Creating your family is supposed to be romantic, but there is little romantic about infertility treatment. As a result, it takes some work to have a happy sex life while in infertility treatment. This is a reality for many people in treatment, but it is seldom discussed. Let’s flip the script and bring this subject out of the shadows.

Making babies should be fun –involving lots of flirting, candles and mood music. Infertility treatment can be a real mood killer with all the charting, testing, and timed sex. It becomes harder and harder for many couples to maintain a healthy and happy sex life while going through infertility treatment.*

We have been trying to get pregnant for 2 years. Sex has become nothing but a chore. My gynecologist said to have sex every day around when I ovulate, so I started charting my cycle obsessively and letting my husband know when we had to have sex. One time, I insisted on sex when he was sick with bronchitis. Nothing has worked and each month when I get my period I am depressed until it is time for us to start having sex again. There is no romance and no fun spontaneous sex in our life. I hate this.

It’s important to note that loss of joy in sex is not a universal feeling for those who are in fertility treatment. Some report that timed intercourse associated with trying to conceive remains fun. Fertility struggles draw some couples emotionally closer together, which make intimacy more special. But those who feel a loss of sexual intimacy report feeling very alone because this is not a subject that is easily discussed.

Reasons Why Infertility Treatment Affects Your Sex Life

Research has found that couples in infertility treatment have less satisfying sex lives. Infertility itself impacts many people’s self-esteem and sense of self as a sexual being. Add to that the effects of infertility medications on our libido and the loss of spontaneity and you have a mixture for a potentially unsatisfying sex life.

Impact of Fertility Medications on Your Sex Life

Fertility medications can absolutely impact your sexual health. Oral medications, especially Clomid, can affect a woman’s mood and her libido. Injectable fertility medications can make a woman feel bloated and the multiple eggs on her ovaries can make sex uncomfortable. Male fertility meds can affect the man’s sex drive as well.

I was irritable and quite frankly “bitchy” the whole time I was on Clomid. I wasn’t really in the mood for anything, much less sex.

Fertility medications made me feel anything but sexy!

Timed Intercourse

In order to get pregnant without infertility treatment, an egg is released from a woman’s ovary, meets up with sperm in her fallopian tubes where one triumphant sperm penetrates the egg. The fertilized egg starts dividing and travels through the fallopian tube to the uterus as an embryo where it will implant and grow for 9 months into a baby. All of this dividing, implanting, and growing depends upon egg and sperm being in the fallopian tubes at the same time, and this required timing your sex to coincide with the woman’s ovulation.

Having times intercourse is not a burden for some couples, especially when they first start trying. It can, however, begin to wear on you as months go by without getting pregnant.

Sex feels like a chore now while it used to be fun. I kind of feel like “why bother” if it’s not when I’m going to ovulate.

Our sex life has become sterile and clinical. No romance.

Sex is just one more thing we have to do. It wasn’t bad at the beginning, but we’re going on almost 2 years of trying and it has gotten OLD.

“Performance” Anxiety

The pressure to perform can affect the ability of some men to maintain an erection. Once this happens a few times, anxiety and fear about it happening again can become a self-fulfilling prophecy. One study found that 22% of men who were part of a couple going through infertility treatment experienced mild to moderate erectile dysfunction.

My husband felt pressured to perform and that really played with his mind. He thought that if he wasn’t able to do it then it would be his fault that we couldn’t have kids.

Impact on Self-Esteem

Researchers have repeatedly found that infertility impacts a person’s self esteem-both for women and men. One survey found that seven in 10 women (71 percent) reported that infertility makes them feel flawed, while half of men (50 percent) say it makes them feel inadequate.

Grief

If you have been trying for a long time to get pregnant, sex can become associated with failure…failure of your body; failure of your dream to become a parent; failure to give your husband a child.

We had at least 48 monthly cycles of trying that failed. That’s a lot of grief tied to sex.

I think having sex is now a reminder in a way that my body doesn’t function and I find sex depressing!

Guilt

Women and men sometimes report feeling guilty for not being able to get pregnant, and guilt is not exactly an aphrodisiac.

I told my husband that he should divorce me and find someone who could make him a dad. My egg reserves are like a woman in her late 40s even though I’m only 34.

I intentionally waited until we had a house and a savings account before we started trying. I was 36 when we started. I feel so guilty for waiting. Guilt puts a wet blanket on wanting to connect in the bed with my husband.

Feeling Resentful

Oftentimes one partner assumes more of the responsibility for solving the couple’s infertility and very often this person is the woman. It is not uncommon for the person doing most of the work to feel a bit (or a lot) resentful of their partner, especially if he doesn’t seem to appreciate what you are doing.

I wanted to scream when my husband complained about having to have sex on a schedule. I had spent hours doing research and had already been to my doctor twice. I was taking medication that made me feel like sh*t, and he was complaining about “having” to have sex. I would have told him to sleep on the couch if it wasn’t when we were supposed to have sex. We had sex, but we were both just going through the motions.

Some partners feel resentful that their partner’s infertility is robbing them of their chance for an easy pregnancy. Although they realize this is unfair, they may still harbor some resentment.

Impact on Womanhood or Manhood

For some, infertility undermines how they feel as a woman or as a man—the essence of their gender identity. How we view our sexuality can and often does affect how we feel about intimacy.

The one ultimately female thing my body was supposed to do was be able to produce a baby. My body, and by extension me, failed at being a female. I know in my head that it is not true, but I can’t help but feel in my gut that it is true. It’s hard to feel sexy when you see your body as a failed woman.

Male infertility is especially hard on men because of our society’s emphasis on equating maleness with virility.

My husband really isn’t interested in sex any more. It might be about his slightly low testosterone, but I think it has more to do with his feeling like his low sperm count means he is not as much a man as our friends who have lots of kids. Guys like to tease about how they can get their wife pregnant just by looking at her. What does it say about him that he can’t get me pregnant no matter what we do.

When Do Things Return to Normal

Most women that I talk with say that it takes a while, but eventually, they get their groove back and start enjoying sex again. How long this takes depends on the woman and couple, but I’ve heard anywhere from “a couple of months” to “about a year.”

I don’t remember how long it took to get back to enjoying sex again after the pregnancy was over after 4 IVF cycles, but I think it is actually better now because we have weathered a storm together and our relationship shows it.

For some, however, improvement takes a very long time.

Infertility and infertility treatment ruined sex for me. I no longer have intercourse because of pain that I think is probably psychosomatic. I did physical therapy for the pain but it never went away! I also have pain during orgasms now. I had a really enjoyable sex life before infertility so it’s a shame but I haven’t been able to recover. It’s been about 5 years like this. The directive to have sex every day, which we were told to do by a fertility doctor, plus miscarriages during that period, probably contributed to feeling like a failure and just being disgusted by sex. I also feel like infertility changed my relationship to feeling feminine and to my gender for a period of time, which gotten much better over time but hasn’t totally healed.

Infertility treatment was a complete disaster for our sex life. Had I known what effect it would have played on me & my marriage I never would have gone down this road.

Some people feel that there is no reason to have sex once they realize that they are not likely to be able to get pregnant with “regular ole sex”. Yes, they realize that sex can be enjoyable and many report that they used to enjoy it, but that once the possibility of conception was gone they lost interest in this form of intimacy.

I find the act of sex pointless at this point. And the fact that I feel this way has made us both depressed and distant. And because we are depressed and distant we feel less like having sex.

How to Get Help

There is no one size fits all solution to maintaining a healthy sex life while in infertility treatment; however, help is available. Couples therapy is often very helpful to learn how to reconnect. It is helpful to find a therapist that is familiar with infertility. Creating a Family has resources on how to find a therapist that specializes in reproductive health.

Many couples find it helpful to take an occasional break from trying to conceive so that they can reconnect without the pressure of conception. Some even use birth control during this break even though the odds of getting pregnant are already low because they want to not have conception in the back of their minds each time they make love.

I cannot recommend enough this Creating a Family Radio Show/Podcast on Impact of Fertility Treatment on Sexual Health. with a panel of three terrific experts:

• Dr. Jody Madeira, a professor at Indiana University-Bloomington, an expert on law and medicine and bioethics, a researcher on the impact of fertility treatment on sexual health, and the author of Taking Baby Steps: How Patients and Fertility Clinics Collaborate in Conception (2018);
• Dr. Beth McAvey, a Board Certified Reproductive Endocrinologist at RMA of NY, and
• Debra Unger, a therapist for over 20 years that specializes in the treatment of couples with infertility.

*Some quotes in this article are direct quotes and some are paraphrases. No names have been used because of the sensitive nature of the topic.

Image credit: Sex by stephanie wauters from the Noun Project; Sex by Rflor from the Noun Project; make love by matias porta lezcano from the Noun Project; love making by anbileru adaleru from the Noun Project; Image credit Natalie Shuttleworth; Image credit Danielle Amy; Image credit Fianeli Arvelo;