When you are first trying have a baby, sex can be fun.  However, when it takes longer than you wanted or hoped, feelings of stress, anger, and sadness can arise, and sex can becomes work.   When sex becomes baby-making and not a way to express intimacy and closeness within a relationship, it usually loses the enjoyment.

If you are unable to conceive or dealing with feelings around pregnancy loss, sexual issues for both men and women can be a normal part of dealing with the experience.   Thus, it is not uncommon for sexual dysfunction to happen as a result of the stress surrounding infertility.  One study found that about 40% of female infertility patients had increase risk for sexual dysfunction compared to the control group with only a 25% increased risk.  Desire and arousal decreased with infertility, and there was a lower frequency of sex.  Men who are experiencing infertility have higher rates of erectile dysfunction and psychological burden and less sexual satisfaction.  If a man is feeling the pressure of sex for the purposes of procreation, his own thoughts and feelings can cause difficulty for him to engage in sex.  It can cause “performance” problems with the demand-nature of what he must do to make conception happen, whether it is in the bedroom or the sperm donation room.

While there are certainly negative features when experiencing the stress of infertility, research shows that infertile couples can overcome sexual stress, and learning how to cope with these stressors helps with long-term protective factors in marriage.  However, it should be remembered that if there were marital problems prior to the infertility or sex was not an important of the relationship, your sex life is more likely to get worse when dealing with the stressors of infertility.   When dealing with sexual issues, here are some tips:

  1. Self-care: If you are not taking care of yourself, it makes it harder to be happy within a relationship. Remember to keep routines, yet change things up when needed.  Keeping these routines and taking care of yourself are important boundaries to hold so that fertility treatment and trying to conceive does not bleed into all areas of your life.  Continue to exercise and eat healthily.  If you are taking care of yourself, then it will help in the bedroom!
  2. Communication: Don’t forget to talk to your partner about how you are feeling and what you are thinking. Communication is key in emotional and sexual intimacy.  Our significant others can’t read our minds or always know the best way to be helpful!
  3. Be creative and spontaneous: Sexual intimacy is not just the few minutes of intercourse or orgasm. You or your partner might not feel like having sex when you feel your body is being poked and prodded during treatment. Find other ways to pleasure your partner and increase your sense of closeness. This might be by telling your partner why you appreciate them, even if they know it is always nice to hear.  You can also carve out some time where you two are together doing something new or something fun that you might not have done in awhile.
  4. Avoid talking about infertility: This doesn’t mean never talk about it, but to limit it so that infertility isn’t all that you discuss! Help your partner out by cleaning the house or running an errand.  Remember physical touch and affection does not need to lead to sex and orgasm in order to be pleasurable.  These will all inevitable help in the bedroom.
  5. Change things up: When there are “baby-making” nights, make them expressly different than the other intimate times together. Try having sex in another room when it is for baby-making and saving the bedroom for the other time.  Also when you are tired and stressed at the end of day it can be even more of a challenge to then have sex so try having it at a different time of the day, such as first thing in the morning before.


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.