We read with interest about the new Fertility device (Twoplus Fertility Sperm guide) that promises to increase the chances of conception by retaining sperm in the vagina for over an hour. The aim is to prevent sperm leakage after intercourse and create a rich pool of sperm in the vagina, thereby increasing the chances of fertilization by enabling more sperm cells to swim up into the uterine cavity.
The device is inserted into the vagina, and the male ejaculates sperm into the pouch of the device. Manufacturers of this device recommend that couples use a lubricant to minimize the male partner’s discomfort during intercourse.
Obviously, the development of any device that facilitates conception is always exciting to the Fertility community.
Although we are yet to see any scientific data to back the efficacy of this device, we anticipate that it would draw great interest among our patients; including same-sex couples who wish to explore self-insemination.
Obviously, the outcome of fertility treatment is influenced by various factors, which is why treatment must always be individualized. Each case is different, and it is essential to ensure that the treatment of choice is suitable for the individual patients.
Devices like this would be much more effective for women who have a good understanding of their ‘body’.
It is extremely helpful for women to understand the ‘fertile window’ and to aim for insemination/intercourse at the time of optimum fertility.
The fertile window is best defined as the 6day interval ending on the day of ovulation. The viability of both eggs and sperm should be maximum during this time. Research has shown that peak fecundity was observed when intercourse occurred within 2 days before ovulation.
Among women who have regular cycles, the likelihood of conception increases during the putative fertile window.
Unfortunately, the timing of the fertile window within a given cycle can vary considerably, even in women who have regular cycles. Although fertility tracking methods (including calendars and apps; cervical monitoring, ovulation detection kits and basal body temperature tracking) can help assist patients to understand their own personal cycle characteristics. A major weakness of these predictor devices is that they are based on the assumption that the timing and duration of a woman’s fertile window are consistent and dependent on cycle length characteristics and trends. But we know that cycles are pretty much variable, and the timing of ovulation can vary from month to month and from woman to woman.
The calendar method is based on the length of the menstrual cycle. The length of the luteal phase (the part of the menstrual cycle after ovulation) is presumed to be about 14days. Thus, the day of ovulation would be cycle day 14 for women who have a 28-day cycle and day 16 for women with a 30days cycle.
The fertile window, therefore, is set as the presumed day of ovulation and the 5 days prior (cycle day 9-14 in a 28 day cycle and cycle days 11-16 in women with a 30 day cycle etc).
Finally, it is important to note that sperm is motile and swims into the cervical canal extremely quickly and shortly after deposition in the vagina. Studies have shown that sperm deposited into the vagina at mid-cycle are found in the fallopian tube within 15 minutes. Sperm has been found in the cervical canal seconds after ejaculation, regardless of the coital position.
Although many women think that lying face upwards for some time after intercourse facilitates sperm transport and prevents leakage of sperm from the vagina, this belief is not backed by any scientific evidence. Lying still in bed or elevating the legs does not necessarily increase the chance to conceive. Motile sperm swims up the genital tract, and some seminal fluid leakage is normal.
Whilst we welcome new devices that help our patients conceive, it is important that the right patient group are identified for each treatment type, and treatment must be individualized.
For more information on the different fertility options available to you at The Surrey Park Clinic, please click here.
Mr Emmanuel Kalu MBBS, DFFP, FRCOG
Consultant Obstetrician and Gynaecologist
Specialist in Reproductive Medicine