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A recognized expert in her field, Dr. Zoldbrod's work featured recently by the American Psychological Association

and featured on That Relationship Show Podcast

Boston Sex Therapy Deals with the Reality of Infertility
Posted on October 16, 2014 by Aline Zoldbrod

By Aline Zoldbrod Ph.D.

Going through the experience of infertility is one of life’s greatest stresses. Unfortunately, just as you are going through this terrible situation with your spouse and need to feel close, your sexual intimacy is affected by the trauma of the fertility problems you are facing.

Life is so ironic! You fell in love with your spouse. Life was good. Life was sweet. Sex was great. You (finally!) felt enough attachment, love, and commitment to another person to want to make a baby as an expression of that love. Sex was especially wonderful too, in the beginning, when you were looking forward to creating a child who was the direct expression of your love for each other.

But when that sexual passion didn’t lead to a baby, sex changed. Infertility brings with it great anxiety, grief and depression, and an obsession with the mechanics of creating a child that sucks the pleasure out of the sex act.

The world itself begins to feel hostile. Everyone else seems to be pregnant or have a baby. Joint and individual activities that used to bring pleasure feel meaningless, as you get on a medical merry-go-round of tests and office visits and “assisted reproduction.” Life, day to day planning, begins to center around medical treatment.

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Often, the stresses of infertility for men and women are different, and they can drive the two of you apart sexually and emotionally.

Women quickly feel personally inadequate, because the social role of “mother” isn’t really optional in our society. Women may feel defective, angry, and jealous of others. Sometimes men don’t understand the strength of their wives’ reactions. Research has shown that typically, it takes men three years of infertility to get upset. (The major social role for men is “worker,” not father. In fact, men who are devastated by infertility often feel more socially isolated than women, since men usually do not sit around and have discussions about how painful it is not to be able to father.)

The sexual stresses for women are huge. No matter who has the fertility problem, biologically, the battle to fight it is fought in the woman’s body, with pills, procedures and surgery that can lead a woman to bad associations with sex, her body in general, or specifically with her pelvis and reproductive organs.

Many times, for women, the grief over infertility means sex is the farthest thing from her mind. Depression is no friend to passion, after all. And even if you want to have non-procreative sex, it’s harder to enjoy now. For women, infertility or not, sexual pleasure takes sexual focus. Part of arousal involves focusing on your body in general, and on your sexual organs and pelvis specifically. If you’re angry with your body for not cooperating, it’s harder to keep your erotic focus.

And sex has its own stresses for men, whether or not they are the infertile partner. For men who are fertile, the pressure to be a “sperm machine” and their wives’ disinterest in passionate sex can make sex feel alienating and create feelings of being unloved.

Despite the myths, men do not function like sexual machines. They need to feel tenderness and connection to their wives, if not to get erections, then to feel sexual and emotional pleasure. Women, if your man is not having trouble obtaining erections, that does not mean that he is undisturbed about the sexual demands being placed upon him by infertility treatment! Having sex when there is no desire is anything but pleasurable. Even when they’re not yet upset about the infertility, husbands are frustrated and saddened by their wives’ emotional pain and any accompanying emotional unavailability.

Infertility causes some men to have disturbing changes in their body imagery and sexual imagery, even when the medical problem lies in their wife! Men report intrusive negative imagery about being judged during intercourse, they dread being teased by other men about being sexual “duds” and they have fears that somehow part of the medical problem is hidden within their body, too.

Men with male-factor infertility, and men with other pre-existing wounds to their sexual self- image, feel the most difficult sexual feelings. Infertile men can have spontaneous negative visual imagery: “I’m making Martian sperm” or ” I see my sperm, trapped helplessly by the gunk” (sperm antibodies). The feelings of being defective are devastating, yet too personal and disturbing for most men to acknowledge or discuss with their partners, friends, or medical professionals like a Boston sex therapist. The knowledge that one’s sperm is unlikely or unable to make a baby may make having sex seem upsetting or pointless.

So the challenges of continuing your sexual connection during infertility are intense. But you can learn how to maintain your sexual connection. Part Two, Revitalize Your Sex Life, will show you how.

Aline Zoldbrod Ph.D. is a Boston based sex therapist and psychologist and the author of the award winning book SexSmart: How Your Childhood Shaped Your Sexual Life and What to Do About It (1998). You can find out more about getting help for infertility at

A recognized expert in her field, Dr. Zoldbrod's work featured recently by the American Psychological Association

and featured on That Relationship Show Podcast

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Dr. Aline Zoldbrod is a licensed psychologist and Boston sex therapy practitioner, seasoned sex therapist, teacher and trainer in sexuality, and author of multiple books on sexuality.

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