Why don’t we talk about sex when we talk about fertility? Despite the very personal nature of fertility treatment, the sex life of a couple navigating infertility often becomes a low priority. Let's talk about why this happens and some easy ways to reconnect with your partner.
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Think about all the intimate details that are shared in fertility support groups and across social media: sperm count, diminished ovarian reserve, endometrial lining, bodily fluids, the uterus, ovaries, and even what kind of underwear to wear on retrieval day.
All those topics are commonplace in the world of fertility, but talking about sex? Surprisingly, that’s still a pretty difficult, taboo topic. In some ways, sex seems like the final frontier in conversations about fertility.
So, if you’re wondering whether anyone else’s sex life is affected by infertility and if other people are struggling to keep the spark alive during fertility treatment…the answer is yes.
What if we shifted the focus from sex to intimacy? When we do, the perspective is often very different. Fertility patients (myself included) report that there is often more conversation, more honesty, and an overall feeling of closeness with a partner that didn’t exist before.
Why? There’s more compassion and more empathy - and that’s true intimacy.
With that in mind, let's unpack the top four (real) reasons that couples going through fertility treatment feel, well, less sexy, and explore a few ways to overcome those obstacles, reconnect with your partner, and maybe - even enjoy yourselves again!
We might be able to admit that there can be humor found in the infertility experience (check out Lori Shandle-Fox, Jay Palumbo and Hilariously Infertile for some relatable laughs) but infertility isn't exactly "let’s get it on" level sexy.
Why not? Well, our reproductive organs are intimately (pun intended) connected to our sex (pleasure) organs. When our sexual pleasure is all tied up in procreation, including thinking about the best timing for a pregnancy to occur, it is not sexy. Or fun. Or hot.
In addition, those going through fertility treatment experience intense hormonal fluctuations (which can affect sex drive), increased levels of anxiety, depression and stress, and physical changes to their bodies.
The earliest lessons we learn about sex usually come from health class, friends, the internet, or our parents. And with those lessons comes the concept that sex = pregnancy.
When you're young, you're not worried about being able to get pregnant - you're mostly concerned about it happening before you're ready. But if you end up being one of the 1 in 6 couples worldwide who ends up having trouble conceiving, your views on sex often shift.
When you're having sex hoping it will lead to pregnancy, and it just isn't happening, a few other frustrating things tend to occur. Let's break down four of the most common challenges.
Infertility is a surefire way to take the fun out of sex.
You end up feeling like you must have sex, especially on certain days and times, whether you’re in the mood or not. Foreplay, pleasure, and orgasms usually stop being the goal, and procreation becomes the main focus.
One fertility patient's husband shared his perspective:
"When we were trying to conceive, there were times when having sex felt like a hassle. Having to have sex on certain nights felt more like a chore and it was hard to get in the mood! Especially on nights we both worked until 11pm. Many months we would just bag it because we worked late and that definitely hindered success."
His wife added, "Personally, I felt sad about it and broke down at times because it took all the romance out of the bedroom. For us, it added stress, and we just kept wondering what we were doing wrong, so to speak."
When we don’t become pregnant in a reasonable amount of time, it's easy to feel upset and frustrated that things aren’t working "correctly." Damaged and broken are other terms I've heard countless times in the last 30+ years I’ve been working in the fertility space.
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Regardless of gender, this one applies to any couple.
It doesn't matter if one partner's biology is the "cause" of our struggle to conceive, if we're facing unexplained infertility, or if we need donor sperm, eggs or embryos - the experience is often accompanied by feelings of guilt, shame and disappointment.
When we're navigating infertility, we don’t always see ourselves as whole and complete. And while our bodies sometimes do undergo physical changes during fertility treatment, it's typically a deeper shift (in our perception of ourselves) that impacts us more.
Think about all of the "what ifs" we experience during this journey: if only I hadn’t had an abortion, if only I hadn’t waited so long, if only I'd put having a baby first, if only I'd gotten fertility testing earlier, if only I'd exercised more (or less), if only I didn’t drink wine on the weekend - the list is endless.
Another Illume Fertility patient shared her experience:
"Once treatment began, I found I was hypersensitive while on the medications. They caused physical discomfort, loss of interest in sex, and crazy mood swings - which didn't help the situation. While waiting to get approved for our first IVF cycle, we’re trying to build our relationship back up and shift our views on sex before moving to that next stage."
Is there anything about fertility treatment that actually improves our sex lives or increases intimacy in our relationships? Thankfully, the answer is yes.
RESOLVE: The National Infertility Association offers a helpful fact sheet on Sex, Relationships & Infertility that explores the many facets of intimacy, one of the most important being the practice of "nurturing the relationship."
Understanding what both you and your partner need is a crucial first step to nurturing your relationship. Here are some questions that can help open up the conversation:
Seemingly unimportant things, like taking the garbage out, picking up the mail, calling your partner just to check in, making a dinner with their favorite foods, planning a surprise date - these bright moments can rekindle the positive feelings associated with intimacy that so often get lost in the shuffle during fertility treatment.
Bringing it back to sex...because isn't that what we're all here to talk about? Here are a few tips that may help you reconnect with your partner as you navigate fertility treatment:
Unless you need to be on it, of course - always check with your physician!
You are not alone if the irony of all the birth control measures you took to not get pregnant smacks you right in the face. This one made me especially crazy - I wanted all the money back that I spent preventing a pregnancy that wasn’t going to happen anyway.
Here’s the positive spin though, you get to toss that birth control now! Cheers to increased spontaneity and one less thing to worry about right now.
It can offer stress relief, time to reconnect with a partner (or yourself) and a break from thinking about fertility treatment.
You don’t have to be in the mood for anything at all, nor do you have to commit to having sex. Just give yourself and your partner a chance. Desire isn’t always the driving force.
Start by holding hands, snuggling on the couch or sharing a kiss. Maybe those actions will lead you to the bedroom...and maybe they won't. Either way, you're staying connected!
Whether you're in-between cycles or taking a mental health break from treatment, this is the perfect time to reengage with your partner, even if it’s not through sex.
Start by asking your partner, "Are you available?" And remember, you don’t have to be in the mood for sex, you can simply be in the mood for foreplay, connection or fun.
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Another fertility patient who’s been there shares what happened in her relationship after they finished treatment: "When we were in treatment, we tried to make the best of it, tried not to make it seem forced...but it was once the pressure was totally off that our sex life definitely improved."
So, if there’s a healthy silver lining, it’s that one way or another, when treatment is over, our sex lives do recover.
I finished fertility treatment over 25 years ago. My experience was that my sexual relationship with myself and my partner had a slow recovery, slower than I would have liked, but with an unexpected richness. What we had gone through together made us more fully appreciate the rediscovery of ourselves and each other.
In the end, it turned out that sex, passion and intimacy wasn’t about eggs, sperm and pregnancy at all - it was really about connection.