Scheduled intercourse: the simplest method of fertilization
Scheduled intercourse is a fertilization method that uses drugs to stimulate ovule production in women, scheduling ovulation and thus increasing the chances of becoming pregnant. After the procedure is done, the couple is scheduled to have intercourse in that period in which the woman produces more eggs. The technique was created in the 60's and has been available in Brazil since the 70's, being considered one of the oldest methods of human reproduction.
Induction of ovulation
How Coito is made Scheduled
In order to stimulate the ovaries and induce ovulation, medications administered from the beginning of the menstrual cycle are used. There are two types, those given orally, such as clomiphene citrate, or by subcutaneous injections, the case of gonadotrophins, which act directly on the ovary follicles, where the egg develops. The dosage of the remedy is individual, and varies according to factors such as age, number of ovarian follicles, weight and height.
Ideally, a maximum of three follicles should be stimulated. During the use of the medications, follicular growth is monitored by serial ultrasound and hormonal dosing. Once the follicles reach a suitable size, the subcutaneous injection of the hormone hCG, which allows ovulation to occur between 36 and 40 hours later, is applied. During this period the couple should have sexual intercourse, and in 15 days it is possible to take the pregnancy test to check if the method was successful.
Duration of treatment
Treatment with the medication lasts on average 15 days, counting with the beginning of the medication, initiated on the second or third day of the menstrual cycle, until the day of the programmed sexual intercourse. After 15 days, the woman can already perform the pregnancy test. If the result is negative, it is possible to resume treatment at the next menstrual cycle.
Oral remedies are used for five consecutive days. Injections are applied for 10 consecutive days on average, and can vary from 8 to 12 days, according to the woman's menstrual cycle. The application of the injection is subcutaneous and can be done in the greasier region of the belly or thigh, for example by the patient or the partner, since the process is not painful.
The follicle growth is monitored four times days after the first injection of the drug or the first injection, using serial ultrasonography and hormonal dosing.
Adverse effects of medication
It is common for a woman to experience abdominal discomfort, mild cramps, swelling, irritability, pain in the breasts and headache for one time. Doctors guarantee that there is no risk of developing cancer of the ovaries, even because the drugs are given for a short time.
For whom Scheduled Coitus is indicated
The method is usually indicated for couples who can not have children due to ovulation problems, but have examinations proving that semen and uterine tubes are normal. This is assessed from the patient's history in which she describes her menstrual cycles according to the number of days of menstruation and the interval between bleeds. After that, hormonal exams, tubal evaluation performed by hysterosalpingography and transvaginal ultrasonography in women are also performed. In men, semen evaluation is indicated by the spermogram ...
Some women with a history of rare menstruation or with polycystic ovarian syndrome may present resistance to the drugs and can not stimulate the follicles.Preparation for Scheduled Coitus
Every woman who wishes to become pregnant needs to have pre-pregnancy care, such as having the correct weight, having the vaccines up to date, avoiding overeating, not smoking, using folic acid and controlling chronic diseases such as diabetes, and hypertension.
In order to be more likely to succeed, it is necessary to use induction medications at the correct times, especially for injectables.
What to Expect from Scheduled Coitus
of the method is about 20 to 25% of cases. Usually this rate decreases according to the woman's age, especially after the age of 35. This is because the woman's natural ovules are used, which since they have existed in the ovaries since her birth, end up aging, which can cause unviable embryos due to genetic alterations or malformations.
Experts indicate up to three attempts, which can be made without detriment to women's health. If the couple still can not get pregnant, doctors usually point to other methods, which have higher success rates, such as artificial insemination.
Scheduled Coitus Risk
There is a 10% risk of one twin pregnancy because more than one follicle is stimulated. And every pregnancy that involves more than one child poses risks both to the fetus and to the mother herself, as there are greater risks of preterm birth and complications such as pre-eclampsia, diabetes, anemia.
There may also be a so-called Hyper Stimulation Syndrome of the ovary (SHO), when there is an increase in the production of estradiol due to the excessive development of follicles, causing swelling and increasing the risk of thrombosis, especially if fertilization occurs. However, the picture is less common in Scheduled Coitus, occurring in about 1% of cases, since the drugs are used in smaller doses than in In Vitro Fertilization, for example.
Ovulation induction medications can be obtained in pharmacies without a prescription. However, if the woman decides to use them on her own without the evaluation of a specialist, she will be exposed to several complications, such as physical discomfort due to the wrong dosage of the medication and multiple pregnancies of up to four or five quintiles.
Contraindications of Coitus Scheduled
Treatment as a whole has the same contraindications as a natural pregnancy. Women with diseases that can be potentiated during pregnancy, such as heart and kidney disease, that have genetic disorders and infectious diseases that can be passed on to their children, should prevent pregnancy. women with ovarian, uterine, or breast cancer, chronic liver disease, and tumors of the hypothalamus or pituitary gland.
Where to Have Access
As one of the simplest assisted reproductive procedures, it can be found mostly of clinics. A gynecologist who knows how to perform transvaginal ultrasound and work with reproductive endocrinology is able to perform an ovulation induction.
Fertility specialist gynecologist Augusto Bussab (CRM-SP 98.488), São Paulo
Reproductive specialist gynecologist (CRM-SP 130.201), from the Clínica VidaBemVinda, from São Paulo
from the University of São Paulo,
To understand how reversal works, you need to know first what vasectomy is. The treatment done by men who no longer want to have children. The surgery consists of a cut in the testicular pouch, which interrupts the passage of sperm through the two vas deferens. The semen continues to be expelled in the relation, but without gametes.
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