during IVF treatment, particularly around the time of embryo transfer. 1, 2
Evidence Supporting Intercourse During IVF
Improved Pregnancy Outcomes
- Exposure to semen around embryo transfer increases the likelihood of successful implantation and early embryo development, with significantly more viable embryos at 6-8 weeks (11.01 vs 7.69 viable embryos per 100 transferred, odds ratio 1.48) 1
- Sexual intercourse the night before frozen embryo transfer improves clinical pregnancy rates (51.72% vs 37.07%) and implantation rates (38.31% vs 24.77%) compared to abstinence 2
- No increase in spontaneous abortion rates was observed with peri-transfer intercourse 2
Mechanism of Benefit
- Seminal plasma exposure promotes embryo development and implantation through immunological and biochemical factors 1
- The beneficial effect appears to be mediated by both the fluid component of ejaculate and the physical act of intercourse itself 2
Practical Recommendations
Timing Considerations
- Intercourse is beneficial during the peri-transfer period, specifically around the time of embryo transfer 1, 2
- One act of intercourse the night before embryo transfer is sufficient to confer benefit 2
- There is no evidence that intercourse during the implantation window (5-9 days post-ovulation) reduces fecundability 3
Safety Considerations
- No detrimental effects from coitus-induced uterine contractions or infection risk have been demonstrated in properly conducted trials 1
- Barrier contraception (condoms) can be used if there are concerns about infection while still potentially providing some benefit from the physical stimulation 2
Common Pitfalls to Avoid
- Do not counsel patients to abstain from intercourse during IVF cycles based on outdated concerns about uterine contractions or infection 1, 2
- Do not advise avoidance of intercourse during the peri-implantation period (5-9 days after ovulation), as this does not reduce fecundability 3
- Recognize that the evidence supports intercourse during both fresh and frozen embryo transfer cycles 1, 2