Infertility can take the fun out of women's sex lives

Women seeking fertility treatment, particularly young women, may experience a negative impact on their sex lives, although it will likely dissipate over time, according to a U.S. study.

"We weren't surprised at all to find sexual distress in couples who are infertile," said senior study author Dr. Tami S. Rowen of the University of California-San Francisco's Irene Betty Moore Women's Hospital. "Sex takes on a really different meaning for people trying to get pregnant."

Infertility affects approximately 6.7 million women in the United States, Rowen and her colleagues write in the journal Sexual Medicine. Couples with infertility have significantly more anxiety, depression and stress, and that can have an ongoing effect on quality of life and the health of a marriage.

To gauge the impact on sexual health among women, the researchers surveyed 382 women in couples seeking fertility treatment at academic or private clinics in the San Francisco area.

Almost 60 percent of couples included in the study were seeking treatment for female infertility only, while 30 percent involved female and male infertility factors and 7 percent involved only male factor infertility.

The study team measured what they termed sexual impact with a seven-item questionnaire, including questions about a participant's amount of sexual enjoyment, perceived attractiveness to partner, inability to have sex because of fertility problems and persistent thoughts about having a child during intercourse.

The results were then translated into a sexual impact score ranging from zero to 90, with higher scores indicating more severe impact.

The majority of participants were between 20 and 45 years old. More than 40 percent had been married at least five years and three-quarters had no children. Many had been treated with oral medications, injectable fertility drugs and intrauterine insemination before entering the study.

On average, the women had a sexual impact score of 38, compared to 25 for men in a previous study of the same couples.

Women who perceived their fertility issues as due only to male factors had the lowest sexual impact, while those who believed their own infertility was the only cause had the highest sexual impact scores.

"Women carry this burden so much and there's so much emotion tied to women's reproductive goals," Rowen said. "We felt in general that most people actually attribute it to themselves more than it was overall attributable, a lot of times it's male and female factor both."

Women younger than age 40 had higher impact scores than those over age 40, though this was not true for women who already had a child, according to the results.

"I think it would be really interesting to do a study of how often doctors talk to patients about sex lives," Rowen said.

When she sees patients struggling with infertility, Rowen added, she talks to them about making sure sex is fun and not a chore, even though they are having sex every day for a specific purpose.

"It seems that emotional problems are common among infertile women," said Dr. Lucia Alves S. Lara of Ribeirao Preto Medical School at the University of Sao Paulo in Brazil, who was not part of the study.

"A previous study showed that women seem to be more affected than men in their sexual life and they have greater tendency to classify the marital relationship as bad when the couple fails to conceive," she told Reuters Health by email.