Trajectories of sexual desire tend to differ in couples with medical infertility undergoing medically assisted reproduction (MAR), and some types are better predicted by education and relationship satisfaction, suggests a recent study.
“[C]linical practice should take this heterogeneity into account in psychoeducation, assessment, and intervention,” the investigators said.
Some 217 couples seeking MAR completed an online survey assessing their demographics (ie, age and education), biological (eg, infertility duration, type of MAR treatments), and psychosocial factors (ie, partner support, relationship satisfaction, and perceived financial burden) at baseline.
The investigators analysed data with dyadic latent class growth analysis and identified predictors through multinomial logistic regression. They assessed sexual desire at baseline, 6, 12, 18, and 24 months with two items from the Female Sexual Function Index for female participants and two nearly identical items from the International Index of Erectile Function for males.
Four unique classes of dyadic trajectories of mostly declining sexual desire were identified, namely Steep Decline with Low Sexual Desire (10 percent), Moderate Sexual Desire (27 percent), Discrepant Sexual Desire (37 percent), and High Sexual Desire (26 percent). [J Sex Med 2026;doi:10.1093/jsxmed/qdag216]
Univariable models generated six factors that significantly predicted class membership, such as male-factor infertility, relationship satisfaction (both partners), MAR receiver’s perception of partner support, MAR receiver’s age, and education. However, in the multivariable model, only education and relationship satisfaction remained significantly associated with class membership.
“[These] findings provide more nuanced information about [the] couples’ sexual desire during this vulnerable period, which may facilitate early assessment and intervention,” the investigators said.
Expectations, feelings
This study recommends information sharing among healthcare professionals regarding sexual desire trajectories and the normalization of such variability, which may help couples to temper their expectations and lessen feelings of distress about their sexual relationship.
“Given that most participants reported declines in sexual desire over time, routine follow-up should include screening for changes in sexual desire and opportunities to discuss whether such changes are causing distress or conflict for the couple,” the investigators said.
Furthermore, individuals who experience distressing consequences could benefit from referral to psychological interventions (ie, psychoeducational, mindfulness-based, and cognitive-behavioural therapies) to improve sexual function in the context of MAR. [Sex Disabil 2022;40:785-806; J Sex Marital Ther 2019;45:21-30; Int J Women's Health 2020;12:975-982; Int J Reprod Biomed 2023;21:147-158]
“Promoting relationship quality through couple-based interventions, such as encouraging couple time that is not focused on infertility and the MAR process and the pursuit of other, non-parenthood related goals, may help couples preserve intimacy and engage in more adaptive dyadic coping with MAR stressors,” the investigators said. [J Sex Marital Ther 2019;45:303-316]
“Recognizing sexual desire during MAR as a dynamic and dyadic experience that does not change in the same way for everyone, can guide tailored, couple-based interventions to improve and/or preserve sexual intimacy throughout treatment,” they added.
Limitations
The current study was limited by a population that excluded individuals with social infertility, was characterized by high education and employment, and was mostly White and heterosexual, which prevent generalizability.
Additionally, the lack of a control group not undergoing MAR limited the ability of the investigators to determine whether patterns are unique to MAR.