Sexual past and Sub-Fertility Guilt
ESC Congress Library. Hamilton R.
May 10, 2018; 208131
Ms. R. Hamilton
Ms. R. Hamilton
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Objective: To identify factors that may contribute toward barriers within sexual intimacy for some couples who are actively seeking to become pregnant. Design and method: A two-year retrospective analysis was undertaken to consider complexities of women and couples attending a clinical sexologist for a variety of sexual dysfunctions, who at this time were also identified as actively trying to become pregnant. The couples had either engaged further support and/or advice from their medical practitioner, with some already linked to fertility sub-specialists. The initial referrals addressed sexual dysfunction from a broad perspective and only focusing on the woman. Little mention was made (if at all) in the referrals of any sub-fertility component or that tertiary intervention were actively involved. Results: During consultation with the clinical sexologist, the common barriers identified were linked to the personal history of the women in relation to past sexual behaviours and gynaecological issues. These included drug use, prostitution, high-risk sexual behaviours, previous terminations, diagnosis of endometriosis or polycystic ovarian syndrome. The majority of women had not shared any of this information with their current partner and many had not discussed this with their treating medical doctor. Subsequently, many women were dealing with matters concerning guilt, shame and confusion. These emotions were then outwardly displayed as sexual dysfunction behaviours, exhibited mainly as low libido, dyspareunia, anorgasmia. Other fundamental behaviours included insomnia, low affect, depression and poor appetite. Conclusions: Engagement of women seeking assistance with sub-fertility issues is crucial. Not all women will require more than the basic level psychosexual support when involving sub-fertility services. However, it is important to offer a one-on-one with a psychologist or sexologist for the couple attending, predominantly around the need to encourage open communication and assistance to retain the ability to be intimate during this intense time. Confusion due to some levels of guilt can also contribute to the woman feeling guilty about events that have no justification within the area of fertility issues. From this opportunity, the service displays a level of listening and respect to each of the couples, thereby reminding them that this journey - although exciting - can be quite taxing on the emotional and intimate complexities of being a couple.  
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