I could only vote the last one. Like BradandJanet - it is became an issue, I'd tell him. But it hasn't yet, so no reason, really, to bring it up.
I have no doubt that one of our dr's knows. He once asked "so this happened during a week when you were abnormally quite active sexually?"
We looked at each other, then at him and said in unison, "no. Why?"
He just smiled and said, "I'm jealous."
Now - whether he suspects we toss an extra set of hands or two in here and there... Who knows
Spoomonkey