“NO INNER RECESS WAS LEFT UNEXPLORED, UNPROBED, AND UNMOLESTED.” “It’s like donating your body to science while you are still alive.”

Common Emotional Reactions to the Diagnosis of Infertility
1. Shock
2. Denial
3. Fear
4. Anger
5. Disbelief
6. Guilt
7. Loss of Control
8. Isolation
9. Sense of Failure

Sexual Problems that Occur in Conjunction with Infertility

1. Dyspareunia (genital pain that is associated with sexual intercourse, usually occurring
during, but may also occur before or after. Dysparenunia can affect both men and women.
Symptoms range from discomfort to sharp pain, and cause distress or interpersonal
difficulty.
2. Male erectile disorder (aka: impotency)
3. Hypoactive sexual desire (aka: inhibited sexual desire)
4. Rigid or very routine approach to sex
5. Poor body image
6. Depression
7. Guilt
8. Ambivalence toward sex
9. Feeling loss of attractiveness
10. Feeling sexually inadequate
11. Both men and women misread lack of sexual interest

Three areas of sexual difficulty:

1. Actual physical condition causing infertility or resulting from infertility treatment
2. Sexual intercourse becomes only a means of reproduction rather than an intimate or
pleasurable activity
3. Global psychological impact of the infertility treatment

AXIOM: The longer the time in infertility treatment, the lower the levels of sexual satisfaction

IN SUMMATION:
1. The ability to reproduce is intimately tied to sexuality, self-image, and self-esteem.
2. Although sexual problems can occur during infertility, sexual difficulties are not universally
experienced by infertile individuals and/or couples.
3. The majority of infertile couples do not develop diagnosable sexual problems requiring intensive treatment, although they may experience episodic, transient problems, warranting education and support.
4. The medical assessment and treatment for infertility may interfere with the infertile couple’s sexual pleasure due to performance demands, treatment requirements, emotional responses to treatment, or the diagnosis of infertility.
5. Most sexual problems may be addressed by the infertility counselor if he or she is educated about the impact of infertility on sexual functioning.
6. It is important to volunteer that you are experiencing sexual problems, as most caregivers do not specifically ask questions about sexual behavior as part of the comprehensive medical history, particularly when the couple is actually having sexual intercourse on a regular basis.
7. When sexual dysfunction is the presenting cause of infertility, assessment and therapy for the individual or couple is necessary and should preclude medical treatment for infertility.
Infertility is sometimes caused by sexually transmitted infections (STIs).
The most common are:
1. Syphilis
2. Gonorrhea
3. Human papiloma virus (HPV)
4. Genital herpes
5. Trichomoniasis
6. Human immunodeficiency virus (HIV)
STIs adversely affect fertility through pregnancy loss, neonatal deaths, the obstruction of either male or female reproductive ducts, impaired semen parameters, and the risk of transmission of HIV to partner or child.
STIs resulting in infertility require that we examine our:
1. Personal decisions,
2. Partner choice(s),
3. Cultural circumstances,
4. Drug and alcohol use and abuse,
5. Social life, and
6. The availability of quality medical care.