What could be more romantic? You and your partner decide you are ready to start a family. You throw away the birth control, have a quiet evening together and excitedly ravish each other before falling peacefully asleep dreaming of strollers, onesies and playdates.
Okay, so despite what your parents told you, one bout of unprotected sex did not result in pregnancy. You know it can sometimes take a while. You try the next month. And the next. And the next. Eventually you realize there may be a problem that goes beyond you just needing "to relax" or to "stop trying so hard" and you enter the grueling world of assisted reproductive technology. Shattered is your dream of creating a love child through...well, love. Instead, it's going to take ultrasounds, syringes, blood tests, medication and needles.
Unfortunately, by the time many heterosexual couples have started medical treatment to help them conceive, their intimate life has been obliterated. What was once a romantic, exciting activity, has become a high-pressure, stressful, obligatory, perfunctory experience associated with failure. As an infertility counsellor, many of the clients I see have stopped having intercourse or physical intimacy of any kind at all. In addition to the stress, fear and shame they are feeling due to the infertility, they are humiliated and ashamed about this too and often fail to tell their physicians who may be counting on them to continue having intercourse at specific times during the treatment process (i.e. timed intercourse while doing ovulation induction, etc.).
What is more, is it isn't always possible for couples to resume sexual activity right away. The pressure and stress can lead many men to develop erectile dysfunction which can increase both partners' fear, shame, guilt and frustration. Many men and women still hold antiquated and unrealistic expectations about male sexual behaviour. We assume that from puberty until death all men want sex all the time, no matter what. But this is not true. Men's libidos vary as much as women's and they also often decrease with age. After 40 in particular, many men find that their sex drive declines and both they and their partners are often shocked and devastated by this experience. No matter his age, however, any man faced with having to perform at a specific time in order to conceive is vulnerable to serious performance anxiety and this anxiety can lead to erectile dysfunction, which increases his anxiety even more. It's a vicious cycle but one that is possible to change.
First off, remember that this situation is normal. Performance anxiety can happen to anyone, particularly when under so much pressure. It is nothing to be ashamed of! Neither infertility nor sexual performance are indicators of either a man or a woman's worth as a human being. Be kind to yourself and to your partner. Be empathetic to yourself and empathetic towards your partner. Both infertility and intimacy issues are stressful life challenges that should not involve guilt, shame or blame.
Second, get help. Even if you do not feel comfortable telling your physician about the situation, find a professional who can give you support. Infertility counsellors and sex therapists can help normalize the situation and give couples tools for communicating. There are many strategies men can use to help them try to relax and stay in the moment. Even if you are undertaking fertility procedures that do not require timed intercourse, remember, it is important for couples to maintain a healthy, satisfying intimate life. Stay on top of it (pun intended) because the longer you drift away from each other physically, the more difficult it can be to reconnect. If you are hoping to create a family, remember it is important for your children to see parents with a strong relationship.
Lastly, remember that intimacy isn't just about intercourse. Start with reconnecting emotionally if you are feeling isolated from one another. Make each other a priority. Carve out time to be with each other. In addition, have no expectations of where things need to go. You are dealing with enough stress and uncertainty while going through fertility treatments!
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