(Excerpt from On Fertile Ground: Healing Infertility best-selling book by Helen Adrienne)

If you want to get pregnant, you can’t stay in the comfort of your bedroom. Your sex life and your menstrual cycle used to be nobody’s business but yours. Why do your private parts need to be under the glare of fluorescent lights? As Donna, a former patient, said when she was interviewed for this book, “My doctor saw more of my vagina than my husband.” A working mom of two, Donna was given bleak odds of conceiving. She beat the odds because, among other things, she was willing to put her legs in stirrups.

You’re no longer in the life that you knew and you may not yet have made the kind of connections which can serve you best in your new reality. Welcome to “No Man’s Land.” Your ovaries, uterus and fallopian tubes have become the focus of scrutiny. This feels dehumanizing especially because your broken heart is left out of the story. You tell yourself that the exquisite advances in reproductive medicine are inspirational. And then you get your period again.

Your doctor tells you to have sex and then come into the office for a post-coital test. Love-making has now become coitus. The formality of science is starting to do something detrimental to the spontaneity and meaning of sex. And brace yourself – here comes the judgment about whether your vaginal fluids are killing your husband’s sperm. How debilitating!

Dehumanized. Debilitated. When it’s suspected that there is a barrier between you and your fertility, sex can shift away from the heart and be reduced to an activity, a means to an end. Before you know it, your sex drive can get driven to some distant planet. Are you too overwrought to respond to each other the way you used to? This goes with the territory (more likely if sexual abuse is in your history). Even if sex has been consistently satisfying, worrying about your prospects for pregnancy could leave little room for enjoyment. Feelings of desperation can trump the heart’s involvement in your sexual connection to each other.

It’s no picnic for men either. Sex on demand (“I’m ovulating, honey! Get over here!”) is a turn-off and turns a choice into a constraint. How unsexy. It is par for the course if a man’s “machinery” shuts down from time to time. With in vitro fertilization, hubby’s ejaculate makes its way to your uterus by way of an intermediary. I have never known a man to be excited – pardon the pun – to ejaculate into a cup. One of my patients spoke with disdain at being called upon to produce a “specimen” in what he called “the Boom-Boom Room.”

Neither you nor your husband signed up for sex to be irrelevant, did you? This is the world of in vitro fertilization. The pressure that infertility puts on your sex life needs to be acknowledged. And you should know that among your peers who are out of the mainstream like you, it is normal for libido to take a serious nose dive and for erectile dysfunction to be an understandable symptom of this stress. If you can accept this, then at least you have one less excuse to fault yourself or your partner for faltering love-making.