UK (Commonwealth Union) – In recent decades, societies around the world have been grappling with a significant demographic challenge: low fertility rates. This global phenomenon, characterized by declining birth rates, poses profound implications for economies, healthcare systems, and social structures. Many scientific factors have been believed to contribute to low fertility rates.
A recent Cochrane review, conducted in collaboration with researchers from Oxford University, the Royal Berkshire Hospital in Reading, and the Princess Anne Hospital in Southampton, has shed light on strategies to enhance the likelihood of successful conception. The findings suggest that employing timed intercourse with the assistance of urine ovulation tests likely enhances both live birth and pregnancy rates in women under 40 who have been attempting to conceive for less than 12 months, as compared to engaging in intercourse without ovulation prediction.
This comprehensive review encompassed seven randomized controlled trials, involving a total of 2,464 women or couples actively pursuing conception. The review underscores the critical importance of identifying the narrow window for optimal conception within a woman’s menstrual cycle. This window, dictated by the limited lifespan of both sperm and egg, commences approximately five days before ovulation (the release of the egg) and extends until several hours afterward.
Various methods can be employed to pinpoint this fertile period, including the utilization of urine ovulation tests (which employ dipstick devices to detect hormonal changes in urine, signaling the impending ovulation), fertility awareness-based methods (FABM) such as calendar tracking and monitoring changes in cervical fluid and body temperature, or even ultrasound to detect the moment of egg release. The primary objective of this review was to evaluate the advantages and potential drawbacks of timed intercourse concerning pregnancy outcomes, live births, adverse effects, and the overall quality of life for couples striving to achieve conception.
The study’s findings revealed that synchronizing intercourse with the fertile period, facilitated by urine ovulation tests, substantially increased the odds of pregnancy and live births by an impressive margin of 20% to 28%, as opposed to a rate of 18% observed when urine ovulation tests were not employed. These promising results are particularly relevant for women under the age of 40 who have been actively trying to conceive for less than 12 months.
Tatjana Gibbons, a DPhil researcher at Oxford’s Nuffield Department of Women’s & Reproductive Health and lead author on the study, said: ‘‘Many couples find it difficult to achieve a pregnancy, which can lead to concerns about their fertility.’
‘The finding that a simple and easily available urine test can increase a couple’s chance of successful conception is quite exciting because it can empower couples with more control over their fertility journey and could potentially reduce the need for infertility investigations and treatments.’
Professor Christian M Becker, from the Nuffield Department of Women’s & Reproductive Health, indicated that the rigorous standards of evidence demanded by a Cochrane review render the moderately high-quality evidence supporting the efficacy of urine ovulation tests particularly impressive. Also stating that it is surprising, given their extended availability in the market.
Nonetheless, the research team has exercised caution in their interpretation of these findings due to a noteworthy caveat. Many of the studies included in the analysis were funded by the manufacturers of urine ovulation tests, which calls for a prudent consideration of the results.
Furthermore, the study did not yield sufficient evidence to draw definitive conclusions regarding the impact of other methods under investigation. This includes the effect of timed intercourse on clinical pregnancy (confirmed through ultrasound), as well as the comparison between using fertility awareness-based methods (FABM) in conjunction with timed intercourse versus engaging in intercourse without ovulation prediction.
The comprehensive paper, titled ‘Timed Intercourse for Couples Endeavoring to Conceive,’ has been published in Cochrane.
