Intimacy While Trying to Conceive

Source: Milan Radulovic/Canva

Some couples feel more bonded as a result of their fertility journey, but most agree that the romance starts to suffer when trying to conceive. Stress, hormone injections, invasive tests and fertility surgeries (for men and women), bloating and cramping, and breast tenderness from high estrogen levels don’t exactly set the mood. Then there is the anxiety that comes with waiting for test results to see if all your efforts were successful; that can put a strain on any libido. In fact, the National Institute of Health published a multi-study review finding that infertility negatively affects the sexuality of 43%-90% of women and 48%-58% of men.¹

The same study found that very few patients, however, are asked about their sex lives by their medical team. They should be asked! When I ask my fertility patients about their sex life, they are usually eager to talk. They often want to hear that it’s okay to be less interested in sex without feeling guilty, or they want advice on how to stay close to their partner while they are both distracted by worrying, watching, and waiting for results.

Some suggestions

Expect stress. Don’t let the stress of the unknown take you by surprise. When our ability to predict what’s coming next goes down, stress goes up. That may be useful in a fight or flight situation, but trying to conceive often goes on and on, without fight or flight – just more trying and waiting. Find stress-reducing activities to do together, like yoga, games and puzzles, redecorating, dog-walking, or cooking – you get the idea. All activities that burn up adrenaline or turn off adrenaline will reduce your stress and help your relationship. And practice gratitude together, because staying focused on the present rather than re-living the past or pre-living the future will reduce your stress and help the relationship.

And then there’s the money, honey. For many couples, the financial strain of fertility treatments (i.e. IVF, IUI) distracts them from intimacy. Vacations, date nights, and even celebrations may seem too expensive now, and worrying about the costs beyond insurance, if there is any insurance coverage, is certainly not conducive to romance. Regaining a sense of control can relieve the strain. Some patients take breaks when they reach certain debt levels until they can build up their finances. Some talk to their HR teams to see if they will add fertility benefits. Some borrow money, apply for grants, negotiate with the fertility practice, use social media fundraising campaigns, or even move to another state to get mandated health insurance. Whatever the plan, make it together if you have a partner. Talking about the costs out loud with your partner is better than worrying about them alone in the middle of the night. It puts you both on the same page and feeling like a team.

Talk! The more you and your partner can talk about hopes and fears and other feelings, the more solid your connection will be, not only when trying to conceive, but also when it’s over. You may want to appear "strong" for your partner and hide your anxiety, but that sends a message that they are the only ones feeling frightened or helpless. Ask for what you need, both emotionally and sexually– it gives permission to your partner to ask also and acknowledges that you know they are not a mind-reader. If you want to postpone intimacy, be honest. And if you do want intimacy in the moment, let your partner know that also. It reassures them that they are not the problem.

Consider support. Research published in the International Journal of Reproductive Biomedicine² suggests that couples who receive support during fertility treatments from a therapist specializing in fertility issues cope better and experience less strain on their relationship. Friends and family can be helpful, of course, but a therapist is trained to give decision-making support, strategies for dealing with intrusive family questions or friends’ pregnancies, suggestions for balancing work demands during treatment, and even crisis-intervention. In fact, most therapists working with fertility patients say six to eight weeks of support can reduce stress levels significantly during treatment, and many find they need only one to three sessions. Ask your fertility practice for a referral if you want to consult a specially trained therapist or, to find a therapist near you, visit the Psychology Today Therapy Directory.

Practice pair-care. A lot has been written about practicing self-care during a fertility journey. Pair-care is equally important. Treat each other to favorite movies, music, foods, and treats. If you need time alone, make sure your partner knows that and doesn’t become confused or hurt, and let them know you will grant them the same grace. Also, try sensate focus—that is, intimate but non-sexual pleasuring. For example, sex therapists often encourage couples to cuddle, massage, share baths or showers, give backrubs, and kiss to maintain intimacy even when they are not engaging in sex. Some of my patients say that once the performance pressure is gone, the closeness is easy and fun and often leads to more. Even if it doesn’t, you will have had time together that was still caring and sharing. Avoiding closeness when you are stressed will make the way back to each other more difficult. This will make the transition back to intimacy feel spontaneous and natural.

Stress-free zones. Perhaps the most important and the most difficult suggestion is to create stress-free zones in your life and in your home while you are trying. Declare a time for conversation, like Sunday morning, that does not include discussion of trying to get pregnant. Declare a zone in your home, like the bed, that is also a place that is free of pregnancy talk. During those times, and in those places, hold hands and focus on each other, on comfort and on affection. After all, romance and intimacy take many forms.