Dear Dr. G,

As we are all easing from the MCO (Movement Control Order), my wife and I are just baffled by our inability to conceive.

We are hoping to get some opinion from Dr. G to position ourselves for better sexual advantage.

My wife and I have been married for five years, and we are both bogged down by our respective careers.

During the MCO, we have the rare opportunity to spend more time together. Therefore, we decided to take advantage of the situation to start a family.

Despite constantly trying throughout the lockdown, I am somewhat perplexed with the fact that she is still not pregnant.

Of course, I have learnt from the Internet that we have to strategically make love during the ovulation period.

However, I also read somewhere we really need to consider certain sexual positions to maximize the delivery of the sperms to the intended destination.

On that note, I would like to put Dr. G on the spot on the issues of sexual positions to maximize the chances of fertility.

First of all, what are common sexual positions couples adopt during sex?

What position would you recommend to be most advantageous for the delivery of sperms?

Since we are on the topic of sexual positions, isn’t there a sexual position that also maximizes the pleasure, fulfilling the advantages of procreation and recreation?

Thanks for your advice.

Yours truly,
Positional Peter

A normal man produces an average of 4 to 6 mls of semen per ejaculate. Although the small volume may not be something to brag about, the typical density ranges from 15 million to 200 million sperms per milliliter of semen. Once deposited in the vagina, the sperms can reach the cervix within 15 minutes, regardless of the sexual position.

Of course, the chance of getting pregnant decreases with lower sperm quality. However, a man is still considered fertile if the number of sperms exceeds 15 million per milliliter, with 40% of the gametes having active motility and more that 4% of them having normal morphology. With such hundreds of millions of sperms release in each climax, any unprotected sex around the time of ovulation should really result in pregnancy.

Although there is no robust scientific evidence to support sexual positions to increase the likelihood of conception, certain penetrative positions have the theoretical advantage to facilitate the little swimmers making their ways to the eggs. In the evolutionary point of view, the sexual position maximizes fertility should also be the most pleasurable.

The most famous manuals depict sexual positions for intercourse is arguably Kama Sutra of Vatsyayana. These are believed to written between 1st to 6th centuries outlining sexual positions to achieve different depth of penetrations and angles of genital contacts. In fact, other civilizations such as Greek-Roman documentations of Philaenis of Samos, originated possibly during the Hellenistic Period also attempted to provide accurate details of different positions to maximize pleasure and perhaps fertility.

In modern Days, Alfred Kinsey analyzed the exact roles of different sexual positions in heightening the sensual pleasure. The categorization of primary positions was made in 1950’s, to scrutinize the importance of the maneuver in sexual pleasure. According to Kinsey, there are common sexual positions couples tend to try in their lifetime. These include penetrating partner on top with front entry (Missionary position), penetrating partner from behind (Doggy or Spoons position), receiving partner from the top (Cowgirl position), sitting and kneeling (pounding on the spot) and lastly standing position. 

The well-recognized maneuver that brings sperms in closer proximity to the cervix is the penetrating partner on top with front entry, also known as the classic missionary position. The widening of the lower limbs, allowing the partner’s legs to straddle the body, permitting mutual genital contacts is probably most comfortable position. The position can further enhance comfort when a pillow is placed underneath the pelvis to enhance support. The partner in the lower position can bend the knees, opening up the pelvis upwards to minimize painful thrusting. This can avoid the maneuver of raising the leg in the air after sex, as the pillow under the lower back can also keep the sperms swimming in the right direction with the help of gravity. Some may even argue this the position that can maximize fertility and sexual pleasure, enhancing procreation and recreation.

The Greek Philosopher during the Classic Period of Ancient Greece, Aristotle once said: “Pleasure in the job puts perfection in the work.” Indeed, in the modern day of rat race, it is not uncommon to plan for sex for the purpose of parenthood and neglect the intended pleasure. The task of family planning has render couples to strategically orchestrate sex during the time of ovulation to maximize success, taking the pleasure out of the “job”.

When faced with difficulties, it is also not uncommon to contemplate different sexual positions, enhancing the theoretical chance of delivery of sperms to the intended destination. In reality, the pleasure of sex is physiologically designed to enhance the delivery of sperms irrespective of the sexual positions. Dr. G is often put on the spot by desperate couples treating sex like a tasks aiming to achieve the intended outcome of pregnancy. His view is to: “Position the pleasure back in the job, will soon put the perfection back in the work.”

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