title: The Sexual Impact of Infertility Among Women Seeking Fertility Care.
abstract: BACKGROUND
  Infertility affects approximately 6.7 million women in the United States. Couples with infertility have significantly more anxiety, depression, and stress. This is compounded by the fact that almost 40% of couples undergoing assisted reproduction technology still cannot conceive, which can have an ongoing effect on quality of life, marital adjustment, and sexual impact.
  
  
  OBJECTIVE
  To assess the sexual impact of infertility in women undergoing fertility treatment.
  
  
  METHODS
  This study is a cross-sectional analysis of women in infertile couples seeking treatment at academic or private infertility clinics. Basic demographic information was collected. Respondents were surveyed regarding sexual impact and perception of their infertility etiology. Multivariate regression analyses were used to identify factors independently associated with increased sexual impact.
  
  
  METHODS
  Sexual impact of perceived fertility diagnosis.
  
  
  RESULTS
  In total, 809 women met the inclusion criteria, of whom 437 (54%) agreed to participate and 382 completed the sexual impact items. Most of the infertility was female factor only (58.8%), whereas 30.4% of infertility was a combination of male and female factors, 7.3% was male factor only, and 3.5% was unexplained infertility. In bivariate and multivariate analyses, women who perceived they had female factor only infertility reported greater sexual impact compared with woman with male factor infertility (P = .01). Respondents who were younger than 40 years experienced a significantly higher sexual impact than respondents older than 40 years (P < .01). When stratified by primary and secondary infertility, respondents with primary infertility overall reported higher sexual impact scores.
  
  
  CONCLUSIONS
  In women seeking fertility treatment, younger age and female factor infertility were associated with increased sexual impact and thus these women are potentially at higher risk of sexual dysfunction. Providers should consider the role young age and an infertility diagnosis plays in a women's sexual well-being.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, University of California-San Francisco, Irene Betty Moore Women's Hospital, San Francisco, CA, USA.
authors.forename: William D
authors.initials: WD
authors.lastname: Winkelman
authors.affiliation: Department of Medicine, University of California-San Francisco, San Francisco, CA, USA; Philip R. Lee Institute for Health Policy Studies, University of California-San Francisco, San Francisco, CA, USA.
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Katz
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, University of California-San Francisco, Irene Betty Moore Women's Hospital, San Francisco, CA, USA; Department of Urology, University of California-San Francisco, San Francisco, CA, USA; Philip R. Lee Institute for Health Policy Studies, University of California-San Francisco, San Francisco, CA, USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Smith
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Medicine, University of California-San Francisco, Irene Betty Moore Women's Hospital, San Francisco, CA, USA. Electronic address: Tami.Rowen@ucsf.edu.
authors.forename: Tami S
authors.initials: TS
authors.lastname: Rowen
keywords: Female Infertility; Female Sexual Impact; Infertility