Infertility and IVF: How the Process Affects Your Sex Life and Relationship

Infertility and fertility treatment are often described in medical terms—cycles, hormones, procedures, outcomes. What’s discussed far less often is how deeply these experiences can affect intimacy, desire, and emotional connection in a relationship.

For many couples, sex changes dramatically during infertility or IVF. What once felt spontaneous or connecting may begin to feel scheduled, pressured, or emotionally loaded. This shift is not a sign of relationship failure—it is a predictable response to an intense, stressful process.

Understanding what’s happening can reduce shame and help couples navigate this season with more compassion and care.

Why Sex Often Changes During Infertility and IVF

Infertility and IVF affect intimacy on multiple levels at once:

• Medicalization of sex
  Sex may become tied to ovulation windows, treatment schedules, or performance expectations.

• Pressure and outcome focus
  Sex can start to feel like a means to an end rather than a shared experience.

• Emotional grief and uncertainty
  Repeated disappointment, loss, or waiting can dampen desire and emotional availability.

• Hormonal and physical effects
  Fertility medications, procedures, and stress can affect energy, mood, and body image.

• Nervous system overload
  Chronic stress activates survival responses that make pleasure and desire harder to access.

None of these changes mean something is “wrong” with you or your relationship.

When Sex Becomes a Task Instead of a Choice

One of the most common experiences during infertility and IVF is that sex begins to feel obligatory.

Sex may feel:

• timed

• monitored

• pressured

• emotionally charged

• disconnected from pleasure

From a sex therapy perspective, desire struggles in this context are not surprising. Desire requires freedom and safety, while infertility often introduces urgency and evaluation.

When sex becomes a responsibility, it often stops feeling erotic.

The Emotional Impact on Each Partner

Partners often experience this process differently.

One partner may feel:

• grief, sadness, or loss of control

• pressure to “get it right”

• anxiety about time or outcomes

The other may feel:

• helpless or excluded

• responsible for emotional support

• unsure how to help without adding pressure

When these differences go unspoken, couples may feel distant—even while facing the same struggle.

Grief, Shame, and Body Image

Infertility can quietly affect how people feel about their bodies and themselves.

Some individuals experience:

• shame or self-blame

• feeling “broken” or defective

• disconnection from their body

• grief around expectations of parenthood

These emotional experiences can directly impact intimacy. Sex often becomes more difficult when the body is associated with disappointment or loss.

Protecting Your Relationship During Fertility Treatment

Barry McCarthy’s work emphasizes sexual teamwork—the idea that intimacy is a shared process that adapts to life circumstances.

Helpful shifts during infertility or IVF include:

• separating sex from treatment when possible

• creating space for touch and closeness without expectations

• naming grief and stress openly

• allowing desire to fluctuate without panic

• expanding intimacy beyond intercourse

• prioritizing emotional connection alongside medical care

The goal is not to “fix” sex during this season, but to protect connection.

It’s Okay If Sex Takes a Back Seat

For some couples, sex naturally becomes less central during fertility treatment. This does not mean intimacy is gone forever.

Periods of reduced sexual interest can be adaptive, allowing people to cope with stress and grief. What matters most is staying emotionally connected and communicating honestly about needs and limits.

Intimacy can—and often does—return in new forms over time.

When Additional Support Helps

Many couples benefit from working with a therapist during infertility or IVF, especially when:

• sex feels stressful or avoided

• communication breaks down

• grief feels overwhelming

• partners feel disconnected or misunderstood

• intimacy doesn’t recover after treatment

Therapy can provide a space to process emotions, reduce pressure, and protect the relationship during an already demanding experience.

You Are Not Alone

Infertility and IVF can feel isolating, but the impact on intimacy and connection is incredibly common.

Your relationship does not have to be another casualty of this process. With understanding, support, and compassion, many couples find ways to stay connected—even in uncertainty.

Support Is Available

If infertility or fertility treatment is affecting your relationship or sense of connection, support is available. Working with a therapist trained in relationship and sexual health can help you navigate this season with clarity and care.

You don’t have to carry this alone.