Researchers in a 2023 study found improved frozen embryo transfer outcomes in patients who had protected sex the night before the procedure, that was not attributed to semen contact.
Sex during different stages of IVF is often discouraged, although some research points to a benefit in success rates as a result of exposure to semen (Crawford et al. 2014). However, it isn’t known if protected sex, without semen exposure, can have a benefit on frozen embryo transfer (FET) outcomes.
Hou et al. (2023) performed a randomized controlled trial (RCT) that compared FET outcomes in patients who had condom-protected sex the night before the procedure (n = 116) or didn’t (n = 107). The study took place between 2018 and 2019 at a single university-based IVF center in China.
Key information:
- Female age was ≤35 years.
- The partners were heterosexual.
- The same physician performed all the transfers.
- Medicated FETs were performed.
- Infertility was due to tubal factor in all patients (no other diagnoses were included).
- Four or more day 3 embryos were available, with at least one being high quality.
- All patients had two day 3 embryos transferred.
- The group that had sex the night before the FET wore a condom.
- The group that abstained, abstained for the whole IVF cycle.
There were no differences in baseline characteristics for the two groups (age, BMI, basal FSH, duration of infertility, gravidity, parity, nulliparous, history of spontaneous abortion (miscarriage), number of high quality embryos, endometrial thickness on day of FET).
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Sex the night before frozen embryo transfer improved outcomes
The researchers found improved implantation and clinical pregnancy rates in patients who had sex the night before their FET compared to those that abstained (implantation: 37.07% vs 24.77%, p = 0.005; pregnancy: 51.72% vs 38.31%, p = 0.045).
There were no differences in the biochemical loss rate (11.43% vs 8.70%) or miscarriage rate (<12 weeks; 11.67% vs 14.63%).
Conclusions
This study found improved implantation and pregnancy rates in patients who had sex the night before their FET. They found no differences in rates for biochemical loss or miscarriage.
The authors explain that these positive results may be due to increased blood flow to the female genital region, which possibly could improve endometrial receptivity.
A limitation of this study was that sex was restricted to only a single time before the FET. They also didn’t investigate the impact of intercourse duration, whether or not an orgasm occurred or the use of sex toys. The partners were also heterosexual, so it’s not clear if the benefits apply to lesbian couples.
Some doctors discourage sex before a transfer because of the risk of infection that might interfere with a successful implantation, so it’s important to discuss this with your doctor first.
“In summary, clinical data obtained from this study demonstrate that the “physical” component of sexual intercourse before the day of embryo transfer may improve clinical pregnancy and implantation rates during FET cycles.”
Hou et al. (2023)
Reference
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About Embryoman
Embryoman (Sean Lauber) is a former embryologist and the founder of Remembryo, an IVF research and fertility education website. After working in an IVF lab in the US, he returned to Canada and now focuses on making fertility research more accessible. He holds a Master’s in Immunology and launched Remembryo in 2018 to help patients and professionals make sense of IVF research. Sean shares weekly study updates on Facebook, Instagram, and Reddit regularly. He also answers questions on Reddit or in his private Facebook group.
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