Intercourse Before Oocyte Pickup (OPU)
Intercourse is generally permitted before oocyte pickup in IVF cycles, with no established contraindications in standard protocols, though specific timing restrictions may apply in the immediate 24-36 hours before the procedure when prophylactic anticoagulation is held.
Standard Practice Considerations
The available guidelines do not explicitly prohibit intercourse before OPU. The focus of pre-OPU protocols centers on:
- Infection prevention measures including vaginal cleansing and antibiotic prophylaxis 1, 2
- Bleeding risk assessment through full blood count (performed by 65% of units) and coagulation profiles (35% of units) 2
- Timing of ovulation trigger with hCG administered when follicular maturation criteria are met, followed by OPU 36-38 hours later 3, 4
Special Populations Requiring Caution
Patients on Anticoagulation
For patients with antiphospholipid antibodies undergoing ART:
- Prophylactic anticoagulation with low-molecular-weight heparin (enoxaparin 40 mg daily) should be started at the beginning of ovarian stimulation 3, 4
- Anticoagulation is withheld 24-36 hours before oocyte retrieval and resumed afterward 3, 4
- During this 24-36 hour window when anticoagulation is held, activities that could increase bleeding risk (including vigorous intercourse) warrant consideration, though this is not explicitly stated in guidelines
Infection Risk Management
Standard pre-OPU infection prevention does not include abstinence recommendations:
- Vaginal infection screening is performed by less than one-third of IVF centers 2
- Antibiotic prophylaxis is used by 52% of clinicians 2
- Vaginal cleansing with sterile water and antiseptics is standard practice 1, 2
Practical Recommendations
There is no evidence-based restriction on intercourse before OPU in standard IVF protocols. However:
- Patients on anticoagulation therapy should exercise caution during the 24-36 hour period when LMWH is held before the procedure 3, 4
- Any vaginal bleeding or infection symptoms should prompt immediate clinical evaluation before proceeding with OPU 2
- Standard hygiene practices apply as with any transvaginal procedure 1
Key Caveat
The literature focuses extensively on technical aspects of the OPU procedure itself but provides minimal guidance on patient activities in the days immediately preceding retrieval 1, 5. The absence of restrictions in published guidelines suggests intercourse is not considered a significant risk factor for OPU complications.