Christian Gnoth1,2,3, Ann-Kristin Keil4, Julia Schiffner4, Sylvia Heil4,5, Peter Mallmann6, Günter Freundl5, Thomas Strowitzki7,5. 1. green-ivf, Grevenbroich Endocrinology and IVF Centre, Rheydter Str. 143, 41515, Grevenbroich, Germany. christian.gnoth@green-ivf.de. 2. Clinic and Polyclinic for Gynecology and Obstetrics, University Women's Hospital Cologne, Kerpener Str. 34, 50931, Cologne, Germany. christian.gnoth@green-ivf.de. 3. Section Natural Fertility of the DGGEF, c/o Clinic for Gynecological Endocrinology and Fertility Disorders, University Women's Hospital Heidelberg, In Neuenheimer Feld 440, 69120, Heidelberg, Germany. christian.gnoth@green-ivf.de. 4. green-ivf, Grevenbroich Endocrinology and IVF Centre, Rheydter Str. 143, 41515, Grevenbroich, Germany. 5. Section Natural Fertility of the DGGEF, c/o Clinic for Gynecological Endocrinology and Fertility Disorders, University Women's Hospital Heidelberg, In Neuenheimer Feld 440, 69120, Heidelberg, Germany. 6. Clinic and Polyclinic for Gynecology and Obstetrics, University Women's Hospital Cologne, Kerpener Str. 34, 50931, Cologne, Germany. 7. Clinic of Gynecological Endocrinology and Fertility Disorders, University Women's Hospital, In the Neuenheimer Feld 440, 69120, Heidelberg, Germany.
Abstract
PURPOSE: Many physicians and other healthcare professionals are often asked questions on interfering factors for conception by couples with a desire for children. Such possible disturbances include, for example, the very common minor diseases, stress and also sexual intercourse during the suspected implantation period. Non-scientifically based statements about disturbances in conception cycles, as found in many layman publications and on the internet, can strongly unsettle couples with a desire for children and force them into corset of rules of conduct. Therefore, a systematic scientific evaluation of the impact of disturbances on conception is urgently needed. METHODS: A search for possible disturbances in natural conception cycles together with up to three of the respective pre-cycles in a large cycle database from users of the symptothermal method of natural family planning in Germany was performed. Disturbances were qualified by scientific panel decision and analysed statistically with their effects on the chances of spontaneous conception. Mixed logistical regression models and survival time analyses were used. RESULTS: A total of 237 women with a total of 747 cycles could be included in the analysis. In 61% of all 237 conception cycles, disturbances occurred. The statistical analysis shows that disturbances in natural conception cycles unexpectedly increase the likelihood of pregnancy by an overall factor of 1.32 (95% CI 1.04-1.70). Sexual intercourse in the window of implantation does not decrease the chances of conception. Relaxation states at the time of ovulation and/or during the implantation period have no representable effect and do not increase the chance of pregnancy. CONCLUSIONS: Couples trying to conceive should at least be informed that disturbances in conception cycles, such as minor diseases, stress or sexual intercourse during the implantation period do not interfere with conception. Relaxation has no effect in favour of success. This takes away the guilty feeling of couples, fearing that they possibly did something wrong in cycles without the desired pregnancy.
PURPOSE: Many physicians and other healthcare professionals are often asked questions on interfering factors for conception by couples with a desire for children. Such possible disturbances include, for example, the very common minor diseases, stress and also sexual intercourse during the suspected implantation period. Non-scientifically based statements about disturbances in conception cycles, as found in many layman publications and on the internet, can strongly unsettle couples with a desire for children and force them into corset of rules of conduct. Therefore, a systematic scientific evaluation of the impact of disturbances on conception is urgently needed. METHODS: A search for possible disturbances in natural conception cycles together with up to three of the respective pre-cycles in a large cycle database from users of the symptothermal method of natural family planning in Germany was performed. Disturbances were qualified by scientific panel decision and analysed statistically with their effects on the chances of spontaneous conception. Mixed logistical regression models and survival time analyses were used. RESULTS: A total of 237 women with a total of 747 cycles could be included in the analysis. In 61% of all 237 conception cycles, disturbances occurred. The statistical analysis shows that disturbances in natural conception cycles unexpectedly increase the likelihood of pregnancy by an overall factor of 1.32 (95% CI 1.04-1.70). Sexual intercourse in the window of implantation does not decrease the chances of conception. Relaxation states at the time of ovulation and/or during the implantation period have no representable effect and do not increase the chance of pregnancy. CONCLUSIONS: Couples trying to conceive should at least be informed that disturbances in conception cycles, such as minor diseases, stress or sexual intercourse during the implantation period do not interfere with conception. Relaxation has no effect in favour of success. This takes away the guilty feeling of couples, fearing that they possibly did something wrong in cycles without the desired pregnancy.
Entities:
Keywords:
Disturbances of conception; Implantation; Minor diseases; Natural family planning; Probability of pregnancy; Spontaneous conception
Authors: Luba Sominsky; Deborah M Hodgson; Eileen A McLaughlin; Roger Smith; Hannah M Wall; Sarah J Spencer Journal: Endocr Rev Date: 2017-10-01 Impact factor: 19.871