Abstinence and sperm quality: How often should you have sex when you’re trying to conceive?

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How often should you have sex when you’re trying to conceive? The short answer: It depends. (Frustrating, we know!)

Luckily, there’s some good evidence that can help you navigate what’s best for your body and your goals, whether you’re trying to conceive naturally, doing fertility treatment, or even testing or freezing sperm. Here’s what you need to know.

The basics of conception

Women are most likely to get pregnant during their fertile window, the five days leading up to ovulation. In a typical cycle, ovulation happens around day 14 (with “day 1” of the cycle being the first day of menstruation). Many factors can affect the timing of a woman’s fertile window and ovulation. To account for these differences in women’s cycles, traditional advice is to have sex at least every other day during the fertile window.

Does it help to do it more often? A 1995 research article from the New England Journal of Medicine suggested that for couples without fertility challenges, sex every day during the fertile window gave them a 25% chance of conceiving. Sex every other day? 22%.

So, men with normal sperm counts can have sex every other day during the fertile window and still have a good chance of impregnating their partner. Since your chances are only slightly better—and daily sex can be stressful for some couples—every other day is the usual advice for conception.

But for men with low sperm counts, the advice changes.

Does abstinence improve chances of conception for men with low sperm count?

Men with low sperm counts have a better chance of conceiving by having sex every day during their partner’s fertile window. This might be contrary to common sense, since it seems like men with low sperm count should “save up” their sperm, but several studies have suggested that shorter abstinence windows specifically benefit men with low sperm count.

One study of over 9,400 semen samples from over 6,000 patients suggest that, for men with low sperm count, peak sperm motility (AKA sperm movement) was reached after just one day of abstinence.

Interestingly, having intercourse multiple times per day might even help. A study of 576 men at an infertility and IVF unit examined the semen analysis results of men ejaculating twice in a 1–4 hour period. This study found that, in contrast to men with normal fertility, men with low sperm counts had no significant difference in the number of sperm produced in the second sample. The “pooled” samples significantly increased the total sperm count, potentially increasing the chance of pregnancy.

Another small study in 2016 had similar results, concluding that, for men with low sperm count, ejaculating twice in one hour produced more normal sperm and better motility in the second ejaculation.

What happens to sperm quality after a long period of abstinence?

For men with normal sperm counts, studies find that semen volume and sperm count/concentration increase after two days of abstinence. However, sperm quality—the motility (movement) and morphology (shape) of sperm—decrease after two days of abstinence, with a significant impact seen after 7–10 days.

Semen analysis results for men with normal sperm count:

Additionally, the genetic health of sperm suffers with longer abstinence windows. In one study, mitochondrial damage and DNA fragmentation increased with increasing periods of abstinence.

Sperm DNA fragmentation analysis results:

Sperm quality is just as important, if not more important, to chances of conception than sperm count. That’s why recommendations for having sex while trying to conceive have to balance the impact of frequent ejaculation on sperm count along with the impact of infrequent ejaculation on sperm quality.
Learn more about sperm DNA fragmentation.

Abstinence before sperm collection for IVF, semen analysis, or sperm freezing

A longstanding recommendation from the WHO suggests that men abstain from ejaculation and sex for a period of two to seven days before collection for in vitro fertilization, semen testing, or sperm freezing. As we outlined above, sperm counts are typically highest after waiting for two days, but sperm quality is negatively affected after seven days.

Learn more in our sperm testing guide.

Understanding your fertility for clear guidance

The biggest takeaway here may be how crucial sperm testing is to your strategy. Arming yourself with a full understanding of your body’s ability to produce viable sperm helps you find the right path for conception.

The real answer to the question “How often should you have sex when you’re trying to conceive?” Use sperm testing for a comprehensive picture of your sperm health, and build a plan based on the results. Sperm testing allows you to take charge of your fertility and be part of the conversation with your partner when the time is right.

Sperm testing can:

• Help you decide how often to have sex during your partner’s fertile window. A normal, healthy sperm count could give you the option for a less demanding intercourse schedule, for example. On the other hand, couples experiencing challenges with sperm count might consider having sex twice a day during ovulation.
• Help you plan. It takes around 74 days for any lifestyle changes to affect sperm. If your test results turn out less than ideal, you’ll have the chance to make necessary changes well before you try to conceive.
• Give you more choices. Lifestyle changes cannot fix everything. If you know your situation is beyond those changes, you can make thoughtful plans for a different solution and avoid years of painful wondering.

With advancements in at-home sperm testing, you’ll get clear answers, privacy, and the right knowledge and tools to decide for yourself what’s best. And that is the most valuable thing of all.

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