Last Updated on August 26, 2019
For obvious reasons, couples rarely want to discuss sex during IVF. Yet, online, it’s completely common for women (and men) to post messages asking about it. Fertility clinics provide tons of guidance on this subject as well.
In this guide, we’ll talk about whether or not sex during IVF is safe and recommended, and sex at the various points of the treatment. We’ll also cover how to make sex during IVF more enjoyable and whether or not you should abstain from it altogether in certain cases. Lastly, some couples really struggle with sex during IVF, as well as before and after. So, we’ll post Q & A about sexual intimacy and infertility in general.
Sex During IVF: When Intimacy Can Go Wrong
Many – quite possibly, most – couples debate about sex during IVF. Is it safe? Is it recommended? How will it affect the treatment? It can be challenging to have conversations about it with your partner, and you may not even be on the same page about it.
Online, you’ll find all sorts of opinions about sex during IVF, including differences in expert opinion. Like exercise during IVF, sexual intercourse during an IVF cycle can be harmful in certain cases and helpful in others.
Let’s look at the most important question first.
Is Sex During IVF Safe?
The answer to that question is: it depends. The in vitro fertilization process lasts for a few weeks and involves multiple processes. Usually, during the ovarian stimulation phase, couples can have sex during IVF with no real safety concerns. Under some circumstances, sex may cause pain due to the enlarged ovaries, but still safe.
But your fertility specialist may ask you to abstain from sex at other points in the process, such as after IVF transfer or even before or after egg and semen collection.
As long as you follow your fertility specialist’s instructions and guidance about sex during IVF, you should be fine and safe. You’ll be told when to avoid it altogether, and when it’s okay.
Sex during IVF doesn’t make treatment less effective, generally, and with just a few exceptions, doesn’t risk anything. But please note that there are certainly exceptions to that rule of thumb!
The Problem with Sex During IVF
Emotionally, you’ll be overwhelmed and potentially anxious through the entire IVF cycle. The closer you get to IVF transfer, the more emotions tend to overwhelm you. Many couples experience a lack of intimacy, rather than a desire for more. Unlike other fertility treatments that either encourage sex or even incorporate it, IVF stresses many couples out. It’s largely invasive at several points throughout the treatment and sometimes uncomfortable.
Sometimes, fertility issues complicate the issue even further. Infertility tends to put a lot of pressure and stress on couples who have been trying naturally – sometimes, for many years prior to treatment.
Couples should avoid putting extra pressure on themselves to have great sex during IVF.
During the ovarian stimulation phase, a woman’s ovaries enlarge dramatically. Ovaries can go from the size of walnuts to the size of grapefruits during this time. This means sex can actually be painful. Avoid sex when it’s painful, as it can lead to psychological issues down the road and could reduce the desire to be intimate later on.
Some fertility clinics also warn against intercourse at this time, because it could lead to OHSS (ovarian hyperstimulation syndrome) or ovarian torsion (twisted ovary). Both conditions cause pain and discomfort. OHSS occurs more commonly than ovarian torsion, but sex could exasperate either condition.
Between egg retrieval and embryo transfer, many women do not feel like having sex at all. Everyone responds differently to egg retrieval, but here’s just a short list of possible short term side effects:
- Mild cramping
- Mild to moderate pain
The uterus may remain bloated and sensitive for up to two or three weeks after egg retrieval. During this time, many women consider sexual intimacy very low on the priority list.
Sex At Various Stages of the IVF Cycle
During this phase , fertility specialists advise couples to use condoms or another form of barrier (physical) contraception. Why? Because of the potential for multiple pregnancies.
Though rare, sex during IVF can lead to multiple pregnancies. If the treatment works, and the couple conceives naturally at the same time, a woman could become pregnant with several babies. Multiples creates significant risk, which is why so many fertility doctors attempt to minimize the risk of them.
Egg Retrieval and Semen Collection
Right before and after egg retrieval, some doctors suggest avoiding sex altogether. Besides feeling uncomfortable and possibly having pain, there’s a small risk of infection due to the procedure. This is a time for healing before the IVF transfer.
Doctors generally also ask males to abstain from intercourse with ejaculation for a few days prior to semen collection. This allows time for replenishment. But too much time can actually be unhelpful or even counterproductive.
Your doctor will ask you not to have sex right after the IVF transfer, and possibly for the entire two week waiting period. Sex – as well as vigorous exercise – could hinder the implantation process. During this two week period, known to some as a “pelvic rest,” you’ll want to do your best to allow for successful implantation. While there’s not much you can do to help it along, you could risk it with activity.
Sex during pregnancy is generally very safe. But, you’ll need to avoid it during the two week wait. It will be worth the wait if your transfer is successful!
Surrogates, Donors, and Sex During IVF
Anyone participating in the IVF treatment process, including surrogates and egg donors, should closely follow clinical guidelines regarding sex during IVF. Everyone involved should do their part to make the treatment successful.
Surrogate mothers should abstain from unprotected sex prior to after IVF transfer to avoid the risk of multiple pregnancies or becoming pregnant naturally. Likewise, they should not have sex after the IVF transfer so that implantation can occur with as little interruption as possible.
How to Make Sex During IVF More Enjoyable
Even though the IVF treatment cycle sometimes creates tension in relationships, couples who want to be intimate should absolutely do so. It’s important to maintain intimacy, especially when you both want to.
But IVF treatment has both physical and emotional side effects. How can couples make sex during IVF more enjoyable for both of them?
Listen to your body
The most common thing that fertility clinics and doctors discuss about sex during IVF is that it can be uncomfortable. Painful sex has consequences down the road, so avoid it at all costs. Change up your sexual routine during IVF to include less invasive, but enjoyable, sexual intimacy.
Ultimately, be gentle with your body during IVF treatment – all phases. In the same way you should avoid vigorous or strenuous exercise during IVF, you should avoid vigorous sex, too. Not only will you lessen the risk of pain, you’ll reduce your risk of ovarian torsion or failed implantation.
Change Things Up
Try positions that are more comfortable for you both, if your ovaries are particularly sore, making sex difficult. Also, sex is just one way for couples to experience intimacy. You can enjoy yoga together or gentle stretching, or opt for a couple’s massage. Both will keep things romantic and intimate while avoiding the potential pain or risk associated with intercourse. They will also help you reduce some stress.
Sexual Intimacy and Infertility
A research study from Stanford University found that “Forty percent of infertile women suffered from sexual problems that caused them distress, compared with 25 percent of a control group of healthy women.” Problems included low sex drive and difficulty being aroused. The issues link back to stress, a feeling of being disappointed, or even the feeling of disappointing her partner.
Often, women struggle emotionally during these times. Men, too, may suffer from feelings of inadequacy and the inability to solve the problem of infertility.
For this reason, sex during IVF should be approached with some level of enthusiasm. An increased sex drive – perhaps due to the anticipation of the possibility of getting pregnant – should be celebrated.
Many couples struggle with infertile for long periods of time. The realization that infertility may be successfully treated with IVF could rekindle the sexual desires. A separate study showed that after IVF treatment, couples reported that their sex lives had improved. Even those whose infertility journey results in adoption or moving on from the desire of parenthood, sexual intimacy often returns to normal.