May 8, 2000 -- Like five million other Americans, Candace and Alan Saylor (not their real names) desperately wanted a baby but couldn't seem to conceive. After a consultation, they were sent home with doctor's orders: Have sex when Candace was most fertile, and have it often.
While that may sound like a dream come true, infertile couples like the Saylors say it can be stressful. "I didn't want to be one of those women tapping on her watch, saying 'Now' at the bedroom door," says Candace, "so I tried to be seductive in creative ways."
They both put more emphasis on foreplay, for instance, so they didn't view each other simply as an egg manufacturer and a sperm-delivery guy. "I'd try to think of my husband as a sexy man, not just the guy who didn't get me pregnant," says Candace. "Sometimes, before intercourse, I'd focus on some physical aspect of him that I particularly adore, and that would turn me on."
Obviously, it worked -- the Saylors' daughter, Caitlin, is now three.
The Stopwatch Mentality
Many other infertile couples who are still trying to conceive say that sex can become tedious when they have to time intercourse to accommodate numerous lab tests or maximize their chances of success. Spontaneity can be replaced with sex as a compulsory act -- sex on a schedule.
Besides this timetable pressure, there can be loss of self-esteem (if, for instance, the woman feels like a failure for not becoming pregnant) and the financial burden of fertility treatments. But through it all, there are ways to minimize the toll.
How Women and Men Respond
First, a couple should understand that each of them tends to react a bit differently, experts say. "A woman in this situation may feel alienated from her body, so it may be hard for her to feel sexual," says Andrea Braverman, PhD, director of psychological services at the Women's Institute for Fertility, Endocrinology, and Menopause in Philadelphia. "She may feel like little more than a set of ovaries and even begin asking herself, 'What's the point of having sex if I'm not getting pregnant?' "
Lack of desire, in turn, can decrease natural lubrication, making sex painful, Braverman says, and resulting in even less sex.
In addition, "A man may feel like nothing more than a sperm donor and become so distanced that he has difficulty achieving erection or orgasm," says Anthony Thomas, MD, a urologist at The Cleveland Clinic Foundation in Ohio and co-author of Overcoming Male Infertility . "Some men even fake orgasm to get sex over with."
Relieving the Pressure
Both partners should avoid getting into "performance" mode. It can help to realize that the window of opportunity for conception stays open longer than what is suggested in movies and television shows, where characters often engage in lunch-hour sex in order to conceive while the woman is fertile. Sperm can live in the cervical mucus for about five days before ovulation, according to Thomas.
In general, infertile couples are advised to have intercourse every other day around the time of ovulation, usually around day 14 of the woman's menstrual cycle. Women can detect ovulation in a number of ways, such as by using a urine test or monitoring changes in vaginal secretions.
However, sex shouldn't be confined to the time of ovulation. Unless instructed otherwise by their doctor, couples should make love throughout the month, not just when they think they might conceive, says Leslie Schover, PhD, a clinical psychologist who has counseled many infertile couples and is co-author of Overcoming Male Infertility. That might help them separate sex from conception -- and sex will become a natural part of life again.
Sex as Recreation, Not Just Procreation
Thinking of sex not as a chore but as fun, the way it usedto be, can help. "We did our best to have a good time -- having sex in different rooms, going to hotels, going out on 'dates' beforehand," Alan recalls.
"Set a romantic mood with things like shared baths and massages," Schover suggests. It's also a good time to explore sexual fantasies and erotica.
Keep Reaching Out
Turning to professional counselors and infertility support groups such as Resolve is often useful. Couples can expect to find practical suggestions, a forum for sharing feelings, and a reminder that they are not alone. And talking on an informal basis with other couples who have overcomeinfertility can help, too. In retrospect, what helped most, Candace says, was staying positive and looking ahead to the day they would hold a brand-new family member in their arms.
Sharon Cohen is a senior editor at Shape and Fit Pregnancy magazines.