The IVF process is, well, it’s a lot — from all the ultrasounds, bloodwork, and injections to the waiting, wondering, and tension, you and your partner will be leaning on each other for support the whole way through. So, if you two typically connect best in bed, you’re probably wondering if can you have sex during IVF. The answer is a little more complex than a simple yes or no, but rest assured, you love birds can still have your intimate moments as long as you are careful and understand the risks.
Can you have sex during IVF?
This is an extremely common question among patients, says Dr. Rebecca Flyckt, M.D., board-certified reproductive endocrinologist and division chief of reproductive endocrinology and infertility at University Hospitals. Her answer is “Yes, but...”
“Overall it’s considered safe and healthy to have sex during the IVF process, but with some precautions,” she says. “The biggest concern for patients is as their ovaries start to grow, eggs become larger [and create] multiple cysts, sex can become uncomfortable. I always tell patients that if they have pain with intercourse, that’s their body telling them that it’s probably time for them to pause and wait until after the IVF process.”
“Abstinence during IVF is complicated and depends on who you ask, your health, complications, and many other factors,” says Dr. Peter Rizk, M.D., FACOG, head of reproductive endocrinology & infertility at the University of South Alabama, and fertility specialist for Fairhaven Health. “Pelvic rest, or abstaining from sex while going through embryo transfer of IVF, used to be something that we commonly advised to all patients, but these days for a healthy woman with no high-risk factors, it’s usually totally fine [to have intercourse] barring any other complications or concerns.”
Here’s why it’s important to listen to your body: When you’re in the part of the IVF cycle where you’re doing injections and trying to get lots of eggs to release from the ovaries, the ovaries can get enlarged and kind of top-heavy. When they’re like this, they could potentially twist (called ovarian torsion) and require emergency surgery.
“Having intercourse, especially penetrative intercourse in particular, is not a great idea because you could be at risk of twisting the ovary,” says Dr. Kimberly Keefe Smith, M.D., board-certified OB-GYN at Brigham and Women’s Hospital. “Thankfully it’s really rare, but penetrative intercourse is something that we would want to avoid during the actual IVF cycle, during the injections where we’re growing the follicles.”
You should also talk to your provider about whether it’s safe to get pregnant while you’re taking the medications they’re prescribing during your IVF treatment. Keefe Smith points out that unprotected sex can, obviously, lead to a pregnancy, and some medications you might be taking aren’t safe to expose an embryo to.
Some doctors may also discourage you from having sex after your embryo transfer to prevent them from coming loose or not implanting well, Flyckt says. But she cites a 2020 study which confirmed that sex won’t shake your soon-to-be-baby loose. She says some fertility practices will still advise you to avoid sex until you have a positive pregnancy test, or to wait a week after embryo transfer, but that it’s not necessary.
“They looked to see, does sex during the implantation window reduce the chance of an embryo implanting? And they found that it did not,” Flyckt says. “We don’t need to avoid intercourse after embryo transfer for fear that we’re going to dislodge an embryo. I use that data to reassure patients that if they feel like being intimate that sex is healthy and safe and normal. The data says that you don’t need to do bed rest or pelvic rest.”
Can sex help with IVF success?
Since orgasms have been associated with helping people get pregnant faster, why wouldn’t they help with IVF, too? “There’s a theory that maybe orgasm could be helpful because it’s an endorphin release, and maybe that would be beneficial. I don’t think there's harm in orgasm during the IVF cycle as long as, again, it doesn’t involve any sort of vaginal penetration or anal penetration, just because the ovaries sit right next to both locations,” says Keefe Smith.
“We don’t really see data that sex is harmful or helpful,” says Flyckt. “There has been some question around the time of embryo transfer whether there may be a benefit to having sex. But I think really like when you look at the data, it’s okay to have sex around an embryo transfer. It doesn’t necessarily improve your chance of getting pregnant, but it probably doesn’t lower it either.”
What should you not do in bed during IVF stimulation?
Both doctors pointed out the importance of stopping sex if you experience any discomfort to prevent an ovarian torsion (no thanks). There are a few other things they want you to be mindful of. First: use protection.
“If you’re not using condoms, there’s a chance that sperm that goes into the reproductive tract, even well in advance of the egg retrieval at the end of the IVF process, that sperm can stay alive for upwards of five days and can fertilize any eggs that happen to release in the body either before or after the egg retrieval,” says Flyckt. This means your doctor won’t have control over how many embryos might be in your body, and you could become pregnant with multiples — twins, triplets, even quadruplets, she says.
Flyckt also asks her patients to abstain for two days before they need to collect sperm to ensure they get a good sample. “Before egg retrieval, we usually like a two-day period of abstinence for the male partner. We find that the sperm that we get that we’re going to put together with the eggs on the day of egg retrieval is best quality like after a two-day period of abstinence. So we wouldn’t want patients having sex, you know, the night before the egg retrieval or the night that they do the trigger,” she says.
Flyckt says that sex is one way you and your partner can stay connected through the arduous process of IVF, and that it’s a great way to show support for one another and relieve stress. And all the high hormone levels from your medications are probably upping your libido anyway, so why not have some fun with that little side effect?
Stanford, J. B., Hansen, J. L., Willis, S. K., Hu, N., & Thomas, A. (2020). Peri-implantation intercourse does not lower fecundability. Human Reproduction, 35(9), 2107–2112. https://doi.org/10.1093/humrep/deaa156
Dr. Rebecca Flyckt, M.D., board-certified reproductive endocrinologist and division chief of reproductive endocrinology and infertility at University Hospitals
Dr. Peter Rizk, M.D., FACOG, head of reproductive endocrinology & infertility at the University of South Alabama, and fertility specialist for Fairhaven Health
Dr. Kimberly Keefe Smith, M.D., board-certified OB-GYN at Brigham and Women’s Hospital