IVF (In vitro fertilisation) is a challenging procedure, which drains the patients physically, emotionally and financially. And it has another far reaching impact, which is that it takes toll of the sex life of the couple, particularly the females who have to bear the major brunt of the treatment. While sex becomes uncomfortable during the treatment, there is also a constant phobia that something might go wrong, which continuously deprives the woman of the pleasure of natural sex.

Whether or not sex is safe during IVF is a question that confuses the patients all the time because the doctors may sometimes recommend abstinence from the same, while nothing might be said explicitly against it. At the same time, patients need to be aware about the facts related to safety of sex during the treatment so that they can cope with the pressure and also save their relationship in the long run.

Should a couple have sex during IVF treatment?

IVF is a protocol based procedure, with a definite hierarchy of events starting with ovarian stimulation, followed by egg retrieval, embryo culture and ending with embryo transfer. The pace is set for every stage and doctors have a number of guidelines for the patients to ensure the success of IVF, and the timing of sexual activity also comes under the word of advice.

Starting with the first stage of the procedure, a woman would probably not feel like having sex during the ovarian stimulation because this is the time she is likely to experience discomfort caused by swollen ovaries. The medication used for stimulating the ovaries is also going to cause hormonal imbalance and vaginal dryness, leading to the libido being at its lowest at this time. On the other hand, men are required to avoid ejaculation for at least two days (some recommend 4-5days of abstinence) before the egg retrieval so that there is plenty of semen for carrying out the lab culture of the embryos.

When it comes to sex after egg retrieval, it is better to refrain because this is the time when the risk of infection is at the highest. And probably, the woman will not feel up to it because she would be drained due to the painful and highly intrusive procedure she has been through recently.

Usually, the patients are asked to abstain from sex after the embryo transfer too because it is believed that sexual activity, particularly orgasm, can hinder the implantation of the embryo in the uterus. In fact, some clinics may recommend abstinence for the entire 2ww (the two week wait between the transfer and confirmation of pregnancy), while others will regard one week as the safe threshold. But the fact is that most of the patients would rather wait for the pregnancy test to be confirmed, because of the amount of monetary, physical and emotional effort they have put in.

Once the woman gets pregnant with a successful IVF, she can have sexual intercourse safely if she feels up to it.  However, it is better to take precaution if there are complications or symptoms such as spotting or cramping.

A rare condition which deserves a special mention with regards to safety of sex for IVF patients, is with relation to women who are at high risk of a condition called Ovarian Hyperstimulation Syndrome (OHSS). In this condition, multiple oocytes are formed during ovarian stimulation and even if a single of these escapes retrieval, the woman might get pregnant through natural intercourse. There have been freak cases of multiple pregnancies, with women conceiving with IVF as well as natural method.

IVF and Sex- Understanding The Emotional Quotient

When a woman is undergoing IVF, she becomes emotionally vulnerable and also, sex becomes a mechanical process rather than a natural one. On the other hand, the man feels left out because he are neither physically involved in the procedure nor does he get sexual fulfillment from his partner. It can be said that sex is like regimented pleasure and stress keeps mounting while IVF treatment goes on, with sexual activity being restricted by the timing, rather than being a spontaneous, pleasurable activity.

A range of factors is responsible for the woman losing her libido during the IVF cycle. While the physical factors have already been discussed, women also tend to avoid sex during the treatment cycle because they feel emotionally depressed and helpless, even physically violated. The emotional pressure piles up if she has to undergo multiple IVF cycles, which happens when success does not come in the first attempt.

Help is at hand with counseling!

When a couple is undergoing an infertility treatment as complicated as IVF, sex is probably the last thing on their mind and that of their doctor too, because all of them are focused on making it a success. Also, couples are neither keen nor comfortable about discussing the loss of libido with the specialist. At the same time, it is crucial to realize that being open can make a real difference to their lives and relationship.

It is but natural for sexual activity to be confined during an IVF cycle due to more than one reason, but counseling and therapy can go a long way in resolving the problem. Being open is the first step in this direction and it is not just about seeking advice from the doctor, but the couple has to communicate with each other too.

They need to realize that sex is not only in body but in mind too, and cuddling and being close otherwise is as important as the act itself. If they take the treatment in a positive light, they may reconnect sexually sooner than expected. And the gift you are going to get at the end of the patient struggle is going to be worth the wait!