Intimate Relations

            In the years which I have discussed marriage with couples, I find that the topic of sex is one of the most difficult to present, and yet one that cannot be avoided. Our society is filled with odd ideas about the proper role of sex both within a marriage and outside the bounds of marriage. Even knowledgeable Christians are influenced by the ideas of the world around them. Sometimes they participate in deeds that they did not recognize as wrong. At other times, they cause themselves difficulties by their zeal in trying to avoid the errors of the world.

            At the time of this writing, the average age for a couple’s first marriage is 27. Yet less than 100 years ago, the average age was 21. At the same time, the average age to reach puberty was 16 in the previous centuries, according to many sources, but today the average age is 11. While it is wonderful that men and women are waiting until a more mature age to decide on their life partners, they are also spending more time facing the temptation of sex. Too many have yielded to the pressure. The actions they have taken often have a major impact on the remainder of their lives.

            Even with all the pressure exerted by society to experiment with sex prior to marriage, I am pleased to run into many couples who have never had sex and plan to wait until their marriage to experience its pleasures for the first time. Even though men and women live in bodies that exhibit sexual urges for many years, it is amazing how little we know about the process of sexual intercourse. True, the public schools have been teaching about sex for decades, but I have found little of that teaching remains in the couples with whom I have talked. At the time they heard about sex, it was a distant event that did not apply to them. Also, the topic is extremely embarrassing, especially to young teenagers who are not used to the sexual responses of their own bodies. Even with young men or women who have experienced sex, the number of misconceptions about sex is tremendously large.

            For these reasons, I spend a good deal of time reviewing the basic details of the reproductive system and sexual intercourse. Even if you know the bulk of the material, there will be facts presented which will fill in the gaps in your knowledge and correct a few misconceptions you might have. Since this book will be read by a wide variety of couples, I will try to cover a broad range of topics. If I miss one you are particularly interested in learning about, please write to me and I will do my best to answer the question. This particular edition is being released to the Internet. Since there is no control over who may read the contents, I'm greatly scaling back the contents. If you are interested in further details, I would suggest talking to a local counselor or ordering the printed version of the book.

Your Questions

Hello. I am 39 years old I have a son; he is 6 years old. My husband and I are doing our best to have another child. I have done vaginal laporoscopy and the doctor found adhesions in the uterus. My husband's sperms are 100 million and the motility is 70%. Is it possible to get pregnant? How long do sperms live inside me in this case?

In regards to your husband, a sperm count over 50 million per ejaculation is considered good. Motility is a measurement of how many of those sperm are actively moving in a fashion that can lead them to an egg. Any value over 50% is considered good. It is possible to father a child with less sperm and less mobile sperm, but the odds begin to rise against it happening.

On your side, the adhesions would definitely impact fertility. An adhesion is scar tissue left over from some type of trauma to the uterus, such as a prior abortion, prolonged use of an IUD for birth control, or an infection, such as endometriosis. Adhesions can be removed via surgery. Until such time, the scar tissue interferes with a fertilized egg from finding a place in the uterus in which to plant itself and mature. Depending on the extent of the scarring, it is still possible to become pregnant, but the odds are considerably less.

After ejaculation sperm lasts for up to six days. Thus sexual intercourse any time within six days of ovulation can lead to a pregnancy.

I wrote to you before about my adhesions in the uterus, but I forgot to tell you that the doctor removed all of them during a hysteroscopy. When I woke up from the anesthesia, he told me that I will have my period on time which was going to be after four days from the date of the hysteroscopy. I had my period on time as usual and he said there will be a great chance to get pregnant the very next month. But what happened is the next month (March) I was suppose to get the period on the 27th March, as my last period was 28th February, unfortunately, I didn't receive my period until today 31 March. I did a pregnancy test and it was negative. The doctor said that I am stressed and he gave me a medicine called utrogestan (progesterone) to regulate my period. I am so much upset. I am fighting with time because as I told you before I am already 39 years and I have a six year old son, he wants so much a brother or sister. I don't know what to do. By the way when I have intercourse with my husband all the semen comes out, I don't feel them inside at all and my husband says that he feels like a wall is preventing him from penetrating, what is this? Thanks sir for your concern, please write to me and pray for us.

I agree with your doctor, you do sound like you are getting stressed about the situation. I'm glad the surgery was successful, but you need to realize that even in the absolute best of circumstances, you won't get pregnant every month you try. The normal case for two healthy adults is an 85% chance of getting pregnant in one year's time of trying. Or another way of looking at it, the odds are on average that it will take about five months of trying to actually become pregnant. Sometimes it is sooner, some times it is later. Since you have had some scar tissue, it might take a bit longer than normal.

A woman's menstruation period can vary up to two weeks. It can be as short as 14 days and as long as 32 days. The average is 28 days, but this is only the average. Stress can cause the time period to shift. If your normal 28 days was March 28, then a three day delay is nothing to be concerned about. But the fact that you had a period means that you didn't manage to get pregnant this month.

I know you are worried about your age, but many women are able to have children with little or no complications up to around the age of 45. So relax, you still have time.

My only concern is that you seem to be trying for the wrong reason. Having a child isn't something you should be doing to please your son. You should be having children because you and your husband would like to have another child. Tell your son that you and his father are interested in having another child, but whether one comes or not will be up to God. "Behold, children are a heritage from the LORD, the fruit of the womb is a reward" (Psalm 127:3). Rather than trying to force God's hand, relax and leave your cares in His hand. He will do what is best, even when we may not fully understand.

If for some reason you are unable to bear a child after trying for a year or two, consider adopting a child. There are many children who need a home and you are wanting a child. Open your heart and you will find joy.

I am going to be married next month. I would like to know if is there any problem if a husband and wife's blood group are same, as we are both A+.

Blood is grouped into several types: A, B, O, and AB. These blood groups are important when transfusions are necessary. In addition there is a second factor called Rh. You and your future wife are both Rh positive, like the majority of the world.

In a marriage, the Rh factor is a consideration only when the wife is Rh negative and the husband is Rh positive. If the woman becomes pregnant, there is a strong chance that the child she bears may be Rh positive, since Rh positive is the dominant trait. While the placenta separates the mother's blood from the child's blood, it is possible for antibodies to cross the membrane. A Rh negative mother can produce antibodies against Rh positive blood which would lead to harm to her unborn child in a future pregnancy.

The antibodies are not produced until the mother is exposed to Rh positive blood, either through a transfusion or by having a child with Rh positive blood. Thus, the first child is rarely a problem, though if a mother miscarried, that counts as the first child. In very rare cases, a Rh negative mother may begin producing antibodies against Rh positive blood near the end of her pregnancy.

Once a mother begins producing antibodies against Rh positive blood, it can't be stopped, but it can be suppressed. Doctors will generally given Rh negative women who are pregnant or seeking to become pregnant a shot to suppress the production of antibodies against Rh positive blood. This gives the child an opportunity to develop normally.

My wife and I are starting the "let's get preganant phase". She went to the doctor and everything looks good to go . My question is when we are done having sex, after I ejaculate into her, how long does she have to wait until she can get up, move around, and clean up? I thought someone told us to stand on your head for 20 minutes?

As hard as it is to believe (at least it seems so judging from the mail I receive), there is no necessary waiting period. Sperm from you semen is able to reach an egg in about twenty minutes, if one is present.

Let's start with the basics. Each time you ejaculate, you release about a half-billion sperm. Chemicals in your semen wake the sperm up so they begin to swim. A sensor in the sperm is able to tell the sperm which direction a egg is in your wife's body, and off they go. Even though you release about two teaspoons of semen, the sperm don't remain in the semen. The excess semen eventually flows back out of your wife's vagina. But even then, it coats the inside of her vagina on the way out -- in other words, not all of it comes back out.

Conceiving a baby is more a matter of timing in which the odds are highly in your favor. A typical couple, trying to have a baby will have an 85% chance of finding a baby on the way in one year's time. An egg is only fertile for 24 hours after it is released, but your sperm is able to survive for up to six days inside your wife. Not all the sperm survive that long. The population will decrease each day. But so long as you had sex within six days of when she releases an egg, the odds are that she will become pregnant.

The hard part is figuring out when she is about to release an egg. A woman releases an egg 14 days before the start of her next period. But the menstruation cycle can be variable, so you don't always know exactly when the optimal time is. One myth is for the husband to "save up" having sex until the optimal day. It actually doesn't help matters for two reasons: 1) you can easily miss the optimal day, and 2) sperm don't last forever, even when they are in a suspended state in the man's body. You might have a greater quantity of semen (but not that much greater), but it might be full of more inactive sperm. The better way is to have sex regularly and frequently, say every one to three days, focusing especially on those days of the month when your wife is more interested in sex, which just happens to coincide with the release of her egg.

For more information, read the chapter on Contraceptives, but read it with an eye toward trying to cause a pregnancy than trying to prevent one.

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 best practices for this problem?

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 are managing to swim out and into your uterus.

I am 38 years old. I had one of my ovary removed shortly after I gave birth to my daughter in 2003. Since giving birth I have had very normal menstruations each month and it varies approximately every 28 days. My last period began twelve days ago. My husband and I are trying to have another baby. Is there any chance that I can conceive, even though I only have one ovary? What should we do? Please help me as I am worried. We don't have enough money to have me checked by the doctors. Thank you very much in advance. Please let me know as soon as possible.

For women who have two ovaries, one ovary each month releases an egg to be fertilized. Usually they take turns, one releasing an egg one month and the other releasing an egg the following month. When a woman has only one ovary, then that ovary tends to release an egg every month. So the odds of you getting pregnant is not all that much different than before you lost your ovary.

There are many factors which allow pregnancy to occur. Most of them cannot be determined without an examination by a doctor. For instance some women end up with scarring in their fallopian tubes. The egg must travel down these tubes to reach the uterus, but scar tissue can block the way for the egg. If the tube on the side with the remaining ovary is scarred, then you will have normal cycles, but you won't be able to get pregnant.

The fact that you have regular cycles indicates that you are eating well and that your hormone levels are probably normal. However, once again, nothing can be certain without a check up.

As you get older, the possibility of having a defect that interferes with conceiving increases. Generally women over 40 have a harder time conceiving a child than younger women.

The best time to conceive a child is two weeks before the start of your next period. Since you know fairly well when that time is, you and your husband can take advantage of that. A husband's sperm lives about six days after ejaculation, but the number of surviving sperm and their activity drops off each day. Some people think that holding off sex until the "perfect" day will increase the odds, but it actually decreases them.

First, a man releases about the same amount of sperm each time he ejaculates. The amount of fluid the sperm is in (the semen) might increase a bit, but the number of sperm cells remain about the same.

Second, sperm is used in the order it is produced. So by holding off you are using older sperm cells.

Third, if your husband works in a hot job, the heat can kill his sperm. Holding on the sperm just gives them more exposure to heat.

Fourth, it is very easy to miss the perfect time. The sperm cells must be in place before ovulation. There is only a 24 hour window from the time an egg is released to the time it can be fertilized.

Thus the best way to become pregnant is to start having sex about three weeks before you expect your next period to begin as often as you can for about ten to twelve days. This will insure that the freshest sperm is available for your egg. Your husband can also improve the quality of his sperm by wearing loose, light clothing and making sure he has breaks from the heat (if this happens to be the problem).

Thank you very much for your immediate answer. I really appreciate them so much and it gives me more hopes and knowledge as to what should we and shouldn't do. As to your explanation, it gives me a clear view on the matter. Just hoping to get pregnant soon. Please pray for us.

More power to you and may you help more people like me who are confused with our body. May the Lord bless you and your family.