Conception: the problems of 'compulsory' sex

The wonderful time comes when a couple decides to have a child. But how easy is it to conceive? In fertile couples, there are 20% chances of the woman getting pregnant in every menstrual cycle, and 85% of women having free sexual contact get pregnant within one year. However, when the first months pass by without having the desired outcome, the couple's sexual life changes: spontaneity is replaced with sex as a compulsory act on a schedule and the sexual satisfaction is translated only in terms of  the final outcome. And when menstruation (period) comes, all expectations are eliminated. It is not rarely that the conception anxiety is converted into anxiety for sexual intercourse under conditions, where the erotic/sexual game is replaced with thermometres and ovulation tests and the sexual initiative becomes an obsessive-compulsive disorder. And it is then that the real problem emerges: the man who is called to achieve erection on a specific date at a specific time fails, and the woman does not want even to hear about sex other than on fertile days, for conception per se has ended up being the sole purpose. According to a very recent study (Fertility Sterility, 2010), 40% of women visiting an Assisted Reproduction Centre faced some sexual problem. The most common problems reported were hypoactive (low) sexual desire and arousal difficulty. With regard to men, a study in 100 infertile couples demonstrated that 1 out of 10 men had some sexual dysfunction. The most frequent problems were difficulty in achieving or maintaining erection and  hyperactive sexual desire (Urology, 2004).  

 The relation between sexual problems and conception difficulty can be mutual! Sexual dysfunction may be the reason for not conceiving; and vice-versa: the effort for conceiving may cause sexual dysfunction. 

Sexual dysfunctions may have preexisted before the fertility problem emerged. In fact, there are couples seeking treatments to resolve the problem of infertility and not their sexual problem, even though they are not sexually active any longer. However, frequent sexual contact is imperative for conceiving, particularly on fertile days. 

The situation becomes worse in couples who have infertility problem (1 out of 6 couples will come face to face with the problem). Psychological consequences often following the diagnosis and treatment of infertility are: intense anxiety, reduced self-esteem, even symptoms of depression. In addition, difficulties in conceiving frequently lead the couple to tension and repeated failed attempts induce even further psychological burdening. All these conditions are aggravating factors that inhibit sexual desire, reduce satisfaction and triger sexual dysfunctions both to the female and male partner. 

The restoration of a couple's sexual life should be an indispensable part of the infertility treatment. A study (2001) has actually shown that couples maintaining their sexual activity during the assisted reproduction treatment manage the problem much better and at the same time have significantly higher chances of conceiving.