The only sexual education (sex-ed) I ever received was in a stuffy 6th-grade science classroom when I was 12 years old. They taught us how babies were made and told us to always use a condom or else we’d get a scary genital disease, or worse – pregnant. In fact, they made becoming pregnant sound too easy, like all it took was a lingering look from the boy across the classroom and–bam!–you were pregnant (okay, maybe that’s a slight exaggeration but you get the point). We’ve all heard that story of a broken condom, a missed pill, or even someone that didn’t miss a pill at all, resulting in an unintended pregnancy. But in reality, becoming pregnant isn’t as simple as one act of unprotected sex. The sex-ed I received was fearmongering. Period.
Sex education has been a part of school curriculums in the United States and other parts of the world for years now, focusing on birth control, pregnancy, and the prevention of sexually transmitted infections (STIs) (1). But due to societal taboos, there are still so many aspects of sex that are not touched upon. Some people spend so many years trying to prevent pregnancy, that when the time comes to actually try and become pregnant, it’s common to think it will happen right away (2,3). When it comes to fertility and conceiving, the sex-ed we received in school has left us totally unprepared. Here are some facts about conception that we definitely did not learn in school.
There are other ways to conceive besides the “traditional method”
Sex-ed today has a dangerous focus on heterosexual, cisgender (cishet) sex. In the US, some states still prohibit teachers from discussing sexual orientation in class (1). LGBTQ+ students who attend schools in these states face a more hostile school environment and have less access to the resources and support that is crucial to their sexual development, safety, and wellbeing (1,4). They are disproportionately impacted by poor sex-ed and as a result, experience higher rates of STIs, unintended pregnancies, and sexual violence (5). It’s not surprising then, that sex-ed may have led us to believe that the only way to create a pregnancy was by a cisgender woman having sex with a cisgender man. While that is one way to conceive, it certainly isn't the only way. In fact, transgender, non-binary and gender non-conforming people plan for pregnancy and become pregnant at rates similar to people who identify as women (6,7).
LBGTQ+ couples, single women, and people who need a sperm donor are able to conceive using assisted reproductive technologies such as intrauterine insemination (IUI), in-vitro fertilization (IVF), and surrogacy. While this article focuses on conceiving through sex, it’s important to note that all methods of conceiving are valid and important.
Timing is everything
The fearmongering in sex-ed is probably what started the misconception that it’s possible to conceive on any day of the menstrual cycle (3)–but that isn’t the case. In reality, conception is only possible for about 6 days each cycle; the 5 days leading up to ovulation, and through the day of ovulation–also known as the “biological fertile window” (8). These are the days you are most likely to become pregnant from sex (or insemination) (9). However, knowing exactly when ovulation happens can be tricky. That’s because ovulation can vary cycle-to-cycle, even if you experience predictable menstrual cycles (8). Being unaware of or missing the window of conception is a common reason couples experience challenges in conceiving (9,10).
Frequency matters, too. While having sex once during the fertile window may be enough, having sex every 2-3 days will increase the chances of conceiving (9). Tracking your cycle, and learning to identify the signs of ovulation can help you get the timing right (11). You can also use Clue Conceive to help predict the days in your cycle when conception is most probable.
Getting pregnant can take some time
Now that you know about the biological fertile window, you may be disappointed to learn that having sex on these days does not guarantee that you will conceive. A person under the age of 30 is estimated to have about a 20% chance of conceiving each cycle. By the age of 40, this drops to about 5% (10). That means it can take several months to conceive, and even a year or longer can be typical (12). While research tells us that the probability of conceiving each month decreases with age, it’s not a one size fits all scenario. People in their 40s can still conceive and age should not be a reason not to try.
It’s generally recommended that you speak to your healthcare provider if you are under the age of 35 and haven’t conceived after 12 months of regular, unprotected sex, or after 6 months if you are between the ages of 35-39. If you are 40 or older, you should speak to your healthcare provider right away (13). Indeed, it is recommended that everyone has a preconception visit with their healthcare provider, especially if you have any concerns about your reproductive health (14).
Infertility isn’t just a “women’s issue”
Cultural assumptions about women’s reproductive responsibilities have meant that the physical and psychological burden of conceiving has been placed on women and people with ovaries. But if you paid attention in biology class, you’ll remember that it takes a sperm and an egg to create an embryo and that the embryo must implant in the lining of the uterus to form a pregnancy (15). Sperm plays an important role in this process, but when things do not go according to plan, the blame tends to fall on the person with ovaries (16,17).
Sperm quality matters, and may be the sole underlying factor in up to 20% of couples who experience challenges conceiving, and a contributing factor in another 30% of cases (18). Reproductive health experts agree that sperm quality should be an essential part of preconception planning, so it’s important for partners with sperm to attend the preconception visit, too (16). Adding movement to their daily routine, eating a diet rich in antioxidant foods, and reducing or eliminating tobacco and other substance use can help optimize sperm for conception (19,20,21).
You don’t need to go through the process alone.
Sex-ed definitely didn’t prepare us for the emotional rollercoaster of trying to conceive. The experience can be challenging, so it’s important to have support throughout the process (22). In some cultures, there can be an element of pressure to conceive quickly, and a sense of shame if you don’t, so it’s important to have someone to talk to (23,24). Whether it’s a friend, family member, or partner, leaning on someone you trust can be helpful (22).
It’s common to feel embarrassed asking your healthcare provider intimate questions about your reproductive health. Writing down your questions and bringing them to the visit might help. Scheduling a preconception visit with an OB/GYN, Nurse Practitioner, or Certified Nurse Midwife before trying to conceive can help you learn more about how to optimize your body and mind for conceiving and pregnancy (14). Remember: having access to the information you need is important so you can feel empowered and informed when making reproductive health choices (3,25).
Trying to conceive can be enjoyable
Sex-ed probably didn’t teach you that sex can be enjoyable. Despite an entire organ dedicated to female pleasure (the clitoris), society still holds onto the paternalistic view that women (and people with vaginas) who enjoy sex are somehow dirty or immoral. Not only is it okay for you to enjoy sex in general, but trying to conceive can be fun too.
Some commonly used lubricants can be harmful to sperm movement and therefore negatively impact conception (26), but there are lubricants on the market that can be used when trying to conceive. In the US, you can look for lubricants marketed as "sperm-friendly" or "fertility-friendly", which means it’s been cleared by the Food and Drug Administration (FDA) (27). Other forms of non-penetrative sex can add to the experience (hello clitoris!), and you can incorporate toys into the mix too if you like (just don’t forget to keep them clean!).
While you don’t need to have an orgasm in order to conceive, having one can release feel-good hormones that can help reduce stress (28,29), and reducing stress might even help you conceive (a win-win!) (30). Taking control of the experience by trying to conceive when and how you want can help you feel more empowered and can even make the process more enjoyable (30).
So, what could the future of sex-ed look like?
While we may have learned how to put a condom on a banana, when it comes to conceiving, sex-ed has for the most part, done us a major disservice. In an ideal world, sex-ed would be followed by fertility-ed, followed by maternity-ed, as well as the mental health elements, to help us have a better understanding of our bodies and greater control over our reproductive choices. Clue’s mission is to provide reproductive health information that can help guide you through each reproductive health decision.
If you need a sex-ed redo, Clue Plus has got you covered with tips and advice from our in-house reproductive health experts.