Infertility, and the accompanying decision-making about treatment, is a stressful process and can cause one to doubt previous notions about one’s self and one’s relationships with others.  Just as we all have unique fingerprints, no two people will experience infertility in exactly the same way nor express their individual needs and emotions  alike.  Thus, for couples, it can be helpful to find commonalities in the experience to help decrease the feelings of isolation that are often associated with infertility.   While infertility can be a time of crisis and stress, it also presents an opportunity to build areas of communication and closeness in a relationship that might otherwise be neglected.  But how do you work on intimacy when you are experiencing the isolation infertility sometimes creates?  It takes a conscious effort and thoughtful process, but there is hope!

Under most circumstances, creating a family generally requires a certain level of closeness between two partners, but when you experience infertility, the process of conceiving a child suddenly becomes more mechanical.  Thus, it can feel less intimate, more intrusive and clinical.  Infertility can cause one to question many things including the sense of self, values and relationships with others. When recreation becomes procreation, sex can feel like a chore, rather than a fun way to increase the connection with your partner.  The associated pressure to conceive, paired with the many emotional and physical implications of infertility and fertility treatment can also make sex feel more like work than pleasure.

Intimacy creates a sense of closeness, togetherness, and an emotional connection. We often associate intimacy with sex, and while sex can be a way to achieve intimacy, it is not the only way and does not always accomplish this. Men and women often express and receive intimacy in different ways.  For women, they tend to focus on love, affection, and feelings around ‘intimate’ moments, while men tend to focus on physical closeness and sex (Hatfield & Rapson, 1994).  For couples, intimacy can encompass many different actions and moments, built over time through work and open discussion.

Whether through words or actions, intimacy involves a level of love, appreciation, and communication between partners.  Sex, love, and intimacy are three different terms, and each can be expressed in different ways.  There is an old saying that “women need to feel loved in order to have sex and men need to have sex in order to feel loved.”  While this may have some truth it, it brings up a larger issue of how people connect.  This goes beyond gender and becomes about personality.

Infertility can drain your resources (physically, emotionally, or financially)  making it much more difficult to engage in intimate moments.  In The Five Love Languages, Gary Chapman (1995) highlights five different ways we express and receive love.  This helps demonstrate that we all have different needs.  Chapman states that the five expressions of love are words of affirmation, quality time, receiving gifts, acts of service, and physical touch.  Understanding these “languages” can assist in awareness about how to communicate love to a partner’s needs, in an effort to achieve a stronger sense of intimacy, as well as identifying what your own needs are.  The following are some suggestions for different expressions of love during infertility:

  1. Words of affirmation: This love language uses words to show appreciation and support. Take the time to think about why it is you love your partner. What brought you two together?  Write a note of admiration and leave it out for your partner.  Or set aside time to talk about these things, making sure you both think about this prior to sitting down together.  Concentrate on the positive and express aspects of appreciation in your partner.  We often focus so much on criticism and for every one piece of criticism it takes five positives to counteract it (Gottman & Silver, 2004).
  2. Quality time: This love language focuses on giving your undivided attention to your partner. Put the electronic devices away. Take time away the discussion of baby-making fertility treatment, and focus on you as a couple.  Make a date.  What is it that you love to do?  Is there something that your partner has wanted to try? Maybe there is something you both love to do together that you haven’t done in awhile.
  3. Receiving gifts: Love can also be expressed through gift-giving. This love language is about taking the time to express a random gesture to your partner.  Buy flowers to give your partner “just because”, or maybe buy tickets to something your partner would enjoy going to.
  4. Acts of service: This love language is expressed through actions. What action might help your partner?  Cleaning up the kitchen without being asked.  Running an errand for your partner.  Making your partner a bubble bath.
  5. Physical touch: The last love language is about the most obvious intimate interaction. Try giving a hug or a gentle kiss.  Have these physical moments outside the times for ‘baby-making.’  Being sexually intimate is not just about intercourse but pleasing your partner though closeness and touch.

Remembering, however, that the experience of infertility is highly stressful and demanding, and that you just may not feel much like love-making when your body is being constantly poked and prodded.  This may go a long way towards taking some pressure off of yourselves and trying to stay intimate and connected in these other ways.

To figure out your and your partner’s love language, you can go to or even download the app for your phone which gives weekly challenges.

Chapman, G. (1995). The Five Love Languages: How to Express Heartfelt Commitment to Your Mate. Chicago: Northfield Publishing.

Gottman, J. & Silver, N. (1999). The Seven Principles for Making Marriages Work . New York: Three Rivers Press.

Hatfield, E., & Rapson, R. L. (1994).  Love and intimacy. Encyclopedia of Mental Health, 2 (pp. 583-592.)  New York:  Academic Press.


Laura Covington, LICSW is a clinical social worker who provides counseling to individuals, couples and groups around developing strategies for stress and coping during fertility treatment, grief and loss related to reproductive health, disclosure around third party reproduction, and all facets of assisted reproduction.   She has a special interest in reproductive health and reproductive traumas, with a focus on the military and combat-related injuries that impair fertility.  Ms. Covington recently authored the chapter “Psychological Aspects of Infertility Post-War Injury” in Intimacy after Injury: Combat Trauma and Sexual Health edited by Elspeth Ritchie and co-authored the chapter, “Counseling Known Participants in Third-Party Reproduction” in Fertility Counseling:  Clinical Guide and Case Studies, edited by Sharon Covington.  She is currently a PhD Candidate at Bryn Mawr College, Graduate School of Social Work and Social Research; her dissertation topic is on the biopsychosocial recovery of military-related injuries that impair fertility and subsequent views on family development.  She has offices in Downtown Washington, DC and in Fair Oaks, VA.