You’d expect that the process of trying for a baby means having lots of sex. And in traditional circumstances, that’s true. But when you’ve had trouble conceiving naturally and need to seek help from fertility treatments, it’s a little different.

The in vitro fertilisation (IVF) process can be emotionally taxing, with couples experiencing a range of feelings from hope to anxiety. Intimacy during this period may be affected by hormonal fluctuations, physical discomfort and the psychological stress associated with IVF. Understanding how sex interacts with IVF can alleviate concerns and support your and your partner’s wellbeing throughout the experience.

A fertility nurse plays a crucial role in guiding patients through the IVF process, providing instruction on sperm collection, discussing travel plans, and addressing potential concerns.

Understanding IVF and how it impacts intimacy

What is IVF?

IVF is a multifaceted and emotionally charged journey. It involves a series of medical procedures designed to help individuals or couples conceive a healthy baby.

IVF involves stimulating a woman’s ovaries to produce multiple eggs, which are then retrieved and fertilised in a laboratory setting. The resulting embryos are cultured and subsequently transferred into the woman’s uterus in the hope of achieving a successful pregnancy. Embryos reaching the blastocyst stage by day five or six after fertilisation can significantly increase live birth rates, although it may decrease the number of embryos available for transfer and cryopreservation.

The IVF process begins with ovarian stimulation, where hormone injections are used to encourage the ovaries to produce multiple eggs. These eggs are then retrieved in a minor surgical procedure and fertilised in a laboratory setting. The resulting embryos are cultured and, at the appropriate time, transferred into the woman’s uterus. The cleavage stage, when the embryo has begun to divide into several individual cells, is significant for embryo transfer decisions and preimplantation genetic screening.

The culmination of this process is the pregnancy test, which determines whether the treatment has been successful. The IVF cycle can be a rollercoaster of emotions, but understanding each step can help you navigate this journey with confidence.

Sex and IVF: The emotional layer

It’s important to acknowledge that IVF can affect intimacy in ways that go beyond the physical. Many women experience similar emotional challenges during IVF. The pressure of timed intercourse, hormonal fluctuations, invasive procedures and emotional highs and lows can all impact desire and connection.

A negative pregnancy test can significantly increase stress and anxiety, contributing to the emotional challenges faced during IVF cycles. Many couples report a sense of detachment between sex and pleasure during fertility treatments — what once was spontaneous may begin to feel medical or goal-oriented. You are not alone if your relationship faces these challenges. Open communication and mutual support are key, and it’s okay to seek counselling to navigate this delicate aspect of your relationship.

Preparing for IVF

Preparing for fertility treatment is a crucial step that requires a comprehensive understanding of the IVF process and its potential risks. Artificial insemination is one of the fertility treatments that may be considered. Consulting with a fertility specialist is essential to discuss your options and tailor a treatment plan that suits your needs.

This preparation often includes a semen analysis to assess the male partner’s sperm quality and blood tests to evaluate the female partner’s hormone levels. The use of a donor egg in IVF can be an option for various couples, particularly same-sex couples and older women. Understanding the treatment cycle, from the early stimulation phase with FSH injections to egg retrieval and embryo transfer, is vital.

The importance of a semen sample in the preparation process cannot be overstated, as it ensures accurate analysis of sperm quality. Being well-informed about what to expect at each stage can help you feel more in control and prepared for the journey ahead.

Initial steps

The initial steps of fertility treatment typically involve a series of tests and evaluations to determine the cause of infertility. This may include a semen analysis to assess the male partner’s sperm quality, blood tests to evaluate hormone levels, and internal scans to examine the reproductive organs. The results of these tests will help the fertility specialist determine the best course of treatment. For instance, if the male partner has a low sperm count, donor sperm may be recommended. Alternatively, if the female partner has blocked fallopian tubes, IVF may be the most suitable option. These diagnostic procedures are crucial in tailoring a treatment plan that addresses the specific needs of each individual or couple.

Medication and stimulation

Ovarian stimulation is a crucial part of the IVF process. It involves the use of hormone injections, such as follicle stimulating hormone (FSH), to stimulate the ovaries to produce multiple eggs. This increases the chances of successful fertilisation and embryo transfer. However, ovarian stimulation can also increase the risk of ovarian hyperstimulation syndrome (OHSS), a potentially life-threatening condition. To minimise this risk, fertility nurses closely monitor the patient’s response to the medication and adjust the dosage as needed. This careful monitoring ensures that the ovaries are stimulated effectively while keeping the patient’s safety a top priority.

The IVF process

The IVF process typically involves several stages, including egg retrieval, fertilisation, and embryo transfer. The number of embryos transferred will depend on various factors, including the patient’s age, medical history, and the quality of the embryos. Each stage of the IVF process is meticulously planned and executed to maximise the chances of a successful pregnancy. Understanding these stages can help patients feel more informed and prepared as they navigate their IVF journey.

Egg retrieval and fertilisation

Egg retrieval is a surgical procedure that involves the use of a needle to retrieve eggs from the ovaries. The eggs are then fertilised with sperm in the embryology laboratory. The resulting embryos are cultured for several days before being transferred to the uterus. In some cases, sperm preparation may be necessary to improve the chances of fertilisation. For example, if the male partner has a low sperm count, intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI) may be recommended.

It’s essential for IVF patients to understand the risks and benefits associated with fertility treatment, including the risk of multiple pregnancy, ectopic pregnancy, and birth defects. A fertility specialist can provide guidance and support throughout the IVF journey, helping patients make informed decisions about their treatment. Additionally, patients should be aware of the importance of pelvic rest after embryo transfer and avoid intercourse until the pregnancy test results are confirmed. By following these guidelines and working closely with their healthcare team, IVF patients can increase their chances of a successful pregnancy.

The role of sexual activity during IVF

Is it okay to have sex before IVF?

Generally, yes — but with a few caveats.

In the months and weeks leading up to IVF, most fertility specialists have no concerns about sexual activity unless there are specific health issues, such as a history of miscarriage, uterine abnormalities, or certain infections.

However, once your fertility team begins monitoring your cycle and preparing for egg retrieval, timing matters. If you have a male partner, it is important to avoid sexual intercourse prior to testing to prevent inaccuracies in test results. Understanding the male partner’s contribution to fertility assessments is crucial. The analysis of the sperm sample, conducted on the day of egg collection, is crucial for tailoring the treatment plan based on the quality of the sperm and other factors. Here’s what you need to know:

Timing abstinence for sperm collection

Doctors often recommend 2–5 days of abstinence before sperm collection to ensure optimal sperm quality and volume. Issues stemming from the male partner can impact fertility assessments and treatment outcomes; too much abstinence can reduce motility, while too little can affect sperm counts. Your fertility clinic will give personalised guidance here.

Caution near ovulation

Generally, sex during the early stimulation phase of an IVF cycle is acceptable as long as the couple is using a form of barrier contraceptive, such as a condom. In the event ovulation was to occur unexpectedly, especially from multiple follicles, you want to avoid the possibility of multiple pregnancies.

However, a woman’s ovaries enlarge and become more fragile at the ovulation stage, leading to enlarged ovaries. Some specialists recommend avoiding sex to prevent discomfort or rare complications like ovarian torsion.

Is it safe to have sex during IVF?

The safety of sexual activity during IVF largely depends on the stage of treatment and individual health considerations. During the IVF stimulation phase, it is crucial to be cautious with activities such as massages, exercise, and even drinking alcohol. Restrictions are usually advised at certain stages: there is an increased risk of complications during procedures like embryo transfer or IUI, where activities that could affect the treatment outcome should be avoided.

After egg retrieval

After the egg collection procedure, your ovaries are still enlarged and tender. Intercourse during this time can cause significant discomfort and increases the risk of ovarian torsion — a rare but serious complication.

A human chorionic gonadotropin (hCG) injection, commonly known as the ‘trigger shot’, is administered to facilitate ovulation approximately 38 to 40 hours before egg retrieval, ensuring that the eggs are fully mature for collection.

Experts advise avoiding intercourse for at least 5 to 7 days after egg retrieval, or until your doctor gives you the green light.

Leading up to embryo transfer

Once fertilisation occurs in the lab and your embryo transfer is scheduled, many clinics suggest refraining from intercourse. Although there’s no conclusive evidence that sex negatively affects embryo implantation, most specialists prefer a cautious approach to minimise uterine contractions and stress. Additionally, the number of embryos transferred is a critical decision influenced by factors such as the age of the patient, cycle history, and embryo quality, aiming to maximise success rates while minimising risks. Deciding how many embryos to transfer involves considering these factors to increase the chances of success while minimising the risk of twins.

The general rule is to abstain from intercourse from egg retrieval through to embryo transfer and for a few days after. However, emerging research suggests that exposure to semen around the time of embryo transfer may enhance endometrial receptivity, potentially improving implantation rates.

When can you have sex after IVF? 

This is perhaps the most emotionally intense part of the process — the infamous “two-week wait” before your pregnancy test results. Understandably, couples may be unsure about resuming intimacy.

Can you have sex after embryo transfer?

Most clinics recommend waiting until after the pregnancy test before resuming intercourse. The rationale is to minimise any uterine contractions that might, in theory, interfere with implantation, although scientific data is limited and mixed on this.

Once a pregnancy is confirmed, your doctor may advise additional precautions based on your individual situation, especially if there’s a history of miscarriage or high-risk factors. These precautions are aimed at promoting a healthy pregnancy and ensuring the best possible outcome for both mother and baby.

Risks and complications

While fertility treatment offers hope to many, it also comes with potential risks and complications. Live birth rates associated with IVF can vary based on factors such as maternal age and treatment protocols.

  • Multiple pregnancy is a common concern, as transferring more than one embryo can increase the chances of twins or triplets.
  • Poor quality embryos present challenges, as they rarely survive the thawing process and may affect the success of embryo donation.
  • Ovarian hyperstimulation syndrome, a condition where the ovaries become swollen and painful, can occur due to hormone injections.
  • Ectopic pregnancy, where the fertilised egg implants outside the uterus, is another risk to be aware of. Recognizing the signs and symptoms of these complications and seeking immediate medical attention is crucial.
  • Hormone injections can sometimes lead to ovarian torsion, a painful condition where the ovary twists.

Following your healthcare team’s advice on pelvic rest after embryo transfer can help mitigate some of these risks. Understanding these potential complications allows you to make informed decisions and seek timely care if needed.

3 ways to reconnect intimately post IVF

Whether IVF is successful or not, the journey will change you and your relationship. Once you’re past the intense treatment phase, it can be helpful to intentionally reconnect with your partner, emotionally and physically, outside of fertility goals. Sexual intimacy often diminishes during fertility treatments, so focusing on rebuilding this aspect of your relationship is crucial. Here are a few ways to reignite intimacy post-IVF:

  1. Schedule “non-goal” intimacy time: No pressure. Just touch, talk, or cuddle.
  2. Try something new together: Dance classes, cooking, travel or a romantic getaway.
  3. Seek counselling, if needed. Fertility journeys test relationships, and professional guidance can make a huge difference.

By focusing on these strategies, you can strengthen your relationship and find new ways to connect after the intense experience of IVF treatment.

What to do if you’re in physical discomfort

If sexual activity causes significant pain or discomfort, it’s crucial to consult with a member of your healthcare team to rule out complications.​

Can you have a good sex life while going through IVF treatment?

Sex and IVF don’t always go hand in hand, but intimacy, connection, and communication can. IVF can help couples get pregnant by increasing the chances of achieving pregnancy through assisted reproductive technologies. Knowing when it’s safe to be sexually active during IVF can help you navigate this journey with confidence and care, potentially improving pregnancy rates.

As always, consult your fertility team for personalised advice based on your treatment protocol and health status. And remember: IVF may be clinical, but your love life doesn’t have to be.

You’ve got this. And we’re here with you, every step of the way.

Looking for more support, real-life stories or expert Q&As? Join the conversation at The IVF Network and connect with others who understand the journey.