“How’s your sex life?” What fertility patients need to know about treatment

           One of the unfortunate results of fertility treatment is that it can contribute to a change in your sex life. Whether it is the stress of not becoming fertile or a hormone imbalance, many women going through fertility treatment experience a disquieting drop in their libido. Aside from the additional challenge that this can create in conceiving, if ignored, it can also have untoward effects upon your relationship.  New information is providing greater insights into this dilemma and along with that solutions are more accessible. Here’s what we know.

           In 2009, the largest clinical study [G1] completed to date found that 43% of women in the US experienced sexual dysfunction. Maybe more surprising was that two thirds of these women that were distressed by their symptoms were in their reproductive years. By far the most common complaint was low sexual desire; often referred to as “low libido.” More recently, studies began focusing on a particularly vulnerable patient population, women that were trying to become pregnant.

           A new study [G2] that is scheduled to be published in the journal Fertility & Sterility surveyed couples at Stanford University that had at least a 12 month history of infertility and planned to undergo fertility treatment, either ovulation induction or IVF treatment. Each couple completed a validated questionnaire used to diagnose sexual dysfunction. Researchers found that 40% of the women undergoing infertility treatment tested positive whereas only 25% of the control group experienced sexual dysfunction. Additionally, the women undergoing fertility treatment noted a decline in their sexual satisfaction as the length of their infertility continued. This study only confirms what has been found in other studies but it’s also not a problem that is limited to women in the USA.

           Using the same validated questionnaire as the Stanford study, a recent publication [G3] has similar results when applied to women treated for infertility in Turkey. They compared over three hundred women going through fertility treatment to those just in for a routine exam and found a significantly higher risk for sexual dysfunction associated with infertility. In their patient population, nearly 2/3 of women undergoing fertility treatment were experiencing sexual dysfunction with problems related to low desire as the most frequent finding.

           The reason that it’s so important to recognize the association between fertility treatment and sexual dysfunction is that failure to do so can place avoidable stress upon a couple’s relationship[G4] . That stress also further lower the chance for success from fertility treatment. By contrast, recognition of this common problem can not only validate an underlying hormonal imbalance but also initiate steps toward diagnosis and management for couples. That’s important as well since even when fertility treatment is successful, sexual dysfunction often persists.

           There are several well researched treatments that are available and others are under consideration for approval. So if you’re undergoing fertility treatment with your partner, it might be worthwhile to request a questionnaire [G5] to assess whether you may be experiencing signs of hypoactive sexual desire disorder. Acknowledgement can be your first step toward resolution.


2 thoughts on ““How’s your sex life?” What fertility patients need to know about treatment

  1. Hi doctor Green, I am from Bolivia and I need an advice. Two days ago I found out that I am pregnant but I am afraid because I have hypothyroidism and I lost a baby before (when I was 9 weeks pregnant). One month ago my endocrinologist said to me that I had to take metformine(640mg) because I had resistance to insuline, so I started taking it, now I don´t know whether to stop or not, because in your book you say that there is no problem wiht it but my doctor doesn´t want me to keep taking it. On the other hand I take 75ug of levotiroxine and I have read in many places on the internet that when you are pregnat you have to increase the dosis but my doctor says that I have to keep that dosis (she didn´t want to take another analysis because I had one in may) so I asked another doctor and this one said that I have to reduce it (but he didn´t even asked for an analisys too) what should I do?. My third problem is that almost a week ago I started having pain when urinate, so I think I have an urinary infection, honestly doctor I am very disappointed with the doctors here where I live, the gynecologist don´t know anything about hypothyroidism and all of them want me to see an endocrinologist, endocrinologist´don´t care about pregnant women they seemed to know anything about it except for the normal situations, and as soon they find out that my situation is not normal they seemed to avoid me.
    Could you please help me? I would really appreciate it.
    Verónica Arraya
    Sucre, Bolivia

    1. Dear Verónica,
      I’m so sorry that I’m not able t provide you with direct advice. I can guide you toward the information that you can then use to work with your physician. If possible, please obtain a copy of my book PERFECT HORMONE BALANCE FOR PREGNANCY. You should be able to access it from http://www.amazon.com. If so, you’ll find that I talk alot about hypothyroidism; especially on pp 164-7. I do hope that you’re able to get this information and utilize it as soon as possible. If you or your doctor have any additional questions, please email me.

      Best thoughts,
      ~Robert

      Robert Greene, MD, FACOG
      Medical Director
      SIRM–Northern California

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