Question:

It's been almost two years since we have been married and trying to get pregnant. we have visited the gynecologist and was told that my husband has a low motility rate. Could you help me with the best ways of getting pregnant with an issue like that? We have been planning our intercourse according to my ovulation dates. But the semen just spills out of my vagina after intercourse. Are we doing something wrong? Could you give me the best practices for this problem?

Answer:

There are two measurements of how fertile a man is: one is the amount of sperm he releases with each ejaculation (his sperm count), and the second is the motility rate, which a measurement of how active his sperm swims. A sperm count over 50 million is considered good, though the typical number is 500 million. A motility rate of 50% or higher is considered good. Since your husband's motility is poor, then less than half of his sperm is swimming well.

Sperm doesn't survive forever in a man. Studies have shown that exposure to heat for long periods of time can decrease the motility of a man's sperm. If your husband works a job where he gets hot for long periods of time, he can try wearing cooler clothing and taking breaks to do cooler tasks while he cools off.

"Saving up" for the optimal time isn't going to increase your chances of getting pregnant. In fact, it will likely decrease your chances. One, it is hard to measure when is the optimal time, so it is easy to miss. And two, since he isn't producing high amounts of mobile sperm, holding back just means he has more inactive sperm in his semen.

Sperm is able to survive up to six days in your body, so the best thing the two of you can do is have sex regularly and frequently especially as you near the probable time for your ovulation. What you want to do is build up the number of active sperm in you. Thus if you had sex every day up to the day you ovulate, you will have six days worth of active sperm in you instead of just one day's amount. Even if he had a 25% motility rate, then you have roughly 150% active sperm over a typical man's ejaculation. Now, this is only roughly because sperm die off each day they are in your body. The toughest sperm will survive six days, but many from six days ago will be gone.

The other advantage is that it forces your husband's body to get rid of the older, more likely not mobile sperm and start using fresher batches of sperm, which have a greater chance of being mobile.

So continue monitoring your ovulation cycle, but at a week before the estimated ovulation, start having sex as often as you can and continue to a week after (in case you missed your guess when ovulation would be). This will greatly increase your odds of getting pregnant.

In regards to semen coming out after intercourse, that is normal; in fact, it is what must happen. A typical man ejaculates about two teaspoons of semen. Within about twenty minutes the active sperm swim out of the semen and into your uterus. The rest is just leftovers and flows out of your vagina along with your normal secretions. But even as it is moving out, it is coating the lining of your vagina, giving more sperm a chance to swim toward your uterus. The problem the two of you are facing is not that the semen is flowing back out, but that not enough sperm in the semen is managing to swim out and into your uterus.

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