Evaluation of Marital and Sexual Interactions of Polish Infertile Couples

IntroductionThe World Health Organization defines infertility as inability to conceive despite regular sexual intercourse sustained for a period exceeding 12 months with no contraceptive methods.AimThe aim of this study was to evaluate the effect of infertility on marital and sexual interactions among infertile couples.MethodsTwo hundred six infertile couples were qualified to the study as the research group. The control group consisted of 190 fertile couples.Main Outcome MeasuresA specific questionnaire was used as a research tool in this study. It included the sociodemographic part, infertility status, and validated scales: Polish version of Index of Marital Satisfaction and Index of Sexual Satisfaction. Statistica 6.0 (Medical University of Silesia; Katowice, Poland) was used in the statistical analysis. The statistical analysis made use of: Mann–Whitney U‐test, chi‐square with Yates' continuity correction, ancova log‐linear analysis of covariance, and logistic regression analysis.ResultsThe study showed a significantly better partner relationship in female infertile as compared with female fertile. Clinically significant disorders of partnership stability were observed in 11.65% of studied women and in 20% of controls. Marital adjustment and sexual satisfaction were comparable among male groups. The probability of marital disorders increased with: age above 30 (odds ratio [OR] = 1.6), female sex (OR = 1.5), and lower education (OR = 1.7) among the study population. Diagnosed male factor and infertility duration of 3–6 years were connected with the highest relationship instability and the lowest sexual satisfaction both in female and male infertile.Conclusions.The risk factors of marital dissatisfaction in infertility include: female sex, age over 30, lower education level, diagnosis of male infertility, and infertility duration of 3–6 years. Drosdzol A, and Skrzypulec V. Evaluation of marital and sexual interactions of Polish infertile couples.     

Depression and anxiety among Polish infertile couples – an evaluative prevalence study

Aim. The aim of this study was to evaluate the influence of infertility on the severity of anxiety and depression in infertile couples.

Material and methods. This was a cross-sectional study of differences between infertile couples (206 women and 188 men) and fertile couples (n = 190) with symptoms of depression and anxiety, as measured by the Beck Depression Inventory and Beck Anxiety Inventory.

Results. Infertile women (35.44%) scored above the cut-off for severe symptoms of depression, compared with 19.47% of fertile women. In the case of anxiety evaluation there was significant total prevalence among infertile women (15.53%). In the male groups there was a comparable frequency of negative results for depression and anxiety and their intensity. Among Female Infertile, depression occurred most frequently in combined infertility, whilst among Male Infertile in male infertility, with a time-frame of 3–6 years causing the creation and severity of depressive symptoms.

Conclusion. The risk factors of depression and anxiety in infertility include: female sex, age over 30, lower level of education, lack of occupational activity, diagnosed male infertility and infertility duration of 3–6 years.     

Modern and traditional practices of Turkish infertile couples

Objective?This investigation was carried out to determine modern and traditional practices of infertile couples in Kayseri, Turkey.

Methods?Two hundred and fifty-two infertile couples were selected from the study area. Modern and traditional practices of the infertile women and their husbands were investigated through a questionnaire. The effects of some factors on the utilization of traditional methods were analysed through the logistic regression method.

Results?It was found out that 92.5% of the infertile women and 71.8% of their husbands had consulted a physician for infertility and 92.1% of the women and 32.6% of their husbands had applied for medical or surgical intervention. However, only 11.1% of the couples had attempted in vitro fertilization. In contrast, 61.5% of the infertile couples admitted to carrying out traditional practices. All traditional practices were more prevalent among the women than the men.

Conclusion?It was concluded that traditional practices were more prevalent in the rural areas and among the older couples.     

A 3-year follow-up of emotional,marital and sexual functioning in couples who were infertile

Abstract

Couples who were attending an infertility clinic were reassessed after 3 years. Their emotional, marital and sexual functioning was compared with initial values to assess the impact of time. Approximately one half of the group for whom data was available had subsequently produced their own biological child. Comparisons between continuing infertile and subsequently fertile groups were made. The findings suggest that psychological functioning does not improve with time where there is continuing infertility. There is some evidence of deterioration in self-esteem in males in these circumstances. Overall marital adjustment tended to deteriorate but this was parallelled in the fertile groups. There was a general decrease in the frequency of sexual intercourse in both fertile and infertile groups. There were suggestions that a diagnosis of male infertility might lead to more negative emotional outcome in males and that men's emotional states early in infertility treatment might influence fertility outcome. In addition particular types of coping strategies were associated with negative emotional adjustment and more marital and sexual dysfunction, especially in women.     

Evaluation of the quality of life and sexual functioning of women using a 30-μg ethinyloestradiol and 3-mg drospirenone combined oral contraceptive

Objectives To evaluate the effect of a 30-μg ethinyloestradiol and 3-mg drospirenone (EE 30 μg/drsp 3 mg) combined oral contraceptive (COC) on the quality of life (QoL) and sexual functioning.

Methods Sixty-one women using this COC were assessed. The control group consisted of 65 women using different types of COC. A questionnaire with a Polish version of the Short Form-36 Health Survey (SF-36), Female Sexual Function Index (FSFI) and Mell–Krat Scale (SFK-K) evaluating QoL and sexuality was used as the research tool.

Results QoL indices for women using EE 30 μg/drsp 3 mg scored higher than for the controls and statistically significantly so with regard to improved general health and mood (p < 0.02), and mental health (p < 0.01). Women taking EE 30 μg/drsp 3 mg functioned sexually better, particularly with regard to sexual arousal (p < 0.006). Using the SFK-K scale, sexual dysfunctions were diagnosed in 66.2% of the women in the control group and 48.3% of those in the EE 30 μg/drsp 3 mg group (p < 0.05).

Conclusions The intake of the COC containing 30 μg ethinyloestradiol and 3 mg drospirenone is associated with an improvement of general QoL and female sexual functioning. However, the limitations of this study should be taken into account.     

Effects of infertility on gender differences in marital relationship and quality of life: a case-control study of Turkish couples

Objectives

Although there are many studies trying to evaluate the effect of infertility on marital relations (MR) and quality of life (QoL) in developed counties, there have been no studies in Turkey. As in many societies around the world, lack of pregnancy and the resulting childlessness are often highly stigmatized, leading to profound social suffering for infertile couples in Turkey.

Study Design

This study was planned as a case–control study in order to investigate the effects of infertility on MR and QoL. It was conducted among 58 primary infertile and 51 fertile couples. The Dyadic Adjustment Scale (DAS) and the World Health Organization QoL Scale (WHOQOL-BREF) were applied at the infertility department of the Istanbul University's faculty of medicine. The t-test, Mann–Whitney U, ANOVA and Pearson's correlation coefficient were used.

Results

The socio-demographic properties were similar for both groups. The QoL average score was higher for the infertile group. There were no gender differences in QoL for infertile couples. The total DAS score was higher than the cut-off score for both groups (114.44 ± 18.53 for infertile, 110.29 ± 18.28 for fertile couples; p > 0.05). Infertile women's DAS and QoL scores were higher than the fertile women's (p < 0.05). Other than in the social domain, all QoL scores were higher for infertile men than fertile men (p < 0.05). There was a positive correlation between the DAS and QoL scores.

Conclusions

It was determined that infertility did not have a negative impact on MR and QoL measurements. There were no gender differences.     

ORIGINAL RESEARCH—COUPLES' SEXUAL DYSFUNCTIONS: Sexual Disorders in Infertile Couples

IntroductionSexuality and the desire for a child are strongly interconnected. The same applies to sexual disorders and the unfulfilled desire for a child.AimThis article indicates the relations between sexual disorders and the unfulfilled desire for a child and outlines the potential effects of diagnostics and treatment in the context of reproductive medicine on the couples' sexuality.MethodsA research drive was undertaken in well-established medical and psychological literature database with the keywords “infertile” or “infertility” and “sexual dysfunction” or “sexual satisfaction.”ResultsSexual dysfunctions (of organic or of psychic origin) as a cause of involuntary childlessness are relatively unusual. By contrast (temporary) sexual disorders resulting from diagnosis and medical therapy are common in couples with fertility problems, with women more frequently affected than men.ConclusionsCounseling for couples with the unfulfilled desire for a child should invariably include explicit and appropriately tactful reference to sexuality and (functional) sexual disorders by the therapist. Wischmann TH. Sexual disorders in infertile couples.     

Incidence and prevalence of sexual dysfunction in infertile females

ObjectiveThe sexual response in women is complex. The association of infertility and sexual dysfunction is overlapping. To find the incidence and prevalence of female sexual dysfunction in infertile females and its correlation with infertility.DesignCase-control study.SettingG.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre (IKDRC)- Dr. H.L. Trivedi Institute of Transplantation Sciences (ITS), India.MethodsTotal of 500 patients in the age group of 24–42 years participated in the prospective study. They were assigned as fertile and infertile groups. Female sexual dysfunction was assessed according to FSFI questionnaire. Patients with past history of any psychiatric illness, endocrinological disorders e.g. diabetes mellitus or on antihypertensive treatment were excluded.ResultsIn our study 170 (63.67%) patients in the infertile group (n = 267) had female sexual dysfunction as compared to108 (46.35%) in the fertile group (n = 233), which is statistically significant (P 0.0001). Most common dysfunction observed was arousal (70%) in infertile patients. Common dysfunctions observed in fertile females were desire (40%) and orgasm (40%). FSD was significantly higher in infertile females of the 31–37 years age group (P 0.002), while more common in fertile females of >42 years of age (P < 0.0001). Higher female sexual dysfunction was observed in illiterate infertile females (P 0.039). Among the pathological factors endometriosis was the statistically significant factor associated with female sexual dysfunction and infertility (P < 0.0001). No significant correlation in duration of infertility or type of infertility was observed with female sexual dysfunction. Female sexual dysfunction as the cause or the effect should be ascertained in infertility.     

Maternal and neonatal outcomes associated with infertility

Objective: To investigate perinatal outcomes in a cohort of fertile and infertile nulliparous women.

Design: Retrospective cohort study.

Setting: Academic medical center.

Patients: All nulliparous women delivering singletons ≥24-week gestation at our center from 1 January 2012 to 31 December 2012 were included. Women were classified into two groups – fertile and infertile – based on a chart review at the time of delivery.

Outcome measure: Perinatal outcomes of interest included mode of delivery, gestational age at delivery, and birth weight.

Results: A total of 3293 mother/infant dyads fulfilled the inclusion criteria. Of these, 277 women (8.4%) were classified as infertile. Infertile women were significantly older than fertile women. In bivariate analyses, infertile women were more likely to undergo cesarean delivery (51.8 versus 36.1%, p?p?β coefficient ?0.42, 95%CI ?0.64, ?0.2). There was no difference in infant birth weight. Late preterm deliveries (34–36 completed gestational weeks) accounted for 8.3% of deliveries for infertile women compared to 4.3% for fertile women (p?=?.032).

Conclusions: We conclude that the increased risk of cesarean section associated with infertility is driven by maternal age. Late preterm infants represent a key cohort for further evaluation in the perinatal outcomes of infertile women.     

Sexual Function and Satisfaction in Couples with Infertility: A Closer Look at the Role of Personal and Relational Characteristics

BackgroundResearch to date suggests that couples undergoing assisted reproductive technology (ART) are at a high risk of experiencing sexual difficulties.AimThis dyadic cross-sectional study aimed to provide a better understanding of the infertility-specific personal (ie, emotional, mind-body) and relational stressors associated with the sexual desire, orgasm, arousal, and sexual satisfaction of infertile couples seeking ART.MethodsThe sample included 185 mixed-sex infertile couples seeking ART. Participants completed online the Fertility Quality of Life tool and either the Female Sexual Function Index or the International Index of Erectile Function. Data were analyzed using path analyses based on the Actor-Partner Interdependence Model.OutcomesIndividuals’ own and their partners’ sexual function (desire, orgasm, arousal domains) and sexual satisfaction.ResultsFor men and women, infertility-related emotional stressors were associated with their own and their partner's lower sexual desire. For women, experiencing greater infertility-related emotional stressors was also associated with their partner's lower sexual satisfaction. While experiencing greater infertility-related mind-body stressors was not associated with men and women's own sexual desire, arousal, orgasm, and satisfaction, for women, it was associated with their partner's lower sexual arousal. Lastly, for men and women, infertility-related relational stressors were associated with their own lower sexual arousal, as well as with their own and their partner's lower sexual satisfaction. For women, experiencing greater relational stressors was also associated with their own lower sexual desire and orgasm.Clinical ImplicationsInterventions addressing the emotional, mind-body, and relational spheres of infertile couples seeking ART may help facilitate improvements in sexual function and satisfaction and better serve their needs.Strengths & LimitationsThis study included a large sample of couples. Our sample was heterogeneous with regards to couples’ cause of infertility and treatment stage. The use of an infertility-related measure allowed us to better capture personal and relational stressors specific to couples seeking ART. Given the cross-sectional design of our study, causality between infertility-related stressors and sexual function and satisfaction cannot be inferred. Our sample included predominantly White, mixed-sex individuals with a high level of education, which may reduce the generalizability of our findings.ConclusionCouples’ subjective experience of infertility and treatment (personal and relational stressors) seems to be strongly associated with their sexual health, allowing us to identify potential targets of intervention with couples seeking ART.S.E. Amiri, A Brassard, N.O. Rosen, et al. Sexual Function and Satisfaction in Couples with Infertility: A Closer Look at the Role of Personal and Relational Characteristics. J Sex Med 2021;18:1984–1997.     

Sexual,Marital, and Social Impact of a Man's Perceived Infertility Diagnosis

IntroductionMale factor infertility is a relatively common problem. This diagnosis may increase sexual, marital, and relationship strain in male partners of infertile couples.AimTo measure the personal, social, sexual, and marital impacts of a male factor infertility diagnosis among men in couples evaluated for infertility.MethodsCross-sectional analysis of 357 men in infertile couples from eight academic and community-based fertility clinics. Participants completed written surveys and face-to-face and telephone interviews at study enrollment. This interview queried each participant's perception of their infertility etiology to determine the primary study exposure (i.e., male factor only, male and female factors, female factor only, unknown).Main Outcome MeasuresPersonal Impact, Social Impact, Marital Impact, and Sexual Impact scales.ResultsAmong the 357 men, no male factor was reported in 47%, isolated male factor was present in 12%, combined male and female factors were present in 16%, and unexplained infertility was present in 25% of couples. Male factor infertility was independently associated with worse Sexual (mean 39 vs. 30, standard deviation [SD] 2.7, P = 0.004) and Personal (mean 37 vs. 29, SD 3.8, P = 0.04) Impact scores relative to men in couples without male factor infertility. These differences remained statistically significant after controlling for male age, partner age, race, religion, educational level, employment status, prior pregnancy, duration of infertility, and prior paternity.ConclusionsMale partners in couples who perceive isolated male factor infertility have a lower sexual and personal quality of life compared with male partners of couples without perceived male factor infertility. Social strain is highest among couples without a clear etiology for infertility. These findings highlight the clinically significant negative sexual, personal, and social strains of a perceived infertility diagnosis for men. Smith JF, Walsh TJ, Shindel AW, Turek PJ, Wing H, Pasch L, Katz PP, and The Infertility Outcomes Program Project Group. Sexual, marital, and social impact of a man's perceived infertility diagnosis. J Sex Med 2009;6:2505–2515.     

The association of trefoil factor 3 gene polymorphisms and haplotypes with unexplained female infertility: Molecular insights into TFF3 regulation in receptive phase endometrium

Abstract

This study examined the genetic variation within the gene trefoil factor 3 (TFF3) in relation to unexplained female infertility in a group of women where aberrant endometrial maturation was suspected. The study consisted of 113 women with a diagnosis of unexplained infertility and 289 healthy fertile volunteers. Five single nucleotide polymorphisms rs225439, rs533093, rs225361, rs11701143, and rs77436142 within TFF3 gene were analyzed using real-time PCR. The formed haplotype pattern within the TFF3 gene in relation to infertility was also assessed. TFF3 protein localization and expression in receptive stage endometrium at the time of implantation was measured in a subset of fertile (n = 7) and infertile (n = 12) women. Allele and genotype frequencies did not differ significantly between fertile and infertile women, nor did the formed haplotypes. TFF3 protein was expressed in all cell types in receptive stage endometria in fertile and infertile women. No significant association was observed between protein expression and analyzed genotypes. A significantly higher TFF3 expression in luminal epithelial cells was detected in women with unexplained infertility (p = 0.003).     

Subjective well-being in infertile couples

The subjective well-being of infertile couples is affected by numerous variables. One hundred and ten infertile couples were investigated using the von Zerssen symptom checklist. With the exception of sterile women of fertile men (group 1: female infertility), women and men in the overall randomized sample and the diagnostic groups (group 2: subfertility of the man; group 3: sterility of both partners; group 4: idiopathic sterility) report fewer general symptoms than the overall population of patients with somatic and psychiatric diseases. Subfertile men show lower rating in the symptom checklist than the norm. Involuntarily childless women express more symptoms than their partners.     

Subjective well-being in infertile couples

The subjective well-being of infertile couples is affected by numerous variables. One hundred and ten infertile couples were investigated using the von Zerssen symptom checklist. With the exception of sterile women of fertile men (group 1: female infertility), women and men in the overall randomized sample and the diagnostic groups (group 2: subfertility of the man; group 3: sterility of both partners; group 4: idiopathic sterility) report fewer general symptoms than the overall population of patients with somatic and psychiatric diseases. Subfertile men show lower rating in the symptom checklist than the norm. Involuntarily childless women express more symptoms than their partners.     

Presence of HSV-1 DNA in semen and menstrual blood

Using a specifically designed diagnostic PCR assay with nested primers the following could be achieved: (1) a group of 22 clinically indistinguishable women attending an infertility clinic, 18 with repeated embryo transfer failure, and asymptomatic for HSV-1 could be divided into two subgroups after testing their menstrual blood. An HSV-DNA positive (50%) and HSV-DNA negative group (50%) could be distinguished. None of the four controls were positive; (2) semen from 154 infertile and 24 fertile men was tested in relation to infertility. In the group of infertile men 37 (24%) were HSV-DNA positive but none of the fertile control (0%) was positive; (3) treatment of both partners with an antiviral drug resulted in two pregnancies; (4) HLA data on four of the couples in which the wife's menstrual blood was HSV positive was compared to seven HSV negative couples and 22 infertile, as well as 22 fertile couples. Clustering of class I HLA (B61 and Cw3) was found with a significant increase in Cw3 in both partners.     

Coping with male infertility. Gender differences

Infertility is a stressor that affects the infertile couple. Coping of infertile couples with the unfulfilled desire for a child is affected by numerous variables. Depending on the diagnose is the patients were assigned to four groups: Group 1: female infertility (infertile women of fertile men), Group 2: infertility of the men, Group 3: infertility of both partners, Group 4: idiopathic sterility). One hundred and ten infertile couples were investigated with the Freiburg questionnaire of Coping with Illness. Compared to their partners, the women of infertile couples report a higher feature rating in the cales ”depressional coping” and ”self-distraction and self-stabilisation”. Women of infertile couples show lower feature ratings compared to the standardised collective of patients with chronic somatic disease only on the scale ”religiousness and search for meaning”. Involuntarily childless men activate all coping strategies to a smaller extent than the reference sample. The experience of infertility is greatly affected by gender and the associated role expectations. Received: 12 March 2001 / Accepted: 16 March 2001     

Quality of life in Turkish infertile couples and related factors

Infertility is a major life crisis affecting couples’ psychosocial and physical health. We aimed to assess the quality of life in Turkish infertile couples. This cross-sectional survey was carried out in 127 infertile couples admitted to a University Hospital. The quality of life was measured using the fertility quality of life tool (FertiQoL) scale. Women had lower overall quality of life than men. Women and men who were married for fewer than 10 years had a significantly lower emotional score. Women who had a history of infertility treatment, men who have lived in the town or village men with primary infertility and men who have had primary education or lower, had lower scores for mind/body subscale. Social scores were found lower in women under the age of 30, women with middle or low income, men who were married for fewer than 10 years, men who did not have children for 5 years or more and men with primary infertility. The tolerability and environment scores were significantly higher in women who had been married more than once. We conclude that health care providers should be aware of the factors affecting the quality of life (QoL) and give counselling to improve couples’ quality of life at infertility clinics.     

Optimizing the control group for evaluating ART outcomes: can outpatient claims data yield a better control group?

PurposeWe previously developed a subfertile comparison group with which to compare outcomes of assisted reproductive technology (ART) treatment. In this study, we evaluated whether insurance claims data in the Massachusetts All Payers Claims Database (APCD) defined a more appropriate comparison group.MethodsWe used Massachusetts vital records of women who delivered between 2013 and 2017 on whom APCD data were available. ART deliveries were those linked to a national ART database. Deliveries were subfertile if fertility treatment was marked on the birth certificate, had prior hospitalization with ICD code for infertility, or prior fertility treatment. An infertile group included women with an APCD outpatient or inpatient ICD 9/10 infertility code prior to delivery. Fertile deliveries were none of the above. Demographics, health risks, and obstetric outcomes were compared among groups. Multivariable generalized estimating equations were used to calculate adjusted relative risk (aRR) and 95% confidence intervals (CI).ResultsThere were 70,726 fertile, 4,763 subfertile, 11,970 infertile, and 7,689 ART-treated deliveries. Only 3,297 deliveries were identified as both subfertile and infertile. Both subfertile and infertile were older, and had more education, chronic hypertension, and diabetes than the fertile group and less than the ART-treated group. Prematurity (aRR = 1.15–1.17) and birthweight (aRR = 1.10–1.21) were increased in all groups compared with the fertile group.ConclusionAlthough the APCD allowed identification of more women than the previously defined subfertile categorization and allowed us to remove previously unidentified infertile women from the fertile group, it is not clear that it offered a clinically significantly improved comparison group.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10815-021-02111-6.     

Prevalence of Sexual Dysfunctions in Transgender Persons: Results from the ENIGI Follow-Up Study

IntroductionStudies about sexual functioning in trans persons have mainly focused on sexual functioning after genital gender-affirming surgery, have had small sample sizes, and have not explored the broad range of possible sexual dysfunctions. Measuring sexual functioning in trans persons during transitioning is important to determine the kind of care trans persons may need in order to regain their sexual health.AimThe first aim of the present study was to explore the prevalence of sexual function disturbances and dysfunctions (with distress) in trans women and trans men 4 to 6 years after initial clinical entry. The second aim was to compare the prevalence of sexual dysfunctions among the various treatment trajectories and between trans persons with or without further genital treatment intentions.MethodsAn online follow-up questionnaire was filled out by 518 trans persons (307 identifying predominantly feminine, 211 identifying predominantly masculine) as a part of the European Network for the Investigation of Gender Incongruence initiative. All participants had their initial clinical appointments in gender clinics in Ghent, Amsterdam, or Hamburg.Main Outcome MeasureThe main outcome measures were the prevalence of sexual dysfunctions and medical treatment data, measured via self-report items.ResultsThe most frequent sexual dysfunctions experienced by trans women and trans men were difficulties initiating and seeking sexual contact (26% and 32%, respectively) and difficulties achieving an orgasm (29% and 15%, respectively). Compared with trans women after hormone treatment and non-genital surgery, trans women after vaginoplasty less often experienced arousal difficulties, sexual aversion, and low sexual desire. Compared with trans men without medical treatment, trans men after a phalloplasty experienced sexual aversion and low sexual desire less often. No significant differences were found between participants with or without further genital treatment intentions.Clinical implicationsClinicians should consider sexual counseling after medical treatments, paying particular attention to potential social and psychological barriers to the sexual health of their patients.Strengths & LimitationsThis study included all trans persons irrespective of treatment decisions, and focused on a broad range of potential sexual difficulties taking the distress criteria into account. Limitations include the cross-sectional design, the limited power for the comparison of treatment groups and the absence of validated questionnaires about sexual functioning for transgender persons.ConclusionSexual dysfunctions among trans men and women were very common among the various treatment groups and were unrelated to intentions to have further genital treatment. Although medical treatment may be helpful or even essential to developing good sexual health, a significant group of trans persons experienced sexual dysfunctions after genital surgery.Kerckhof ME, Kreukels BPC, Nieder TO, et al. Prevalence of Sexual Dysfunctions in Transgender Persons: Results from the ENIGI Follow-Up Study. J Sex Med 2019; 16:2018–2019.     

Sexual satisfaction,intimacy and relationship of couples undergoing infertility treatment

Objective: To explore the infertility-related sexual and relationship concerns, sexual satisfaction and perceived intimacy of infertile couples.

Background: Infertility is known to affect the psychosocial well-being of couples. Fertility treatment and the scheduled regime of sexual activities places further pressure on infertile couples.

Methods: This was a cross-sectional study. Infertile couples who attended fertility clinics for treatment between November 2015 and March 2016 were invited. A total of 113 pairs of infertile women and men participated in the study as couples.

Results: A significantly higher proportion of women than men reported that their partner did not understand how the problem of fertility affected them and had worries that they were drifting apart in their relationship. Significantly more men than women considered their sex life to be lacking in quality. In terms of perceived intimacy, more women than men reported that they had disclosed their feelings and negative emotions to their partner. The correlation analysis revealed significant positive correlations between sexual (dis)satisfaction and infertility-related sexual and relationship concerns in couples.

Conclusions: The results show that infertile couples suffer from infertility-related sexual and relationship concerns. An intervention study should be conducted to help these couples overcome such concerns.