Sex three times a week is recommended for those trying to conceive, but the stresses of modern life mean even committed couples can struggle

There’s a question that is frequently brushed over in fertility clinics and it may well surprise you: how frequently do you have sex? You might assume that by the time a couple seeks IVF they have long been trying to conceive naturally. But although the sex question is on the forms during many fertility consultations, it has become the elephant in the room.

This week, experts warned that modern couples are often too distracted or time-poor to have the amount of sex necessary to conceive naturally. Many, they added, end up having IVF not because they are infertile, but because they have too much on.

“People don’t make the time because they are too busy and too tired – they have a poor work-life balance and sex starts to seem like another chore,” says Charles Kingsland, of clinic group Care Fertility. “There is no doubt that some people are opting for IVF simply because sex isn’t something they have time to do.”

“Modern life has taken the joy out of it and there are too many other things like emails and work competing for our attention,” notes Prof Allan Pacey at the University of Sheffield. “Couples that I see now have very different expectations of what a healthy sex life is.”

Hank Greely, director of Stanford Law School’s Center for Law and the Biosciences, has predicted that we will have stopped having sex to make babies within the next 30 years, instead picking from a petri dish of embryos created in a lab, using a couple’s DNA.

The current decline in sex is nothing new, but it’s one that IVF clinics have ignored for years – and it appears to be worsening. In my work as a fertility mentor, I often notice the subject has fallen by the wayside. As, it appears, has sex itself. Many couples have told me: “You’re the first person to ask.”

I remember one pair who had been celibate for two years. They had been advised by the private clinic they visited to go straight to IVF – a process that would cost them thousands of pounds – with no questions asked.

My view was that it would be better to address the central issue, and consider IVF later, and if necessary. We discussed the emotional backdrop, her past history of abuse and put together a treatment plan that included acupuncture, counselling and lifestyle changes (such as no electronics in the bedroom). They went on to conceive naturally.

For a small number of patients I see, having a baby is the priority but having sex is not – and neither partner is interested in increasing how much they’re having. Though that might sound incredible, it appears to be a reflection of our sex lives right now, with sexless relationships becoming more common. And not just among those trying for a family.

According to recent findings by French polling company Ifop, the proportion of British women who say they have not had sex in the past 12 months rose from 42 per cent to 46 per cent between 2016 and 2021 (the increase was even steeper in French women, from 31 per cent to 41 per cent). The latest UK data from the National Survey of Sexual Attitudes and Lifestyles showed fewer than half of those aged 16-44 were managing to have sex at least once a week.

The reasons for this are complicated and go beyond a lack of time. Financial worries, Netflix culture, social media, technology in the bedroom and longer working hours are all contributing factors that didn’t impact our parents’ or grandparents’ generations.

And when it comes to babymaking sex, even the most sexually committed couple will tell you that urinating on sticks, looking at apps and googling every twinge only adds to the inertia. The change from “I want you” to “we’re trying” can be the death knell for fun sex.

Some are able to keep the spontaneity for a while, but if it takes too long then sex becomes another item on the to-do list. Despite three times a week being the recommended amount for those trying to conceive, I’ve found that many couples limit sex to “fertile days” and don’t touch one another for the rest of the month.

Devices such as ovulation sticks can, ironically, reduce the number of times that couples have sex in a month. A few years ago, I conducted an audit in my clinic comparing couples who used ovulation sticks and apps, with couples who didn’t. The results were revealing: those who used the ovulation aids were having 20 per cent less sex, and were more anxious, than those who didn’t.

Over the past three decades, I’ve witnessed another change in behaviour: expectation. Women, in particular, can be driven by a need to “get everything right”, which has its roots in perfectionism and is exacerbated

For some of the patients I see, having a baby is the priority – but having sex is not