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Challenge: Infertility

Sendoff Sex - Intimacy Before IVF

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In the beginning of my relationship, sex was spontaneous and as often as possible. It was fun and funny and exciting. It was cute and coy and we both had energy and put in so much effort to keep things new and intoxicating.

Hotel rooms. Showers. A store dressing room (okay, one time, I felt extremely naughty but also really turned on). A single person bathroom at a wedding. The kitchen countertop. Several positions. Different accessories. Food additives. Ice cubes.

It kept us on our toes, on edge, and enthralled with each other.

Then, we started trying to conceive.


Our efforts slowly transitioned to sex during my ovulation window. In bed. Missionary style. Him on top. It became… vanilla. Effort. Thought. The opposite of spontaneous.

Each month’s negative pregnancy test made my heart sink even further… and made me much less emotionally available for fun, off-the-cuff intimacy.

Sex became… very matter of fact. It had a goal. And an end point. And we kind of got lost in that.

It was really really difficult for us to connect during that time.

I think one of the most unexpectedly difficult things about going through infertility is the constraints and challenges it places on intimacy.

Before I started TTC… I didn’t know that trying to have a baby, really, really trying - it wasn’t all fun and games.
Before I started fertility treatments… I didn’t know that my sex life would become scheduled by other people.
Before I started IVF… I didn’t know that I wouldn’t be able to be intimate with my partner… for a good chunk of time.
- Infertility & Intimacy

Then, we went through IVF.

We went from sex on a schedule, to someone else scheduling our sex, to not being able to have sex at all. The transition pulled us apart, and then brought us back together.

During that time, we worked hard to discover ways to be intimate with each other outside of intercourse, but we missed the connection and normalcy that sex gave us.

During my first cycle in 2018, I went straight from STIMS to egg retrieval, right in to a fresh embryo transfer and after we got a negative beta, we grieved - together. Intimately. It was the first time we’d been able to connect that way in a really long time, and the relief and closeness we rediscovered was immeasurable.


When we began a second cycle, we both felt nervous about losing the connection we’d just found.

We chose to do something intentional about it. We decided we’d have somewhat scheduled, somewhat celebratory “sendoff sex” the night before beginning PIO injections. This is the time in which the other IVF restrictions, such as not lifting heavy things, working out intensely or prolonged bedrest also take effect and we knew that if we came out the other side with a positive pregnancy test, our lives would change forever.

For us, Sendoff Sex felt like taking back a tiny bit of our freedom.

Scheduled intercourse month after month in our TTC days had worn deep into our psyche, and then the dictated rules about when we were intimate during fertility treatments felt like we were barely in control of when and how we enjoyed each other. With Sendoff Sex, we found joy in the intentionality that that time would be special and that it would carry us through until the next time it was safe for us to be together that way.

I busted out the lingerie. We put together a playlist. We turned our phones on silent and really, connected. We both came with a freedom we had been missing, and it felt like an explosion of hope and frustration and anticipation of the months both behind and ahead of us.

That transfer was successful, but I experienced a subchorionic hematoma (SCH) and subsequent bleeding early in my pregnancy, so we weren’t actually given the blessing for intimacy until the end of my first trimester.

At that point, we’d only had sex a few times in nearly half a year - the space between our failed transfer and our successful one. I was vomiting daily and still trying to feel secure in my pregnancy after struggling with infertility. It felt a little different and a little awkward, to be honest, to find our groove again.

It was strange having to relearn how to connect with my husband.

We’d been at the beginning once before - but then it came with newness, excitement, and getting to know what brought each other pleasure. This time, it was strange to realize that we were the same people we’d been before - we’d just walked together through an emotional landmine and my body was still experiencing a very physical set of challenges.

We didn’t previously know anyone else who had gone through infertility or IVF and subsequently, we had no idea that it would impact our marriage and our sex life too.

New traditions were born.

This past September, when we began prep for our last FET, we giddily planned again to have Sendoff Sex. This time, it was filled with anticipation and a little anxiety and also some excitement. We knew what IVF and pregnancy were like now; we had become veterans and were back for another round.


While postpartum sex after having my daughter was new and different, my husband and I had found a really good, really easy, healthy rhythm over the last year and we both felt somewhat disappointed that IVF again required this to pause. We worried that the loss in physical connection would be harder to adjust to this time around, as we were living with an active toddler, working, and parenting full time - all during a global pandemic.

We took out all the stops again this time - music and lube and no time constraints, and we got lost in each other. It made me feel empowered and supported as I launched into the hardest part of IVF - injections and a transfer and so so much waiting.

I share more about the failure of that transfer here, but the physical and mental implications for me were significant. There was no immediate acceptance for me; there was grief and loss and definitely no desire to be touched or naked or seen and touched intimately.

We planned to roll right into another FET prep and made peace with the fact that sex would just have to wait. A mid-cycle diagnosis of Chronic Endometritis cancelled our transfer and delayed our next round, leaving us in another space of waiting - waiting for instructions, for medication to work, for a surgical procedure, for another biopsy, for the go ahead to continue with our treatments.

The only silver lining, in what felt like a million delays to our transfer schedule, was that we still had the ability to be intimate on our own terms. During that season, we fell right back in to a groove. Sex was consistent and fulfilling and intimate - and we found gratitude in the connection we’ve worked so hard to maintain. Becoming parents looked and felt different than we’d planned, and growing our family has been far more frustrating than we could’ve imagined, but we have each other and a deep rooted sense of hope that whatever came our way we’d be able to roll with.

Here we go again.

This week, we began PIO shots again. Ceremoniously, the night before we tried to revel in Sendoff Sex. To be honest, it was hard to feel both celebratory and significantly anxious. There wasn’t as much fanfare as past attempts. but there was a little extra lingering. Connection. Foreplay. Focusing on each others pleasure. It turns out it was exactly what we both needed in this season.

Afterwards, we talked a lot about how this is our last frozen embryo, and the road will feel discouraging and quite long if we have to again return to STIMS.

The thing is, I’m entirely more grateful than I can explain to and for my partner. Struggling with infertility not just once now, but at least twice, has shown us so much about one another…

How we process grief and pain and disappointment and loss.

How we hope.

How we cope.

This season I am straddling huge emotions. Walking into another transfer, I am balancing cautious optimism paired with nervousness and anticipation, and I think about all of the things I know now that I didn’t know a few years back. I think about the hard lessons we had to learn and the ways we’ve rebounded stronger and better than we once were. I think about the ways that Infertility can make and break a relationship, how it requires partnership and support in every single way, and I wonder how I got so lucky to do it with my husband by my side.

I also think about you, and whether it’s your first IVF cycle or your 20th, I want to offer any words of wisdom I can. If you haven’t had Sendoff Sex before - maybe it’s worth trying! If you have, I’d love to hear about your experience. How has intentional connection changed your sex life or your relationship? How has a pause in intimacy impacted your communication, your sense of normalcy, and your level of contentment?

Feel free to comment below or drop me an email to chat. I’m always here for you.

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