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4 Reasons Your Sex Life Tanks During Fertility Treatment (And What to Do About It) Blog Feature
Lisa Rosenthal

By: Lisa Rosenthal on April 13th, 2021

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4 Reasons Your Sex Life Tanks During Fertility Treatment (And What to Do About It)

relationships | Sex | Fertility Treatment | Mental Health

Why don’t we talk about sex when we talk about fertility?

Look at the intimacies that are shared in fertility support meetings, and all over the media—sperm count, follicle count, diminished ovarian reserve, depth of endometrial lining, is the vaginal mucous mucous-y enough, what’s the right underwear for retrieval day (yes, that’s really a thing), boxers versus briefs, uteruses, ovaries, and so on...

All those topics are commonplace in fertility, but talking about sex? Gasp! That’s still a pretty hard, taboo topic.

So, yes, sex still seems like the final frontier in fertility conversations.

If you’re wondering whether anyone else’s sex life is affected by infertility and fertility treatment…the simple answer is yes.

Intimacy vs. Sex 

What if we reframed this question? What if we focused on intimacy instead of sex?

When we do, the perspective is often very different. Fertility patients (myself included) report that there is often more talking, more sharing, and an overall feeling of closeness with their partner that didn’t exist pre-fertility treatment. There’s more compassion and more empathy, and that’s intimacy! 

In this blog, we'll unpack the top four reasons that real patients know make things feel less sexy during fertility treatment, as well as a few tips for overcoming those obstacles, reconnecting with a partner, and maybe - gasp - enjoying yourself!

4 Reasons People Give About Why Infertility is NOT Sexy

Infertility is not sexy. It might be funny, (check out Lori Shandler-Fox, Jay Palumbo and Hilariously Infertile) but it’s not “oh-so-hot, let’s-get-it-on" sexy.

Why not?

Form follows function. Truth: our reproductive organs are intimately (pun intended) connected to our sexual (pleasure) organs. When our sexual pleasure is all wrapped in procreation, including thinking about the best timing for a pregnancy to occur, it is not sexy. Or fun. Or hot.

The earliest lessons we learn about sex usually come through the birds and bees or health class (or our friends, the internet, and even occasionally, our parents).

Another “supposed” truth: it’s through the act of sex that pregnancies occur.

Ha! That’s the hope...but when you’re one of the 1 in 8 couples trying to conceive without success?

Double ha!

Following that train of thought, when one is having sex hoping for pregnancy, and it just isn't happening, four other things tend to occur:

1. Sex becomes functional, not fun.

It’s a quick way to take the fun out of sex. You feel like you must have sex, especially on certain days and times, whether you’re tired or in the mood or feeling sexy - or not. Foreplay, pleasure, and orgasms (oh my!) cease to be the point of sex, especially when procreation is your main focus.

One woman shared this from her husband: “When we were TTC, I felt 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 romance out of the bedroom. For us, it added stress, and we kept wondering what we were doing wrong, so to speak.”

2. We feel broken.

When we don’t become pregnant in a reasonable amount of time, we often feel upset that things aren’t working “correctly.” That might be the understatement of the decade! Damaged, broken, and "less than" are other terms I’ve heard more times than I can count in the 31 years that I’ve been in the infertility field.

3. We’re disappointing our partners.

That is a completely gender-blind statement, as it goes both ways. No matter whose biology is the “cause” of a struggle to conceive, TTC is often accompanied by feelings of guilt, shame, and disappointment. Not sexy feelings.

4. We see ourselves differently.

We don’t see ourselves as whole and complete. Our bodies sometimes do undergo some physical changes during fertility treatment, but often it’s a deeper shift in our perception of ourselves. 

Think about the all the “what ifs” we experience during this journey…if I only lost weight, hadn’t had an abortion, hadn’t waited so long, put having a baby first, had been checked earlier, exercised more (or less), didn’t drink wine on the weekend - the list is endless.

One woman faced with infertility and fertility treatment shared her thoughts during Ladies Night In, saying “Once treatment started, I found I was hypersensitive while on the medications. They caused discomfort, loss of interest in sex, and crazy mood swings which didn't help the situation. We’re in the process of getting approved for our first IVF cycle and in the meantime, we’re working to build our relationship back up to a more positive view of sex before we start that next stage of our journey.”

P.S. The number one comment I heard when I asked women about their sex lives during fertility treatment was, “what sex life?"


A Return to Intimacy

Positive Messages About Sex, Fertility, and Intimacy

Is there anything about fertility treatment that improves our sex lives? Increases intimacy?

Well, actually, yes, thankfully.

RESOLVE: The National Infertility Association talks about one key ingredient to intimacy, which is “nurturing the relationship." I agree. And I would add that understanding what both you and your partner need is a crucial first step.

Here are some questions to ask of yourself and of your partner:

  • What makes you feel loved?
  • What makes you feel that your partner thought about you?
  • What makes you feel cherished? (Good working definition of cherished is “adored, cared for, loved beyond measure.”)
  • You’re both working hard. What makes you feel appreciated? What makes it worth putting out so much effort?

These are the things that bring about intimacy. Seemingly unimportant things, like taking the garbage out, picking up the mail, calling just to say hi, planning a dinner full of your partner's favorite foods, 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.

3 Tips for Connecting with Your Partner 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 for connecting with your partner during the wild ride that is a fertility journey.

1. Throw out the birth control.

(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 it! Cheers to increased spontaneity and one less thing to worry about right now.

2. Focus on the other things that sex can do...

...aside from causing a pregnancy. It can create some relief and time to reconnect with a partner (or yourself), outside of TTC and talking about treatment. Not trying may also create some unexpected intimacy - because we all know that intimacy doesn't always have to be sex. It can be holding hands, snuggling on the couch, sharing a kiss. One thing does lead to another, sometimes!

3. Enjoy Each Other

Whether you're in-between cycles, off cycles, or just taking a mental health break from treatment, this is the time to reengage, even if it’s not through sex. Maybe it’s neither sexy sex nor functional sex; it might be sweet sex. Start by asking your partner, “Are you available?” And remember, you don’t have to be in the mood for sex, you can be in the mood for foreplay.

You don’t have to be in the mood for anything at all; just give yourself and your partner a chance. Desire isn’t always the driving force.

A few words of hope from another woman who’s been there and is willing to share what happened after treatment was finished. “I will say 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 maybe, if there’s a healthy silver lining (sorry, Brene Brown!), it’s that one way or another, when treatment is over, our sexual selves recover.

Sex After Infertility

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 - it was really about connection.


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About Lisa Rosenthal

Lisa has over thirty years of experience in the fertility field. After her personal infertility journey, she felt dissatisfied with the lack of comprehensive services available to support her. She was determined to help others undergoing fertility treatment. Lisa has been with RMACT for eleven years and serves as Patient Advocate and the Strategic Content Lead.

Lisa is the teacher and founder of Fertile Yoga, a program designed to support men and women on their quest for their families through gentle movement and meditation.

Lisa’s true passion is supporting patients getting into treatment, being able to stay in treatment and staying whole and complete throughout the process. Lisa is also a Certified Grief Recovery Specialist, which is helpful in her work with fertility patients.

Her experience also includes working with RESOLVE: The National Infertility Association and The American Fertility Association (now Path2Parenthood), where she was Educational Coordinator, Conference Director and Assistant Executive Director.