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Expert Q&A

	By Craig Sweet, M.D. Reproductive Endocrinologist

Until recently I had 28-day cycles. In July it went to 26 days. I know that your cycle can change. This last cycle was abnormal though. Normally my cycle lasts roughly 4 to 5 days and is light. This month it only really lasted 2 1/2 days and is lighter than normal. Is that going to interfere with us trying to conceive? Also, will it increase our chances if he ejaculates a couple days before my fertile time?

According to most infertility texts, a normal menstrual cycle interval ranges from 21 to 35 days, although I have to admit that a true normal range may be a bit tighter at 23 to 33 days. Regardless, your cycle interval is normal as described above. The duration of a menstrual bleed is less significant and may truly change from month to month.

Some people try to time sexual activity to the day. To do so may be a true error. On average, a woman will get some sort of urinary LH surge (as picked up by the urine test kits) on Day 13 and will ovulate on Day 14. There is so much variance in this that it is hard to truly predict. As a result, it is often just better to have intercourse with a reasonable level of frequency during the middle part of the cycle. Healthy sperm probably live in the upper female genital tract for up to five or six days, so one is often just periodically increasing the concentration of sperm with regular intercourse. As an example (only an example), having relations every 36 to 48 hours from days 11 though 18 will often cover the majority of ovulatory cycles. More is probably fine and less often if necessary. In reality, it is better to have relations early rather than later since once ovulation occurs, progesterone levels start to increase and the thickened cervical mucous make it harder for even the most healthy sperm to head "north."

I have a few thousand active patients right now, and I don't have one on temperature graphs. In addition, if a couple has a reasonable frequency of intercourse during the middle part of the cycle (3-4 times per week), I am unaware of any data that shows that urinary testing for the timing of intercourse is any better than simply just being together with relative frequency.

Look for menstrual patterns and not variations from month to month. I call these frequent changes in a menstrual cycle "ghosts" since every time I seem to look for problems that could cause them, they disappear!

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