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There are many effective ways to nurture your relationship whatever the outcome of your family building journey.

How is Infertility Affecting Your Sexuality?

“What sexuality?” you may be thinking. Going through an infertility work-up can desensitize even the most sexually active couple. All of a sudden you are thrown into a situation where any sense of privacy is thrown out the window.

Someone was recently recounting her hysterosalpingogram: the physician had trouble injecting the dye into her so at one point six people were in the room trying to figure out what to do. “Hello, anyone else want to join us in here, my uterus is on display.”

It is understandably difficult to go from that to making love with your partner. Naturally, infertility not only increases normal levels of stress, but it can put a damper on our sexuality. Men and women alike suffer the consequences of infertility treatment. When it becomes imperative to have intercourse at specific times, making love becomes baby making. What was once an intimate moment can become very clinical. Going into a sterile room with a cup, under the pressure of performance, can harm even the strongest ego. For decades this issue has been brushed aside. No one really addressed the scientific understanding until recently.

A study conducted at Duke University Medical Center, and presented at ASRM by Dr. Jennifer Norten, examined “sexual satisfaction and functioning in patients seeking infertility treatment.” Dr. Norten proved what many suspected, and in doing so validated our feelings. “The results of this study suggest that women undergoing infertility treatment experience significant changes in various aspects of sexual desire, arousal, orgasm, length of foreplay and frequency of intercourse.”

When Couples Disagree

By Jan Elman Stout, PsyD
Reprinted from Family Building magazine, Spring 2006

You’ve spent months or years trying to conceive your biological child. You’ve managed to cope while undergoing every imaginable procedure to diagnose your infertility. You’ve been poked and prodded, and survived the treatment process.

You’ve dealt with all kinds of personal questions and insensitive remarks from friends, family and acquaintances. You’ve attended one baby shower after another and received countless birth announcements. It seems everyone you know has a child, many two children, but you’ve handled all this.

At a Crossroads

And now, you and your partner are at a crossroads. Your doctor has told you that he’s done everything he can to help you become pregnant with your genetic child. Where will you turn? And when?

Couples face all kinds of challenges in coping with infertility and the treatment process, and two of the most stressful decisions they might face are when to stop treatment and where to go from there. If treatment fails, couples must consider whether to live without parenting or become parents through alternate means. If determined to parent, you must choose between collaborative reproduction (i.e., sperm, egg or embryo donation or a surrogacy arrangement) and adoption. These can be difficult decisions to make when couples agree and are on the same timetable. However, when partners disagree about their choices and are on different timetables, the impact of these differences may feel overwhelming.

If you and your partner disagree or are on different timetables, how can you reach agreement? Unfortunately, there is no clear answer, much less a step-by-step manual for reaching consensus and readiness. However, I often counsel couples facing this predicament and will share some of my advice here.

Know that it is not uncommon to feel at odds or out of synch with your partner while actively making a decision. Couples are comprised of two people with different life experiences, family backgrounds, personalities and ways of coping. Individuals have different needs, priorities and timetables, so be realistic about the likelihood you’ll experience tension in the process. Tell yourselves that just because you currently disagree does not mean that you will always disagree—couples ultimately find resolution. Remind yourselves that because this is a process you will sometimes feel that you are making progress, but sometimes feel stalled. Keep in mind that there are common gender differences in coping styles. Women tend to seek support, want to talk and express their emotions when facing a challenge or crisis. Men tend to be stoic, withdraw or isolate themselves and take a problem-solving approach in discussions. These differences can lead men to feel that women are overreacting and lead women to feel that men are uncaring or unaffected.

Learn All You Can

The first step in decision making is to learn as much as you can about all your options with an open mind. There is a great deal of myth and misinformation available; make it your goal to dispel it. Gather information as if on a fact-finding mission. Read about the various options. Attend workshops that address these choices. Consciously try to back away from conclusions you previously drew and avoid coming to new conclusions just yet. Talk to couples you know who have faced these choices and try to understand how they made their decisions. Attend support groups focused on decision making or specific options.

Evaluate and Discuss Your Options

Once you’ve both gathered a substantial amount of information, begin evaluating it together. Try to identify what your priorities and needs are and why. Once you have completed these tasks, you’re ready to begin communicating about your findings, attitudes, feelings, needs and preferences.

Be attentive to the context in which you try make a decision with your partner. Most couples find it difficult to discuss emotional issues in public places, so try to find private settings for your talks, and schedule them ahead of time. Beginning a discussion when your partner has just walked in the door after a hard day at the office, or has had an argument with a sibling, tends to heighten emotions and complicate decision making. Couples often find it optimal to discuss options after they’ve enjoyed a pleasurable recreational activity together that has nothing to do with infertility, or if one promises to follow their talk. You should set ground rules for your talks, including how long to talk at any given time and how heated a discussion can become before abandoning it, with interrupting, criticizing and blaming forbidden.

You should attempt to use active listening skills when trying to reconcile your differences. Try to be very attentive to your partner and pay attention to nonverbal cues. Try to summarize your partner’s points and reflect his/her feeling before sharing your own thoughts and feelings. Good communication is impeded by being out of touch with your own feelings and/or being unable to communicate them honestly and directly, being insensitive to your partner’s feelings, jumping to conclusions, being on the attack, or trying to dictate, control or manipulate.

In deciding which course to take, couples must try to assess whether their differences are fundamental or a function of having different timetables. If one partner wants to adopt and the other doesn’t, it might reflect a real difference in their views or it might instead reflect a difference in readiness to proceed. Obviously, the implications are different. When a couple’s timetables are different, the “slower” partner must be given time to catch up, which may be difficult for the partner who feels ready to forge ahead. Ironically, planning vacations from treatment and breaks from decision making can help the “slower” partner reach resolution. The emotional impact of differing timetables can be minimized if couples establish timeframes for their decision making, such as agreeing to undergo one more in vitro fertilization (IVF) cycle; waiting three months before moving on to egg donation, or waiting two months before pursuing adoption. Agree to reevaluate and modify this decision if necessary.

If you feel that your discussions are unproductive, counterproductive, damaging to your relationship or excessively stressful, consult with an infertility counselor who can guide you through the decision-making process and toward resolution. A mental health professional can help you better understand your options, attitudes and feelings, improve your communication skills, feel less distress and reach resolution more quickly and comfortably.

Becoming a Couple Again

By Iris Waichler, MSW, LCSW
Reprinted from Family Building magazine, Summer 2007

The struggle with infertility presents numerous challenges to couples. Regardless of how you resolve your infertility, it affects your relationship. Your infertility experiences may strengthen your bond as a couple or that bond may weaken or become fragile. Infertility changes us. We make many sacrifices in our parenting quest: personal, physical, emotional, professional and relationship sacrifices.


People who have children through infertility treatment or adoption have huge adjustments to make. Parenting impacts your life in so many ways, including your relationship as a couple, and that relationship may not be your top priority after a child comes. Children need constant attention and often become the center of our lives. Have you and your partner discussed your vision of parenting styles? Are there differences? Does that spill into your relationship as a couple?

When you face infertility, you do it as a team with common goals, but in parenting, there may be differences in child raising techniques and approaches. As parents, you need to make multiple daily decisions that can cause intense disagreements. Couples’ communication and intimacy can suffer from sleep deprivation and the stress of being new parents.

No matter how hard it feels when struggling to adjust as new parents, remember, there are many effective ways to nurture your relationship. Good communication is imperative. Make time to talk. Whether it’s a night out for a relaxed candlelight dinner or a quiet evening in, it’s important to set aside time just for the two of you. Use this time to discuss things besides your child. This is a huge challenge, especially for new parents. You should use this agreed-upon time to nurture your relationship and to have fun. Try to re-establish intimacy, rekindle that flame that may be ebbing. If paying a babysitter is prohibitive and no family or friends are available, make time when your child goes to bed to do something special. A nice meal, a quiet bath, dancing or a massage can feel very special. Strengthening your relationship as a couple can strengthen your parental relationship as well.


Some couples’ infertility journeys end without children either because they cannot have a biological child and/or choose to remain childfree. Letting go of the parenting dream involves grieving. Your dream of a future together had included children. Individuals may feel sadness, loss and anger. This can change a loving bond into a dysfunctional, quarrelsome relationship. Try to be open to working through these feelings individually and as a couple. If you cannot openly communicate, you may need to see a couple’s counselor.

Your life after infertility treatment can be rich and fulfilling. Your challenge is to think about what brought meaning to your lives before infertility. Remember your courtship days. What brought you together and what strengthened your love? What qualities in your partner helped during infertility treatment? How can these qualities bring a new depth to your current and future relationship as a couple?

Your childfree lives will include more day-to-day freedom. Your sexual relationship can be more spontaneous without infertility constraints. You may have felt the need to isolate and protect yourselves during your infertility journey. When you feel ready, spend time with people with whom you feel comfortable. Begin to break down those barriers. This may mean being away from kids―whether they be nieces and nephews or friends’ children―for a while.

You may have more financial flexibility than you anticipated. This opens up opportunities to travel, take classes and indulge in art, music or hobbies. Your relationship now will be exclusively husband and wife/partners without the role of parent. Consider what your relationship as a couple means to you and create ways to help it grow stronger.

Whatever the outcome of your infertility experience, much of your future quality of life depends on the quality of your relationship with each other. Whether you are childfree or a new parent, a new life journey begins. Sometimes this involves letting go of dreams. Sometimes it means adapting to the reality of your dreams coming true. Adjusting expectations and changing goals can challenge couples. The challenge of starting a new life journey together can also be the source of future growth and renewal for you both. Good luck on your journey!