I’m 42, and six weeks pregnant (with a confirmed heartbeat) for the first time via IVF. We’re overjoyed, but there’s a small wrinkle — our fertility doctor has advised us to hold off on sex (intercourse and/or me orgasming) until we reach 12 weeks. The end of the whole first trimester! It’s already been months since we stopped while doing IVF, the embryo transfer, the two-week wait, etc. Waiting another six weeks feels like torture. How risky is it for our pregnancy if we do it?
—Waiting Impatiently
In writing this, I consulted with Dr. Breonna Slocum, a reproductive endocrinologist and ParentData contributor.
First off: congratulations!
I can see why this advice is both frustrating (this is a long time to wait) and confusing. If you had gotten pregnant without IVF, you would not get this advice. Sex and orgasm are not considered risky activities in the first trimester of pregnancy in general. The question for the data is whether there is something different about IVF.
Many doctors will suggest abstaining from sex and (often) exercise during the ovarian-stimulation portion of IVF. This is because of the possibility of pain and the risk of ovarian torsion due to the large number of eggs being developed.
There is also a theoretical concern that sex during the implantation window (this would be in the range of 5 to 10 days after transfer) could affect implantation. The worry is about uterine contractions or an immune response to semen. The evidence to support this is quite weak (e.g. one paper with very small samples and quite noisy results). There is more data from non-IVF pregnancies to suggest this is not a concern in practice. And, in fact, there is at least one randomized trial suggesting that IVF transfers are more successful with semen exposure during implantation.
All of this evidence is about this early implantation period, because of the theoretical concerns. Once the pregnancy is established, as yours is, there is nothing in the data or theory that would suggest sex is linked to miscarriage risk. At this stage, we know that perhaps 90% or more of miscarriages are a result of chromosomal abnormalities, so there is very little that matters in terms of behavior.
This raises an interesting question of how to address this with your provider. It seems to me worth asking — in a spirit of curiosity, rather than confrontation — why they made this suggestion. The answer may be some version of “out of an abundance of caution” or “in case something does happen, I wouldn’t want you to blame yourself.” Once you’ve got an answer here, you can decide what to do with it. But the bottom line is, the data does not support the need for avoiding sex.
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