Female sexual dysfunction and infertility

Abstract

The link between infertility and sexuality is complex, and infertility clearly impacts the sexual functioning and sexual health of women in numerous ways. Sexual dysfunction may have an etiological role in infertility, or it may be a consequence of the disorder secondary to psychological stress in either or both partners. Testing for identifiable and correctable causes of infertility as a result of female factors is relatively straightforward and falls into three main categories: hormonal (ovulation and luteal function post-ovulation), anatomic factors (cervical abnormalities, endometrial defects, and tubal/peritoneal factors), and egg factors (advanced age with diminished egg quantity and anticipated high rate of oocyte aneuploidy). For some couples, a diagnosis is never identified, and even for those who are properly diagnosed, treatment may still be ineffective. Although some patients may proceed with infertility treatment in the presence of some sexual dysfunctions, medical treatment should be in conjunction with psychotherapy and/or sex therapy, emphasizing the importance of sexual health and well-being in infertile couples. Whether sexual dysfunction is a preexisting condition or an unwelcome side effect of infertility treatment, it can be a devastating and discouraging blow, compounding the disappointment of childlessness and the distress of medical treatment.