Programmed Intercourse


Programmed intercourse can optimize your natural fertility

Programmed intercourse, also called timed intercourse, is a way to increase your likelihood of achieving pregnancy. Programmed intercourse can be practiced on its own or combined with OI to maximize your chances of conceiving.

How it works

Because of the limited life span of the sperm and egg, conception is possible only during about 6 days of each menstrual cycle—the days leading up to and including ovulation, known as the “fertile window.” Tracking ovulation to identify the fertile window, and timing intercourse accordingly, can optimize your chances of conceiving.

Research suggests that pregnancy rates with programmed intercourse are highest when intercourse occurs the day before ovulation. In one study, pregnancy rates were similar whether a couple had intercourse every day, every other day, or every 3 days during the fertile window. The optimal frequency will be what works best for you and your partner.*

When programmed intercourse is combined with ovulation induction (OI), your doctor will monitor the development of follicles and advise when the “fertile window” is in effect.

*Research by the Practice Committee of the American Society for Reproductive Medicine and the Practice Committee of the Society for Reproductive Endocrinology and Infertility, published as “Optimizing natural fertility: a committee opinion" in Fertility and Sterility 2022;117(1).

Who it’s for

Programmed intercourse alone is an option for male-female couples:

  • With no history of infertility or concerns about their current fertility

Programmed intercourse combined with OI is an option for male-female couples in which the male partner’s semen analysis is normal, and:

  • In which the female member ovulates normally, but the couple wants to increase chances of conceiving
  • In which the female partner experiences no ovulation (anovulation) or infrequent ovulation (oligo-ovulatory cycles)
  • In which the female partner has minimal to mild endometriosis

A recent study showed that OI combined with programmed intercourse had a rate of confirmed pregnancy similar to that of OI combined with IUI.*

*The Practice Committee of the American Society for Reproductive Medicine and the Practice Committee of the Society for Reproductive Endocrinology and Infertility. Optimizing natural fertility: a committee opinion. Fertility and Sterility. 2022;117(1).

Possible side effects*

  • Programmed intercourse itself has no medical side effects, but some couples experience stress from monitoring ovulation and trying to maximize their chances of conceiving.

With OI treatment:

  • Hot flashes, mood swings, breast tenderness, or nausea
  • Rarely, headaches or vision problems
  • Ovarian cysts, which typically disappear over time
  • Increased chance of getting pregnant with multiples (twins, triplets, or more), which can have health risks for both the mother and babies

*This may not represent all side effects. Please discuss with your healthcare provider.


Programmed Intercourse
Ranges in this chart are estimated and may vary depending on each patient’s medical history and physician’s recommendations.

What women can expect in a cycle of OI and programmed intercourse

STEP 1: Testing & assessments

A thorough assessment of your reproductive health is necessary before you begin your cycle. Your RE will conduct examinations, ultrasounds, and blood work to assess your current fertility.

STEP 2: Estrogen-blocking oral medication or gonadotropins

With gonadotropins, your doctor will prescribe either follicle stimulating hormone (FSH) alone, or FSH together with luteinizing hormone (LH). You’ll give yourself injections at least once a day, for a week or more.

STEP 3: Monitoring

Blood work will be conducted leading up to ovulation to monitor follicle growth and hormone levels.

STEP 4: Ovulation

Estrogen-blocking oral medications do not trigger ovulation in all women. Depending on your response to the drug, your doctor may adjust your dosage or talk to you about other fertility medications, such as human chorionic gonadotropin.

When your eggs are almost mature, most women will receive an injection of human chorionic gonadotropin (hCG), which mimics the natural luteinizing hormone (LH) surge your body experiences before ovulation. This triggers the ovaries to release an egg. This is often called a “trigger shot.”

STEP 5: Programmed Intercourse

Following the trigger shot, the couple engages in intercourse more than once over the next 2 days to optimize the chances of conceiving.

STEP 6: Two-week wait

After ovulation and programmed intercourse comes a waiting period before a pregnancy test can be taken known as the “two-week wait.” This can be a difficult time, filled with hope and anxiety. Building a support network can help you during the wait.

STEP 7: Pregnancy testing and care

If you get the joyous news of a positive pregnancy test, your clinic will closely monitor your pregnancy with scans and blood work to ensure the health of you and your baby. You’ll be released to your OB when your pregnancy is 8 to 10 weeks along.


Know your options for stateside infertility services, and how to preserve your fertility before deployment.

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