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A couple's decision to commence a treatment programme, such as IVF or donor insemination signifies hope and excitement that they can overcome infertility and produce children like everyone else. However, like the investigative period, it again signals a further, if not more intense, invasion of their sexuality and sexual relationship.
Once accepted on to an IVF programme, most women are confronted at each attempt with the barriers to becoming pregnant, to become mothers, and thereby expressing a major aspect of "femaleness". The low pregnancy rate about 35% per treatment cycle means most will leave the programme with a reconfirmed sense of failure, at least for a short time, and certainly if they have had little emotional support.
The use of donor sperm to cause a pregnancy, as in a donor insemination programme where the male partner is infertile, brings home to the man his inability to reproduce. Some of the feelings of inadequacy may have been worked through during the period following diagnosis, but it is not uncommon for these feelings to be rearoused when the programme actually begins.
During IVF treatment, after the embryo transfer, most doctors will advise patients not to have intercourse. However, this does not mean that you cannot have sex! Sex does not always mean putting a penis in the vagina - and you can use your imagination to give each other sexual pleasure in other ways - for example, by mutual masturbation.
With nearly all forms of infertility treatment, rarely is the infertility cured, and clearly not where donor eggs or sperm are used. For example, women with blocked fallopian tubes who become pregnant on an IVF programme still face further IVF attempts if they wish to become pregnant again. A feeling of defectiveness may remain despite pregnancy and a live birth.
Menopause is a time when all women are confronted by their sexual identity, simply because the physical signs of being a woman are changing forever. It is a difficult time of adjustment for many women, and for those with infertility it means saying goodbye, yet again, to motherhood.
It is useful to ventilate feelings of frustration, anger, and feeling "taken over", as your sexuality gets trampled upon throughout the course of investigation and treatment. This will restore a sense of personal worth. Remember that it is normal, expected and almost inevitable that your sex life will take a beating for a time.
It is useful at this stage to join a support group or talk to a counsellor - who can help you to separate sex from reproduction - perhaps by throwing away the temperature chart for a while, or taking a break in the middle of a treatment programme to have a romantic holiday.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
