Pregnancy

Andrew and Ella decide to try for a child. Their sex life suddenly swerves to an unfamiliar path. They are acutely aware of the significance of their intimacy and feel self conscious as they try to casually approach sexual connection.  

The dynamics of trying to conceive (TTC) can significantly impact a couple’s sexual relationship, introducing both physical and emotional complexities. While sexual intimacy often begins as a natural expression of love and connection, the goal of conceiving can shift the focus from pleasure and closeness to performance and timing. Below are key dynamics that affect a couple’s sexuality during the TTC journey:

Shift from Pleasure to Functionality

When a couple is trying to conceive, the act of sex can transform from an intimate, spontaneous experience to a task with a specific goal: pregnancy. Ovulation calendars, fertility tracking, and scheduled intercourse during the “fertile window” can have sex feel more like an obligation than an expression of affection.

• Timing and Performance Pressure: Couples often feel pressure to have intercourse at the “right” time during the woman’s ovulation period, leading to stress if things don’t go as planned. This can lead to “performance anxiety,” particularly for men who may feel the need to maintain erections and ejaculate on demand.
• Impact on Sexual Desire: Sex becomes associated with reproduction rather than pleasure, potentially reducing spontaneous desire. Both men and women might feel less aroused knowing that the primary motivation is conception, which can diminish the emotional and erotic connectionbetween partners. Clinically, I sometimes also see difficulty with intimacy when there is ambivalence about becoming a parent. This might be largely unconscious, but they feel avoidant and start to dread sex. 

Emotional Stress and Anxiety 

Fertility challenges, especially when conception does not happen immediately, can introduce emotional strain. Both partners may experience a range of emotions, from hope and excitement to frustration and grief, particularly if months pass without a positive pregnancy test.

• Stress and Libido: Emotional stress, anxiety, and even depression can dampen libido for one or both partners. The disappointment of unsuccessful conception attempts can create feelings of inadequacy or self-doubt, impacting their emotional connection and desire for each other.
• Communication Barriers: If emotions around infertility are not openly discussed, resentment, guilt, or frustration may build up. Some couples may avoid discussing their feelings for fear of hurting their partner, but this lack of communication can lead to further emotional and sexual distance.

Amy and Emily have juggled schedules for months trying to get pregnant via IVF. They feel frustrated, fearful and jealous that their straight friends had none of the same challenges. They find sexual connection fraught as they feel preoccupied with pregnancy goals.  

Medical Interventions and Their Impact 

For couples facing fertility challenges, medical interventions such as fertility drugs, intrauterine insemination (IUI), or in vitro fertilization (IVF) can also complicate sexual dynamics. These treatments often come with strict schedules, hormone injections, and medical appointments, thus having sex feel even more mechanical or less relevant in the process.

• Hormonal Changes: Women undergoing fertility treatments often experience hormonal changes that can affect mood, libido, and body image.Medications may cause bloating, mood swings, and other side effects, reducing the desire for sexual intimacy.
• Feeling of Loss of Control: Some couples feel like they have lost control over their reproductive journey as the process becomes more medicalized. This may leave partners feeling disconnected from each other or emotionally distant, further complicating their sexual relationship.
• Struggles for Both: The non gestational partner often gets missed here.They are watching the process and participating, but ultimately not having much control. They may feel helpless and invisible as much of the social support goes to the gestational partner.

Body Image and Self-esteem 

The process of trying to get pregnant can also affect how individuals feel about their bodies, which in turn impacts their sexual self-esteem. 

• Body Changes: Women might feel less confident due to weight fluctuations, bloating, or changes related to fertility treatments. Similarly, men may struggle with feelings of inadequacy if they are diagnosed with fertility issues, affecting their sense of sexual virility.
• Sexual Confidence: The emotional toll of infertility can cause both partners to feel less sexually confident. If either partner associates their self-worth with their ability to conceive, they might struggle with feelings of failure, further reducing sexual interest or leading to sexual avoidance.

Impact on Relationship Dynamics 

Sexual intimacy is closely tied to the overall emotional connection between partners. Trying to conceive can strengthen a couple’s bond as they unite toward a shared goal, but it can also create tension if the process becomes fraught with stress or disappointment.

• Intimacy Beyond Sex: For some couples, focusing on non-sexual intimacy can help relieve the pressure to perform sexually and sustain their emotional bond. Cuddling, emotional support, and affectionate gestures can help partners stay connected during this challenging time.
• Sexual Variety: Some couples find relief in exploring sexual activities that aren’t centered on conception, allowing them to reconnect emotionally and physically without the pressure of making a baby. This can bring back some of the playfulness and spontaneity that may have been lost during the TTC process.

Potential for Growth or Conflict 

Trying to conceive can be a transformative experience for couples. For some, the challenges may bring them closer, fostering stronger communication and deeper emotional intimacy. Others may experience strain if unresolved issues arise around sexuality, fertility, or unmet expectations.

• Increased Compassion and Understanding: Couples who communicate openly and support each other through the emotional ups and downs of TTC may develop a stronger relationship, with increased empathy and patience for each other’s struggles.
• Conflict and Distance: If one partner is more invested in conceiving than the other, or if communication breaks down, it can lead to resentment and emotional distance. The pressure to conceive may overshadow other important aspects of the relationship, leading to conflicts that affect both their sexual and emotional connection.

Navigating the Sexual Dynamics of Trying to Conceive

Open communication, patience, and an understanding of the emotional toll that TTC can take are key to maintaining a healthy sexual and emotional connection. For many couples, balancing the desire for pregnancy with the need for ongoing intimacy requires intentional effort, flexibility, and a willingness to prioritize their relationship beyond the pursuit of parenthood.