According to research byHigher Institute of Health15% of couples experience infertility.
The main factor considered in arriving at this diagnosis is the time between targeted unprotected intercourse and the rate of conception, which may decrease with increasing age.
Failure to conceive is defined primary when a pregnancy has never been achieved, secondary when, after one or more previous pregnancies (even if interrupted), you are no longer able to conceive.
A 2011 study highlighted the influence of infertility:
- on sexual self-esteem;
- on sexual relations;
- on sexual function.
From a relational point of view, the emotional support of the partner can be fundamental as a moderator of the stress related to infertility. A strong couple union seems to protect against the onset of anxious and depressive experiences, which tend to increase after a first failed attempt at in vitro fertilization.
Sexual dysfunctions and infertility
Sexual dysfunctions are the cause of infertility in 5% of cases. In women, the problem is often linked to vaginismus, that is, the involuntary contraction of the vaginal muscles, which can hinder penetration. Male sexual dysfunctions that can cause infertility are:
- chronic erectile dysfunction;
- anejaculation, i.e. the absence of ejaculation;
ejaculation ante-doorsthat is, when it occurs before penetration.
Sexual satisfaction
During infertility treatment, it may be more common to observe a decrease in self-esteem and sexual satisfaction in men than in women, probably due to the medicalization and mechanization of sexual activity. In particular, erectile dysfunction and premature ejaculation seem to prevail in male partners of infertile couples.
In women, however, the following may occur:
- an impact on sexual desire;
- decreased sexual arousal;
- sexual aversion disorder;
- dyspareunia, or feeling pain during penetration;
- vaginismus;
- secondary anorgasmia.
Not only sexual function, but also women’s marital satisfaction may be affected.
The importance of a multidisciplinary approach: psychologist, andrologist and gynecologist
The management of infertility and its repercussions on sexuality may require an integrated approach, involving different specialists. According to the recommendations of the European Society of Human Reproduction and Embryology (ESHRE, 2023), collaboration between a psychologist, andrologist and gynecologist is essential to offer complete support to the couple.
- Psychologist or psychotherapist: can help process emotions related to infertility, improve communication and manage any sexual dysfunctions of psychological origin.
- Andrologist: deals with male sexual and reproductive health, evaluating and treating any dysfunctions that may affect fertility.
- Gynecologist: follows female reproductive health, identifying any organic causes of infertility and proposing targeted diagnostic and therapeutic paths.
Teamwork between these professionals can help address both the medical and emotional and relational aspects, increasing the chances of successful treatments and the overall well-being of the couple.
Practical strategies to improve communication and intimacy in couples
Facing infertility together also means working on communication and intimacy, aspects that can be put to the test by the emotional weight of the situation. Couples therapy experts suggest some practical strategies that can help:
- Dedicate time to dialogue: Carving out regular moments to talk openly about your feelings, without judgment, can foster mutual understanding and reduce feelings of isolation.
- Use nonviolent communication: expressing your needs and emotions using first-person messages (“I feel…”, “I need…”) can help avoid misunderstandings and conflicts.
- Rediscover sexuality beyond conception: reserving spaces of intimacy that are not linked exclusively to the desire to have a child can help reduce pressure and rediscover the pleasure of sharing.
- Experiment with partner exercises: some therapists propose exercises such as “sensate focus”, which consists of concentrating on bodily sensations and physical contact without the goal of penetration, to rediscover complicity and mutual pleasure.
Integrating these strategies into everyday life can strengthen the couple’s bond and promote greater resilience in the face of difficulties.
Psychological impact of infertility: experiences and emotions in the couple
Infertility can generate a wide range of emotions, which often manifest differently between partners. According to the guidelines of the European Association of Urology (EAU, 2022), the emotional stress related to infertility can be comparable to that experienced in the presence of chronic diseases.
Among the most common experiences are:
- Guilt: many people feel responsible for infertility, even when the cause is not attributable to just one of them. This can lead to feelings of inadequacy and shame.
- Anxiety and worry: uncertainty regarding the future and treatments can generate constant anxiety, which is also reflected in the sexual sphere.
- Anger and frustration: the repetition of failed attempts can fuel anger towards oneself, the partner or the medical context.
- Sadness and isolation: the difficulty in sharing one’s experiences with friends or family can lead to a sense of loneliness.
Emotional reactions can also vary based on gender. According to a study published in “Human Reproduction” (Greil et al., 2011), women tend to manifest depressive and anxious symptoms more frequently, while men may show a greater tendency towards emotional withdrawal and minimization of the problem. Understanding these differences can help the couple support each other and seek shared coping strategies.
Who should you contact?
In these cases, contact a sexologist for couples therapy it can represent a useful solution to promptly address difficulties and continue, or begin, to peacefully experience intimacy as a couple.
In Italy there is still no official and legal recognition of the figure of the sexologist. Generally, this term refers to any figure with scientific skills who works in the area of human sexuality and sexual health.
A psychologist specialized in sexology, as a professional expert in human relationships, can be of help in examining the relational aspects within the couple that contribute to the onset and maintenance of the problem.
If you feel the need for support to deal with the difficulties related to infertility and sexuality as a couple, Evidence Network can help you find the professional best suited to your needs. Start the questionnaire and take the first step towards a shared wellbeing journey.
