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Intimacy for Infertile Couples: Lovemaking or Baby Making?

by Connie Shapiro, PhD,  Psychology Today,  Feb 9, 2010
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Couples who have difficulty conceiving or carrying a pregnancy to a healthy birth often find themselves shifting their love making to "baby making." This shift tends to be gradual, and it builds on a foundation of increasing disappointment and sadness as, month by month, the woman's menstrual period begins just at the time she had hoped for a positive pregnancy test. Or, if a positive pregnancy test is followed by a pregnancy loss, the sadness becomes active grief as hope for this baby vanishes and, once again, efforts to conceive are the focus of the couple's life.

The infertile couples whom I counsel are often somewhat shocked when, in our very first meeting, I work in a question about their love making. Yet this provides a perfect opportunity for me to share with them that well over 90 percent of my clients are clear that their infertility has interrupted their pleasure in love making. We can then begin to talk further about their preoccupation with creating a pregnancy, rather than enjoying sexual closeness and arousal as a way of heightening their emotional intimacy.

Sometimes it is the diagnosis of infertility that casts the initial shadow on a couple's love life. A low sperm count can cause a guy to believe he is "less masculine," and if he understands himself to be the cause of the couple's incapacity to conceive, he may struggle with his own image of himself as a desirable sexual partner. In addition, even if his sperm health is not identified as a cause for concern, the man will be less than enthusiastic about having sex on schedule or producing semen on demand for use by an infertility specialist in medical procedures. A diagnosis that identifies the woman as the source of the couple's infertility may very well cause her to think of herself as barren or guilty (perhaps because of having waited so many years to begin trying to become pregnant, or because of a decision earlier in her life to terminate an unplanned pregnancy).

For many couples diagnosed as infertile, this emphasis on conceiving begins with a focus on timing intercourse to coincide with ovulation. Whether it is simply a conscious effort to have intercourse around the time of the month when the woman is ovulating, whether it involves the use of ovulation kits to identify when ovulation occurs, or whether a physician is involved in timing medical intervention with ovulation, there is no question that the couple's attention to conceiving is heightened and focused to the few days each month that the woman stands a chance of conceiving. So what does this do to one's love life the other days of the month? In the words of one couple I quote in my upcoming book, When You're Not Expecting, "Once we began a formal infertility workup, it was as if the doctor was right there in bed with us. Somehow, sex became a very medical thing, and in the process of timing our intercourse, we pretty much let go of being spontaneous." Read more.

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