Keeping Love Alive: How to Maintain Intimacy During the Infertility Journey

Infertility and infertility treatment is a grueling experience. For most couples, it comes with a series of surprise challenges to their relationship. Before trying to conceive you may have had problems, as any couple does. Throw the disappointment and scariness of an infertility diagnosis into the mix, add the pressures of treatment, and you have a relationship thrown off balance, if not into an actual crisis. How do you manage a crisis like this, which has no obvious rules of engagement and also seems to have no dependable timeline to a resolution?

The first step is to understand that the infertility experience affects every couple relationship. There are no exceptions, and no one entirely escapes from problems that affect their self-image, intimacy with their partner, and their sexual lives. The next step is to educate yourselves about what you are up against, so you can face it together. It really isn't fair for her to "do all the research" or for him to "just be strong for her". The more you can do this together, the stronger your coupleness will be. Inform yourselves well, make treatment choices together, and do your best to not allow the fertility quest to take over your lives, as it will threaten to do. Then allow the loving feelings and positive history you have with your partner to guide you. If ever there was a time in your relationship to be considerate and tender toward your partner, this is one of those times.

It is helpful to know that men and women travel at different rates of speed on the fertility journey. Women tend to zip along and men tend to lag behind. This is completely normal. The trick is to recognize this and be understanding about it. Keep up the communication and give each other the chance to say what is on their mind. If you have the common goal of making a family together, that is a good thing and it is the main thing. If you disagree about methods of treatment, waiting times, sharing with others, and how far to take all of this, that is about negotiation and exercising patience. Get professional help if you think you need it. If you do, try to find a counselor who is knowledgeable about fertility and family building.

Be sensitive to how infertility can affect your partner's self esteem. Depending on the diagnosis, both women and men can feel "defective" or incomplete. Feelings of shame or guilt can lead to a partner's pulling away. "If he had a different wife, he'd have a baby by now." "What does it make me if I can't get my wife pregnant?" These are personal crises that can profoundly affect your relationship and create distance. Be honest about how you are feeling and when your partner says it's not your fault and you are lovable for who you really are, believe it. No man, woman, or couple is defined by their "fertility status". Until your child arrives, you are a family of two and deserve to nourish each other.

There should be no surprise that a couple's sexual life suffers. That, too, is almost universally a part of the fertility journey. Lovemaking becomes a means to an end and stops being intimate and fun. You are being told when to have sex and you may not even "need" to have sex at all to make a baby. Technology is a double-edged sword. Intercourse is not necessary if you are doing inseminations or in vitro fertilization. Talk to your partner about your sexual needs and how they may have changed. Women are especially vulnerable to feeling unsexy and have decreased desire. Men may feel exploited as in, "I'm just the sperm source", when their partner wants to have sex only around her ovulation. Simply put, women tend to feel sad and have lower libido, and men tend to feel angry and miss the sexual intimacy more.

Every relationship that lasts past the dating stage will eventually have sexual highs and lows. The fertility experience disrupts the rhythm of a couple's intimacy and it usually disrupts everything else-work, social life, financial plans, vacations, and even holidays. So this is not the time to have expectations for high- octane sex. You can, however, keep your love alive through honest (and diplomatic) communication and a little creativity.

Redefine intimacy and broaden it to include dinner table conversation, cuddling under a blanket watching a favorite television show, and a really good hug. Tell your partner when you need that hug and tell your partner when you are feeling a little deprived. If it is too hard to plan a vacation around treatment cycles (and too expensive), do something spontaneous and not costly. Look into a bargain night at a hotel in your area and have a nice breakfast the next day. Go out to dinner at a favorite café and do not talk about fertility for even one minute. Reminisce about how you met and why you made a commitment to be together as life partners.

When it comes to sex, considerate patience goes a long way. For some couples it works well to plan to have sex (and then anticipate it, just like in the early part of your relationship) on a day in the women's cycle when she isn't fertile. This works because it turns the single-minded goal of the fertility quest on its head and gives back the fun part of sexual intimacy.

Take good care of yourselves and each other. Book a massage now and then (men, too), take a class together (yoga, cooking, salsa dancing?) at the local recreation center, or have a winter picnic in your family room, like one couple who spread out a blanket and had a basket of goodies. It was snowy outside, but it was warm and bright where they were. Looking ahead, you are hoping to be a couple without children in the home again after your children-to-be have left the nest. Working on your relationship now will not only make this part of your life journey easier. It will also ensure that you remain each other's dearest valentine as you travel through the rest of your lives together.

Marie Davidson, Ph.D., is a licensed clinical psychologist on staff at the Fertility Centers of Illinois in Chicago. She can be contacted at