Sex and TTC with Sexologist Aleeya Hachem
We have asked the expert advice of sexologist Aleeya Hachem. She is also a fertility counsellor who is passionate about normalising the conversation around sex, pleasure and fertility. She has a special interest in working with LGBTQIA+ clients, as well as clients experiencing sexual issues relating to fertility and pregnancy. She holds a membership with the Society of Australian Sexologists (SAS) and Fertility Society of Australia (FSA).
Issues around sex for conception
This is largely attributed to heterosexual couples because same sex couples would usually access fertility treatments. Aleeya’s clinical experience with couples trying to conceive is that there’s a lot of pressure. Couples are discouraged when conception doesn’t happen within the first couple of months, and they start to think that there’s something wrong. There’s a lot of pressure to have sex at the right time and to have an ejaculation for the male counterpart. This can impact desire and the couple’s relationship in general.
It’s also about looking into the barriers to sex for conception, such as sexual pain, vaginismus, delayed ejaculation, erectile dysfunction or even arousal disorders. These will all impact the ability to conceive as well because they’re issues relating to sexual functioning.
The female partner is the one who carries the burden of treatment because they’re the ones ovulating. Sometimes even when they do know when they’re ovulating, they refrain from telling their partner as well. They experience a lot of pressure for them to even lie about their ovulation. There can also be pressure in trying to initiate sex with their partner.
Couples usually reach out for help when it’s already been a few months, or when they’ve already experienced recurrent loss or miscarriage perhaps from their fertility treatments. It usually begins with much excitement until about three or four months. When nothing happens, this is where couples tend to feel more stressed.
When there are issues around sex for conception, people don’t necessarily think to go to a sexologist. They’re more likely to access a gynecologist, obstetrician, fertility specialist or even a GP rather than actually fix what’s going on in the bedroom.
Fertility treatments can have a huge impact or burden on the couple from a financial, physical and emotional perspective. If it can be treated based on what’s going on from a sexual perspective and hopefully have conception that way, then it’s a win-win situation. Couples can improve their sexual quality of life and they can also save themselves from going through fertility treatment, unless of course there is a diagnosis preventing them from doing so.
Awareness of the statistics around getting pregnant
One thing that people are probably not aware of is that statistically, falling pregnant within the first couple of months of trying is actually not that common. In a healthy couple in their 20s, the statistics fall within 12 months. It’s quite normal for it to take up to a year or even more.
Sex education is largely centered around contraception and trying not to get pregnant yet. No one talks about fertility. Couples get to a point in their lives where they want to try and conceive, yet no one ever told them there was only a 20% chance of conception within the first 12 months of trying. They think that had they known about the fertility window, it would have allowed them to make more informed decisions around it earlier, or they would have had more chances to discuss it with their partner.
It’s important to have that awareness of fertility declining at 33 for females. This can allow them to make decisions about planning ahead, or freezing their eggs.
Same Sex Couples and TTC
With same sex couples, the pressure to conceive is not on them. They frequently go for IVF in order to have a baby. This means they rely on the fertility specialist to make it happen for them. It’s not necessarily the same type of pressure and stress that is seen in heterosexual couples. There can be some issues along the way too.
If it’s two females, it can be really stressful for the one partner who is carrying the burden of treatment. The one who is being poked and prodded with hormones and getting either inseminated, an embryo transfer or eggs collected can have an impact on desire because of hormonal aspects.
For same sex male couples, they have to deal with the surrogate too. So that’s the added stress.
What sexologists recommend
It’s about having the correct information around the fertile window. There is so much misinformation about this. It would be easy to think that couples need to have sex everyday for three weeks to be able to get pregnant. Whereas facts state that they can only get pregnant for the next 12 hours once the egg is released.
When they know the fertile window and when the female is ovulating. They’ll know that they can have sex every second day within that three or four day period. This can take the pressure off immensely. There can be a bit more planning to it.
Aleeya also frequently ask couples: How are you having sex? What does sex look like? Are you doing it in the same position? Is it routine? Is it monotonous? How can we actually make it fun? How can we take that pressure off?
It’s about unpacking it a little bit more, and making it fun by using toys, different positions, focusing on foreplay, etc in order to take that pressure off the ‘main event’. In this way, it doesn’t necessarily become all about sex for conception. It can also go back to reconnecting as a couple as well.
It can also be about unpacking the couple’s desires, too. What does that look like for each of the partners? Female sexual desire is very different to male sexual desire. And that’s okay. And so couples need to have an understanding of that as well.
Couples don’t need to struggle on their own. They can reach out for help, and see a fertility specialist or a sexologist so that they can help. It’s worth unpacking the above and facilitating a dialogue in the relationship around it. Sometimes it can be quite daunting to talk about sex with your partner. There are times when you don’t know how to. Coming to these experts would take the pressure of having to work within their relationship, and they’ll have someone else looking after it.
Communication is also one thing that couples can work on. Some would find talking about sex with their partners challenging. Conversation cards are a good way to take the pressure off having to initiate that conversation about sex.
It’s also about having that mindfulness that couples will eventually have their baby one way or another. But how can we make the journey fun? There’s a lot of uncertainty that causes stress and anxiety in trying to conceive. But when they know they’ll have their baby eventually, and just focus on making the journey better, it takes off a lot of the pressure from them.
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