Reason for sexless marriage

ALL IN Therapy Clinic- What is a Sexless Marriage and Are You In One?


No couple imagines on the day they get married that someday they will stop having sex. Yet, 15 to 20 percent of all couples experience long periods of time where they are no longer sexually intimate.



If this is a situation you find yourself in, read below to learn more about sexless marriages, the impact that is has on people, and some ideas of ways to address it. What is a sexless marriage? How do you know you are in a sexless marriage?  Let’s find this out.




Table of Contents

(click on a question below to be directed quickly)


What is a sexless marriage?
How frequently does that average couple have sex?
Why do marriages become sexless?
How long do sexless marriages last?
How do I deal with a spouse that does not want sex?
Is having sex once per month considered a sexless marriage?
How often should married couples have sex?
What age do people stop being sexually active?
How do you survive a sexless marriage without cheating?
Does sexless marriage justify adultery?
Is a sexless marriage grounds for divorce?



What is a sexless marriage?


A sexless marriage is one in which a couple is not being sexually intimate. This can be for a variety of reasons. The most common reason is because of a lack of desire on one or both parts.


When one or both partners are no longer interested in sex, it can signal significant problems underlying the relationship will soon experience. A sexless relationship can also be the result of long-standing problems.


It’s important to understand that a short-term cessation of sex does not make your marriage sexless. Instead, sex must have stopped happening for 1 year or longer.



How frequently does that average couple have sex?


The average couple has sex 60 times per year, or once per week, according to famed sexual therapist Barry McCarthy. Many couples have sex more frequent than weekly, and many couples have sex less than weekly. It is important that each couple identify what is the healthiest sexual frequency for them. Further, one should know how much their partner desires sex in general.


In general, both men and women both report physical intimacy to be an important part of a relationship. Sexual intercourse is one aspect of physical intimacy.



Why do marriages become sexless?



Marriages become sexless for a variety of reasons. Common reasons are a lack of desire, postpartum depression, frequent marital conflict, or a recent marital crisis or personal crisis that has impacted the client.


When couples begin noticing a lack of sexual contact in their relationship, they should see that as a crucial time to address it directly and discern what is causing the change.

Top reasons marriages become sexless:

1- Low or non-existent sex drive
2- Relationship issues
3- Lack of love and closeness
4- Unresolved trauma in one or both partners’ past
5- Chronic Illness or medical reasons
6- Sexual dysfunction or sexual pain
7- Childcare stresses or family dynamics
8- Lack of sexual desire or attraction
9- Hormonal imbalance
10- Mental health issues


How long do sexless marriages last?


When couples have frequent sex, they are less likely to divorce and will report an overall higher level of satisfaction when compared to sexless marriages.


Thus, sexual frequency is related to marital satisfaction. When a marriage stops experiencing sexual frequency, it may serve as a signal of a problem underlying the relationship.


It is impossible to predict when a marriage will end, and the cessation of sex does not inherently mean the marriage will end. Many marriages are sexless. And whether sexlessness will lead to the end of your marriage is not an answer we can provide.



How do I deal with a spouse that does not want sex?


Being married to someone that does not want sex is challenging and stressful to a marital bond. When you are married to someone that does not have to have sex, there are a few things to keep in mind.


1- It is okay that you still want to have sex. Sometimes partners that no longer want to have sex try to encourage their partner to become tolerant of no longer having sex.


2- You partner may have a legitimate reason to not want to have sex right now. It is important to accurately understand what the reason is that is causing the cessation of sex.


3- The only way to change the issue is to talk about it. If a couple is unable or unwilling to communicate about their sex life, they should never expect to have a satisfying sex life.



Is having sex once per month considered a sexless marriage?


A sexless marriage is one in which sex has not happened for 1 year or greater. A low-sex marriage is one that is having sex 10 times a year or less. So, a marriage that is having sex roughly once a month does not meet either of these definitions. However, that may provide you little comfort if you believe having sex once a month is not enough.


Having sex one time a month is not inherently a problem. That level of sexual frequency is only problematic if the couple sees it as problematic. If a couple is only having sex one time per month, it may not provide the couple enough time together to be able to experience a full sexually intimate connection.



How often should married couples have sex?


This is hard to say because each couple is so different. Some couples do best when they have sex daily.  Other couples prefer weekly or every other week. There are even couples that prefer to not have sex at all.


Resident sex therapist Dr. Kyle Zrenchik recommends couples to have sex no less than 1-2 times every 1-2 weeks to ensure that they are experiencing enough sexual intimacy.


Sexual intimacy, as Dr. Zrenchik states, is more than just sexual frequency. “It involves sharing emotions, being vulnerable, and taking risks. Also, it involves experiencing something inside the bedroom that is different and special.


Sexual intimacy provides a vehicle for connection and relationship building that cannot be replicated in any other way.


Both emotional and sexual intimacy are crucial factors that affect a couples overall relationship quality.


Ultimately, it is up to the couple to determine their ideal sexual frequency. As long as the couple feels sexually connected and satisfied, then the number is largely irrelevant.




What age do people stop being sexually active?



It is common knowledge that people often have sex less frequently as they age. This is particularly true between midlife and later life.  This is due to a variety of factors. However, there is no set age in which people are unable or incapable of having sex.


In fact, people in the age group of 70+ are seemingly having more sex now than that same age group in the past.


Sleep disturbances are a regular part of being a new parent, in this situation a sleep disturbance tends to be characterized by difficulty sleeping even when the infant is asleep, and others have offered to care for the infant.



How do you survive a sexless marriage without cheating?


Sadly, many people have to live in a marriage where there is no sex happening. They endure this by using a variety of strategies. Some include frequent masturbation, grieving the loss of their sex life, and trying to focus more on what they are getting out the marriage rather than what they are not.


Some couples have agreed to allow exceptions to their fidelity agreement, including opening up their marriage. If this is something you are wanting to try, please consider working with a couples counselor first as this strategy can backfire if done poorly.



Does sexless marriage justify adultery?


When you married, you likely made a promise, explicitly or implicitly, that you would not cheat on your spouse.  So, violating the marital agreement is not justified under any condition.


With that said, spouses typically promise when they marry that they would tend to the needs of each person. This includes sexual needs. If one partner has stopped engaging in sex, and is unwilling to address that, they also likely violated the marital agreement.


Solving your sexless marriage with adultery is a highly risky and traumatic decision. Adultery, risks the physical and emotional health of a marriage.



Is a sexless marriage grounds for divorce?


That is an individual decision. People divorce for many reasons, and many believe their reasons justify their decision. It is problematic if your partner regularly declines having sex with you.  Also, if your spouse also doesn’t have any interest in changing that, then you are being faced with a very difficult problem. Living without and sexual touch or intimacy can be troubling and damaging to your health.


Before considering divorce, consider working with a sex therapist as it can help couples improve their sex lives and save their relationship.


Should you be unsure if you want to continue in a sexless marriage, Dr. Zrenchik of ALL IN suggests you consider Discernment Counseling. It is a short-term decision making process that helps couples determine the future of their marriage.


For further reading about sexual behavior, consider The Social Organization of Sexuality.





Jackson, S. E., Yang, L., Koyanagi, A., Stubbs, B., Veronese, N., & Smith, L. (2020). Declines in sexual activity and function predict incident health problems in older adults: prospective findings from the English longitudinal study of ageing. Archives of sexual behavior49(3), 929-940.

Karraker, A., DeLamater, J., & Schwartz, C. R. (2011). Sexual frequency decline from midlife to later life. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 66(4), 502-512.

Snyder, D. K., Baucom, D. H., & Gordon, K. C. (2007). Treating infidelity: An integrative approach to resolving trauma and promoting forgiveness. Infidelity: A practitioner’s guide to working with couples in crisis. New York, NY: Routledge.

Twenge, J. M., Sherman, R. A., & Wells, B. E. (2017). Declines in sexual frequency among American adults, 1989–2014. Archives of Sexual Behavior, 46(8), 2389-2401.

Yoo, H., Bartle-Haring, S., Day, R. D., & Gangamma, R. (2014). Couple communication, emotional and sexual intimacy, and relationship satisfaction. Journal of sex & marital therapy40(4), 275-293.




Disclaimer: ALL IN Therapy Clinic aims to improve people’s lives through providing effective mental health counseling by passionate professionals. We publish quality material for your own education. Our publications are researched, cited, reviewed, and edited by licensed mental health professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of a qualified healthcare provider.




Filed under: Couples & Relationships by All in therapy Clinic

8 Causes & Tips to Deal With It

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Published: September 30, 2022 Updated: October 18, 2022

Published: 09/30/2022 Updated: 10/18/2022

We need to feel close to our romantic partners both emotionally and physically. This kind of intimacy comes in many forms, sex being one of them, but many couples report being in a sexless marriage. This doesn’t necessarily spell disaster for the relationship, though. There are ways to improve intimacy and feel close to your partner again.

Talkspace (Online Therapy For Individuals & Couples)

In couples counseling, you can work together on improving communication, building trust, and resolving conflict. Also, you can work on making sex more enjoyable and fulfilling. Talkspace works with several major insurers including Optum, Cigna, Aetna, and UnitedHealthCare. Check Your Insurance Eligibility

Choosing Therapy partners with leading mental health companies and is compensated for referrals by Talkspace.

Try Talkspace

What Is a Sexless Marriage?

While there’s not a universal sexless marriage definition, it refers to a marriage with little or no sexual activity between partners (less than 10 times per year). 1,2
It’s important to note that what people define as sexual activity varies. Ultimately, the number of sexual encounters is less important than your satisfaction and happiness in the relationship.

Is a Sexless Marriage Normal?

Many people in sexless relationships report feeling alone with the issue. However, an estimated 15% of married couples have not had sex in the past six months to a year.3
According to Dr. Robert Epstein, 10-20% of romantic relationships in the U.S. are sexless, which accounts for an estimated 40 million people.4
In other words, if you are in a sexless marriage, you are not alone.

“A sexless marriage can mean something different to each person. Most times, when people refer to being in a sexless marriage, they mean sex is very infrequent or in fact does not happen within their marriage. This is not uncommon. I find many of the couples who come to see a sex therapist often wait years until they can’t continue in the marriage this way. This creates a sense of urgency for the client and/or couple to work on their sex life immediately,” says Dr. Michael Stokes, certified sex therapist and professional consultant at Between Us Clinic

It’s common to believe that men want more sex and women want less. While this does occur, it’s not uncommon for it to be the other way around. Jen Gunter, an obstetrician and gynecologist practicing in California states, “Our society seems almost built on the erroneous idea that all men want sex all the time…I want women to know that if they are on the wanting end for sex, they are not alone.”5

8 Causes of a Sexless Relationship

If you and your partner aren’t having sex, I encourage you to question where there is a reason, including health issues,unmatched libidos, life transitions, communication issues, other relationship issues, hormone changes, mental health issues, and medication side effects.

Here are eight potential causes of a sexless relationship or marriage:

1. Health Issues

If you or your partner are dealing with health concerns, this may impact your desire (or ability) to have sex. Several medical conditions, including diabetes, cancer, cirrhosis of the liver, and heart disease are known to reduce libido.6 Some conditions even impact physiology in a way that can make sex difficult, painful, or impossible.

2. Unmatched Libido

Difference in sexual desire is one of the most common causes of sexlessness in a marriage. Usually, it’s not the fact that a couple has different levels of desire but rather how they manage these differences that leads to a decline in sex.

The person who wants it more feels rejected and unloved, often leading to a decline in initiating. The partner who wants it less feels guilty for not wanting it more. These feelings lead to distance in the relationship, which exacerbates intimacy issues.

3. Life Transitions

We all face challenges in life that impact our health and happiness. During these times, it is normal for sexual desire to decrease as we focus on getting through the struggle and re-establishing our balance.

Life transitions include:

  • Job loss
  • Financial issues
  • Grief (loss of a loved one or other significant loss)
  • High stress (due to work, a move, family issues, etc.)
  • Childbirth
  • Infertility
  • Menopause

4. Communication Issues

If you and your partner are experiencing difficulties with lack of communication, this is going to impact your connection and closeness. It is difficult to have sex with your partner when you are feel distant and disconnected. Emotional connection is a prerequisite to sex, especially for women.

Stokes states, “The most common reason for a sexless marriage is a lack of communication. So many people are uncomfortable talking about sex so they fall into a routine of sex that seems manualized and not satisfying. The idea of telling their partner they want to have sex or they want to try something different in the bedroom is too overwhelming, so they simply do not.

5. Other Relationship Issues

Other relationship challenges may lead to a decline in sexual intimacy as well, including feeling alone in your relationship, infidelity, addiction, lies, emotional affairs, or other betrayals. If there is an issue of trust in the relationship, it is hard to be vulnerable and therefore difficult to engage in sexual activity.

6. Hormone Changes

Estrogen, progesterone, and testosterone all affect sexual desire and arousal.7 If your hormones become imbalanced, it may lead to a decline in libido.

Hormone fluctuations can occur for many reasons, including:7

  • Pregnancy
  • Menopause
  • Age
  • Menstruation
  • Stress
  • Medications
  • Environment

7. Mental Health Issues

Mental health concerns have also been linked to a decline in sexual desire and arousal.8 Specific issues can cause changes in brain chemistry that decrease sexual desire and impair one’s ability to engage in sexual activity, especially if someone has a history with sexual trauma or relationship post traumatic stress disorder (PTSD).

Mental health issues include:9

  • Depression
  • Anxiety
  • Schizophrenia
  • PTSD
  • Eating disorders
  • Personality disorders

8. Medication Side Effects

Medications are sometimes necessary to treat physical health or mental health conditions; however, they can impact our hormones and disrupt our level of sexual desire and arousal. Medications that affect sex drive often have mechanisms that affect the biologic or hormonal mediators of libido.10

Marriage & Couples Online Counseling Options

While having both members of a couple participate in counseling is ideal, often one person does want to participate. The services below help both individuals and couples with relationship issues.

Regain – Receive couples counseling from a licensed therapist, starting at $60 per week. Get Matched With A Therapist

Online-Therapy – Video and text based relationship couples counseling, starting at $50 per week. Try Online-Therapy

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Choosing Therapy partners with leading mental health companies and is compensated for referrals by Regain, Online-Therapy, and Ritual.

How Important Is Sex In a Relationship?

So, how important is sex in a relationship? The importance of sex in a relationship is determined by the people who are in the relationship. If it’s a concern for one person, it’s a concern for the relationship. If, however, a lack of sex is not bothersome to you and your partner, it’s not an issue.

Exploring Other Forms of Intimacy 

Sex is an obvious and positive way to express intimacy. That said, other forms of intimacy (emotional and physical) are crucial for a relationship to flourish as well as to lay the groundwork for a healthy sex life. Other forms of physical intimacy include hugging, kissing, snuggling, holding hands, and playful touch.<

Emotional intimacy is created by building a strong friendship. This includes knowing each other, expressing appreciation for each other, and being there to support each other. When you focus on fostering emotional intimacy and other forms of physical intimacy, sex is more likely to occur. If not, you will both still feel a great sense of satisfaction in the relationship.

How to Address Your Sexless Relationship With Your Partner

If your sex life has been waning or is non-existent and you want this to change, talk to your partner about your concerns. It’s imperative that you approach them gently and avoid criticism. If your partner feels blamed, criticized, or attacked, they will have a hard time hearing you.

The best way to ensure that you bring up your concern gently is by using what Dr. John Gottman (who coined the Four Horsemen of the Apocalypse in a relationship) calls the Softened Start Up. 11
In this approach, share how you feel, what the issue is, and your positive needs.

For example, you might say, “I am feeling sad that our sex life has declined. I would love it if we could talk about this and explore ways to connect more physically.” Or, “I have been missing you and I would love it if we could figure out a way to reconnect physically.”

5 Tips to Rebuild Your Sex Life

Once you have an open conversation about your feelings, if you both decide to try rebuil

Stokes advises, “I would encourage couples to start by talking about this in an open way. This can be difficult, but necessary. If talking about this on your own is not working, it might be time to talk to an AASECT Certified Sex Therapist who can help assess the problem and facilitate interventions that can help towards their goals.”

Here are five tips to rebuild your sex life:

  1. Make time to talk about sex outside of the bedroom: share what you like, desire, fantasize about, etc. Talking openly and honestly about sex is key to having a good sex life.
  2. Increase your physical affection: sex starts long before you are in the bedroom. Small acts of romance and affection throughout the day will help you feel more emotionally connected and enhance your desire for physical connectedness.
  3. Take the pressure off: when orgasm is the objective, it can put pressure on the act and impede pleasure. Instead, shift the focus to being present and engaged regardless of the “outcome.”
  4. Try new things: get an informative book about sex, buy some toys, find ways to spice things up, and keep it interesting
  5. Schedule sex: if it’s hard to find time to be intimate due to busy schedules, make sex a priority by carving out specific time

When to Seek Professional Help

If you and your partner have tried to get your sex life back on track but are feeling stuck, it may be time to work on finding a couples therapist to help you move forward. If your partner is willing to attend, marriage and couples counseling and/or sex therapy may be beneficial as well. If your partner isn’t willing to attend, seeing a therapist individually can still be useful.

How to Find a Therapist

You can search an online therapist directory for licensed marriage and family therapists (LMFT). You could also ask people you know and trust, including a primary care provider, for their recommendations.

When to Walk Away From a Sexless Marriage

The decision to divorce and end a marriage is a painful choice that only you can make for yourself. Some signs that it may be time to walk away include an infidelity one partner can’t get over, incompatible sexual interests, or an unwillingness to address intimacy issues.

If you’re unsure whether you want to continue the relationship, consider discernment counseling, a short-term process that helps couples determine whether they want to divorce.

Stokes encourages, “Walking away from any marriage is a difficult and individualized decision. There is not one particular point in time that warrants you to leave. I encourage couples to continue to communicate, be vulnerable with one another, and work as a team. Your decision to walk away should be your decision.”

Here are four reasons to consider walking away from a sexless marriage:

  1. Your partner isn’t willing to work on intimacy issues or make any changes despite you sharing how important it is for you
  2. The lack of sex has led to infidelity that one partner can’t get over
  3. You and/or your partner realize you have incompatible sexual interests and neither is willing to compromise
  4. You are no longer in love

Final Thoughts On Sexless Marriage

Couples should understand and expect that there are going to be ebbs and flows in their sex life throughout the course of their relationship. While sex is often an important aspect of romantic relationships, it’s not the only way to share intimacy. As long as you’re both willing to work on it, there are ways to stay connected emotionally and physically and maintain a healthy, happy relationship.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for referrals by the companies mentioned below.

BetterHelp (Online Therapy) – What are the next steps for the relationship? Can the relationship be improved? BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you. Get Started (Couples Counseling) – Would your partner and you benefit from couples therapy? Find Out. The standard plan includes a weekly 45 minute video session, unlimited text messaging between sessions, and self-guided activities like journaling. Recently, they added instructional Yoga videos. Get Started

Choosing Therapy’s Directory – Find an experienced therapist who is experienced in couples counseling. You can search for a therapist by specialty, availability, insurance, and affordability. Therapist profiles and introductory videos provide insight into the therapist’s personality so you find the right fit. Find a therapist today.

Choosing Therapy partners with leading mental health companies and is compensated for referrals by BetterHelp and

11 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Kim JH, Tam WS, Muennig P. Sociodemographic Correlates of Sexlessness Among American Adults and Associations with Self-Reported Happiness Levels: Evidence from the U.S. General Social Survey. Arch Sex Behav. 2017;46(8):2403-2415. doi:10.1007/s10508-017-0968-7

  • Denise A. Donnelly (1993) Sexually inactive marriages, The Journal of Sex Research, 30:2, 171-179, DOI: 10.1080/00224499309551698

  • Parker-Pope, T. (2009, June 3). When Sex Leaves the Marriage.  The New York Times. Retrieved from

  • Suszynski, M. (2011, September 8). Are Sexless Marriages and  Relationships Normal? Everyday Health. Retrieved from

  • Gunter, J. (2018, March 10). When the Cause of a Sexless  Relationship Is — Surprise! — the Man. New York Times. Retrieved  from

  • Bussey, A. (2021, July 25). What are the medical causes of low  libido? Healthily. Retrieved from

  • Eske, J. (2019, April 5). What to know about female sex hormones. Medical News Today. Retrieved from

  • Phillips, R.L. & Slaughter, J.R. (2000, August 15). Depression and sexual desire. American Family Physician, 62(4), 782-786

  • Balon R (ed): Sexual Dysfunction. The Brain-Body Connection. Adv  Psychosom Med. Basel, Karger, 2008, vol 29, 89-106. Retrieved  from

  • Knudsen, D. (2010). How Medications Impact Libido. Women’s  Health, 26(3) Retrieved from https://www.

  • Gottman, J.M. & Silver, N. (1999). The Seven Principles For Making  Marriage Work. New York, NY: Three Rivers Press.

update history

We regularly update the articles on to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

  • Originally Published: November 5, 2021
    Original Author: Kimberly Panganiban, LMFT
    Original Reviewer: Kristen Fuller, MD

  • Updated: September 30, 2022
    Author: No Change
    Reviewer: No Change
    Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources.

If you are in need of immediate medical help:


Suicide Hotline

Infertile marriage: symptoms, diagnosis, treatment of infertile marriage

The main activity of the department is to overcome various forms of infertile marriage with the use of assisted reproductive technologies. Currently, it is generally accepted that infertility is the inability of a mature organism to conceive, and a barren marriage is the absence of pregnancy after 12 months of regular sexual activity without contraception. This term - 1 year is determined statistically. It has been proven that in 20% of healthy couples, pregnancy occurs in the first three months of marriage, in another 60% during the next seven, in the remaining 20% ​​in eleven to twelve months after the onset of sexual activity. Thus, a year is a sufficient period to assess the fertility of a couple and, in the absence of pregnancy, speak of a fruitless marriage.

The unique advantage of our department is the possibility of hospitalization of the patient for all the necessary manipulations. We see many advantages in this, such as adequate preparation before and clear observation after all manipulations, the possibility of hospital-polyclinic continuity, when the same doctor prepares the patient for the IVF program, and then conducts this program himself. This achieves a high level of awareness of the doctor about all the characteristics of the patient, as well as a high psychological level of comfort for a married couple who trusts the same doctor. When conducting ART programs, we usually hospitalize the patient the day before the follicle puncture and discharge the next day after the transfer of embryos into the uterine cavity. If, for any reason, there is a need for hospitalization, it continues until the difficult situation is resolved. On average, hospitalization in our department takes from 5 to 8 days.

Our department uses the most modern and high-tech methods to overcome a fruitless marriage. We briefly list the main ones from simpler to more complex, so:

• Artificial insemination with husband's or donor's sperm in a natural cycle. It can be used for immunological factor of infertility, with passable fallopian tubes and fertile indicators of sperm.

• Artificial insemination with husband's or donor's sperm with ovulation induction. It can be used with a combination of an immunological factor of infertility and an endocrine factor, with passable fallopian tubes and fertile indicators of sperm. It can also be used in patients without ovulation disorders, for example, when the patient's age exceeds 35 years and it is necessary to use a obviously more effective ART method.

• In vitro fertilization and transfer of embryos into the uterine cavity. The "gold standard" for the treatment of all types of infertile marriages, the most common ART method in the world. It consists of several stages - selection and examination of a married couple, stimulation of superovulation, follicle puncture and egg collection under ultrasound control, in vitro fertilization and embryo cultivation, embryo transfer into the uterine cavity, hormonal therapy for the period after embryo transfer and management of early pregnancy.

• In vitro fertilization and transfer of the embryo into the uterine cavity in a natural cycle. The method can be used in patients with premature ovarian failure syndrome, as well as in the presence of contraindications to superovulation stimulation

• Donation of oocytes. The program is intended for patients with premature ovarian failure syndrome, or for patients with ovaries removed for any reason, or for patients in the peri- and postmenopausal period who insist on the implementation of reproductive function

• Surrogacy. The program is intended for patients with a removed uterus, or for patients with gross, irreparable anatomical defects of the uterine cavity, or for patients who, for any reason, are contraindicated for pregnancy and childbirth.

• Sperm donation. The program is designed for couples with severe irreparable disorders of the male reproductive system; unmarried patients, but interested in the implementation of the reproductive function; in severe forms of the immunological factor of male infertility

• Various cryopreservation programs. Cryopreservation of sperm, embryos, vitrification of embryos.

• Auxiliary hatching. This method is one or another method of dissection of the transparent shell of the embryo, which, according to numerous studies, can increase the percentage of successful implantation. There are mechanical, chemical and laser hatching

• Intracytoplasmic sperm injection into the oocyte (ICSI). Method of fertilization of obtained oocytes in severe forms of male infertility. The essence of the method lies in the fact that under a microscope, a single spermatozoon is introduced into the cytoplasm of the egg, which allows leveling the poor mobility of spermatozoa, their insufficient number. One of the options for this procedure is the injection of sperm under the pellucida

• Transfer of gametes or embryos into the fallopian tubes (ZIFT, GIFT), which, according to various authors, is more physiological than the classic transfer of embryos into the uterine cavity
Here is a short list of the methods of assisted reproductive technologies that our department can offer you. We work on the most modern equipment of the world's leading manufacturers in the field of ART. Our state-of-the-art embryology laboratory works with the most advanced culture media and consumables.

We hope that our continuous improvement of knowledge, skills and technologies in the field of assisted reproductive technologies will help you realize your dreams of a long-awaited child.

Tubal-peritoneal infertility factor

The department has everything you need, both for the diagnosis and treatment of tubal-peritoneal factor of female infertility.

The share of tubal-peritoneal factor of infertility in the structure of infertile marriage is, according to various authors, from 20% to 30%.

As a rule, tubal-peritoneal infertility factor can be suspected in patients with previous inflammatory diseases of the pelvic organs, especially chlamydia; after surgical interventions on the pelvic organs, regardless of the type of access, with external genital endometriosis, as well as with a number of other diseases.

In our department, there are possibilities for diagnosing this pathological process, both with the help of modern X-ray methods, and with the use of endoscopic equipment. With laparoscopy, in addition to the diagnostic component, there is a technical possibility of simultaneously conducting a number of therapeutic and diagnostic surgical interventions with correction of the identified pathological processes.

The widespread use of bacteriological diagnostic methods and the use of the most modern methods of histological examination make it possible to clarify the diagnosis and prescribe more effective treatment methods for each particular patient.

endocrine factor infertility

The mechanism of development of endocrine infertility is associated, as a rule, with the absence of ovulation for one reason or another. The share of endocrine infertility accounts for 27% to 40% in the structure of infertile marriages. One of the most common reasons for the lack of ovulation is polycystic ovary syndrome (synonyms: PCOS, polycystic ovaries, sclerocystic ovaries, Stein-Leventhal syndrome). This pathology, like any other endocrine disease, affects many organs and systems. The hormonal imbalance in PCOS and the thick, hard shell of the ovary prevent the maturation of a mature follicle and the process of ovulation. This subsequently leads to a violation of the hormonal regulation of growth and maturation of the endometrium and entails various types of menstrual irregularities. Much attention is also paid to the diagnosis and correction of hyperprolactinemia, which is the second most common cause of the absence of ovulation.

The department has accumulated considerable experience in diagnosing the causes of endocrine infertility, and has developed treatment regimens for this pathology, both by conservative methods and using modern surgical endoscopic techniques.

If it is necessary to induce ovulation or stimulate superovulation for the IVF program, our specialists will help you choose an individual regimen for the use of drugs that is optimal for you.

Endometriosis-associated infertility factor

Since the formation of reproductive medicine as a science, endometriosis and infertility have gone hand in hand. The proportion of endometriosis-associated infertility factor in the structure of infertile marriages, according to various sources, ranges from 15% to 50%. Without dwelling on the causes and mechanisms for the development of endometriosis, which continue to be studied, it should be noted that a clear and quick diagnosis of the leading pathological process in infertility caused by endometriosis is often one of the determining factors in overcoming an infertile marriage.

In our department, various methods of diagnosis and treatment of endometriosis are widely used. These are various types of ultrasound and laboratory diagnostics, a wide range of endoscopic and other minimally invasive interventions using various types of surgical energies, a wide variety of medical correction methods, and many physiotherapy programs aimed at the speedy restoration of reproductive function.

Immunological factor of infertility

In recent years, more and more attention has been paid to the immunological factor of infertility, characterized by the production of antisperm antibodies, both in men and women. The share of this factor in the structure of infertile marriage is up to 3%. In addition to the possibilities of complex laboratory diagnostics of the immunological status of our patients, our department has the possibility of conducting additional diagnostic methods, such as a postcoital test (Shuvarsky test), as well as a MAR test of sperm with an assessment of the number of spermatozoa inactivated by antibodies.

One of the main ART methods used for immunological infertility is intrauterine insemination, performed both with the husband's sperm and, if indicated, with donor sperm. Artificial insemination can be carried out both with ovulation induction and in the natural cycle. The method has a relatively low cost, there is practically no massive drug load on the body. However, there are a number of certain conditions for its use - the main ones are the patency of the fallopian tubes, and the spermogram indicators are sufficient for insemination.

Male factor infertility

The male factor is considered the cause of an infertile marriage if the woman is healthy, and the man has a decrease in the fertilizing ability of sperm.
In the structure of an infertile marriage, the isolated male factor reaches 40-50%. The reason for the development of male factor infertility can be many reasons, these are past viral diseases, in particular mumps, viral hepatitis; severe somatic diseases, inflammatory and venereal diseases, malformations and anomalies in the development of the genital organs, varicose veins of the spermatic cord or varicocele, smoking, alcohol abuse, neurological and mental causes, and many other factors.

Taking into account the high frequency of the male factor in the structure of an infertile marriage, we recommend starting the examination of a married couple with a semen analysis. All conditions have been created in our department for psychologically comfortable and convenient for our patients to pass this analysis. If necessary, there is the possibility of an additional examination, including a MAR test, bacteriological seeding of sperm, a consultation with a urologist-andrologist with a more detailed and in-depth study of the problem at the most modern level using high-tech diagnostic and treatment methods.

The main method of overcoming severe forms of male infertility is intracytoplasmic sperm injection into the oocyte (ICSI). This technique is most often one of the stages in the implementation of the IVF program. Its distinguishing feature is that its use is possible even in severe disorders of the spermogram, when the fertilizing ability of sperm is significantly reduced.

In our department, if necessary, it is possible to use methods for obtaining spermatozoa for obstructive lesions of the genitourinary system of men, if the man's sperm does not contain live spermatozoa, it is possible to collect spermatozoa or spermatogenesis cells directly from the testicle or its epididymis (auxiliary surgical technologies TESE and MESA).

Ovarian hyperstimulation syndrome

Ovarian hyperstimulation syndrome is a consequence of stimulation of superovulation in IVF programs. The incidence of severe OHSS is stable and ranges from 0.1 to 2% of all stimulations. The final mechanisms of its development are still being actively studied, however, it is known that the main factor in the implementation of this syndrome is the pathological activation of the renin-angiotensin-aldosterone system. The main clinical manifestations of this syndrome are realized due to the phenomenon of "increased vascular permeability". Against the background of stimulation of superovulation, many follicles grow in the ovaries and, as a result, the formation of many new vessels with an imperfect vascular wall, through which blood plasma flows into the intervascular space. Due to this, fluid accumulates in the abdominal cavity, and meanwhile, there is not enough fluid in the blood itself, the blood “thickens”, and the risk of thrombosis increases. In severe forms of ovarian hyperstimulation syndrome, fluid can accumulate not only in the abdominal cavity, but also in the pleural and pericardial cavities.
Successful correction of this pathological condition is possible only with a clear understanding of all the links of the pathological process.

Our department has accumulated extensive experience in managing patients with ovarian hyperstimulation syndrome, there are all the necessary medications and equipment. Our highly qualified paramedical staff is trained to adequately monitor the condition of patients, and without this it is impossible to objectively assess the dynamics of the development of the syndrome.

The main methods of therapy for this pathological condition are the replenishment of the volume of intravascular fluid, the prevention of thrombotic complications. In the case of intense ascites, it is necessary to puncture the abdominal cavity and remove the ascitic fluid.

It is well known that when pregnancy occurs, ovarian hyperstimulation syndrome begins to progress. Managing pregnancy against the background of ovarian hyperstimulation syndrome is not an easy task, but the doctors of our department have the necessary knowledge and experience to solve this problem.

Threat of abortion in the first trimester

The unfavorable ecological situation, the increase in the infectious index of the population, the widespread use of assisted reproductive technologies make us take a fresh look at the problem of managing pregnancy in the first trimester. Many married couples postpone the birth of a child until the late reproductive period; for many infertile couples, the issue of maintaining such a long-awaited and hard-won pregnancy becomes a key one. However, our department works under the slogan - pregnancy is not a disease, and you should not make a pregnant woman sick. Our task is to promptly identify and correct as carefully as possible those deviations from the normal course of pregnancy that may prevent spouses from becoming parents. Head of the department prof., d.m.s. Klara Georgievna Serebrennikova is known throughout the country for her individual approach and sensitive attitude towards pregnant women, which she instills in all her employees, thanks to which the department is famous for its results in this matter.

Reasons and tips for recovery

Last update - June 24, 2022, last checked by an expert January 28, 2022.
  • What is it
  • Causes
  • Mental health effects
  • Is this a deal breaker?
  • Tips
  • Review

Wondering why there is not enough sexual intimacy in a love relationship? Do you want to overcome the drought and revive your sex life? Let's talk.

One of the most common complaints among people in long-term relationships? Asexuality.

Not having sex in a romantic partnership can be frustrating, whether you're someone who wants more sex or someone who doesn't.

But there are many ways you can improve your sex life and improve your relationship in the meantime.

What is sexless marriage?

Generally speaking, an asexual marriage or relationship is one in which there is little or no sexual contact between the partners. There is no generally accepted definition.

Some signs that you may be in an asexual relationship include:

  • having less than 10 or no sex per year
  • lack of physical and emotional intimacy
  • tension between partners over frequency of sex

One study in 1993 found that 16% of couples had been sexually inactive in the previous month.

Dr. Laura Wauels, sex and relationship psychotherapist, researcher at the University of Lausanne (Switzerland), estimates that between 2 and 10% of marriages today are asexual.

Sexual desire and frequency of sexual intercourse is different for everyone, so if you have a period of dryness or you just feel out of sync with your partner, try not to get upset. This is natural and does not necessarily mean that you are in an asexual relationship.

Consensual sexless marriage

Lack of sex is a problem when the level of desire varies between partners. But for couples who mutually agree that sex is not a priority, sexless or low-sex marriages can flourish.

There are many good reasons why people remain abstinent in marriage, including:

  • asexuality
  • equally low sex drive
  • religious practice
  • avoiding STDs and unwanted pregnancies

that sex is necessary for the manifestation and maintenance of a loving connection, strong relationships can be maintained.

Why is this happening?

When it comes to sexless marriages, there are many possible causes, and sometimes the exact cause is difficult to pinpoint. Here are some common reasons why one or both partners may not be interested in sex.

Sexual Desire Divergence (SDD)

SDD basically means that one partner wants sex more than the other. Your sexual desires are out of sync.

One 2015 study found that 80% of people have experienced DDS as part of their relationship in the last month.

Everyone - regardless of gender identity - experiences ups and downs of desire. However, if your partner wants sex much more than you do (or vice versa), feelings may be hurt and frustration may mount.

Mental or physical illness

Chronic health conditions, depression, joint or muscle pain, cancer and other ailments can significantly affect your sex life.

Decreased libido may be a side effect of the disease itself or the drugs used to treat it.

For example, selective serotonin reuptake inhibitors (SSRIs) are the first pharmacological agents for the treatment of depression. But sexual dysfunction is among their most common side effects.

Poor communication

In one study, Dr. Laura Wawels found that dissatisfaction in relationships where partners had different levels of desire mainly stemmed from poor communication and disconnection.

By not making any effort to work with your loved one during periods of diverging sexual desire, you only make the situation worse and can turn into a snowball of complete lack of sex.


After being in a committed relationship for years, it's easy to get bored with your usual, tasteless sex.

If sex is no longer pleasurable and exciting, you are much less likely to make the time and effort to have it.

How can sexless marriage affect mental health?

It is generally true that sex and intimacy are good for your mental health.

One 2015 study confirmed previous findings that frequency of sex is related to people's well-being in relationships. While relationship and life satisfaction remained fairly stable for couples who had sex at least once a week, those who had sex less often expressed lower levels of satisfaction.

The frustration and conflict that can accompany an asexual relationship can take a toll on mental health.

With regard to a person with great sexual desire, “over time they often begin to feel less confident about the state of their relationship (Does my partner still love me? Are we still stable?) or their own sexual self (I still Am I good enough in bed to make my partner want to have sex with me?),” says Dr. Laura Wawels.

Relationship and intimacy coach Amy Color from Vancouver, BC also explains: “Asexual or sexually impoverished relationships make people feel alone, insecure, rejected and ashamed. Negative feelings lead to negative behaviors: rage, … romance, substance use, overeating, over-shopping, overeating and depression.”

Is this a deal break?

Most people agree that sex is a necessary part of any romantic relationship. In one Pew Research Center survey, 63% of respondents said that satisfying sexual relationships are important to maintaining a successful marriage.

However, this does not mean that lack of sex must always mean the end.

Dr. Laura Wawels believes that a happy relationship is possible without sex.

“There are people who are happy to stay in a sexless marriage because there are so many reasons why a person might want to stay in a relationship,” she says. “Sex is generally good for relationships and provides a range of benefits for people, but that doesn’t mean it’s necessary to still have a healthy relationship.”

However, a decrease in sex and intimacy can certainly have a negative impact on relationships. Whether this is a “relationship destroyer” is up to you.

How can we restore our partnership?

While you may feel discouraged if your partnership goes a long way without sex, keep in mind that there are ways to restore and revitalize your sexual relationship.

Communication is key

Communication is the most important component when it comes to your sex life.

One British study found that maintaining sexual interest in one's partner was associated with ease of communication and emotional closeness.

But what should you communicate about? To increase your sex life and enjoy the sex you have, consider these tips:

  • Tell them what you want. You don't have to be shy. Research shows that when women are open about their sexual likes and dislikes, they have more orgasms.
  • Talk about performance issues. Although it can be embarrassing, talking frankly about erectile dysfunction, delayed orgasm, or pain is important.
  • Treat with understanding. It may seem that your partner does not want to have sex, but try not to jump to conclusions. Maybe they're feeling sick, they've had a long day at work, or they're just not in the right state of mind to have sex tonight.

Couples Therapy

While it may seem like a drastic step, seeing a therapist can help break down communication walls and provide the guidance you and your partner need to improve your sex life.

Dr. Laura Wauels uses Emotionally Focused Therapy and Sensitive Focusing with her clients.

“Emotion Focused Therapy focuses on understanding the cycle of negative interactions and helping couples break out of this cycle and reconnect emotionally with each other,” says Dr. Laura Wauels. “[She] helps couples talk to each other about problems and open up an emotional dialogue about their fears, needs, and yearnings.”

Sensitive focus, she explains, “combines elements of mindfulness (being in the present moment) and exposure therapy (gradually getting used to something that is feared or avoided).”

Get intimate

Being intimate doesn't always mean sex.

Intimacy can include physical touching, such as:

  • Massage
  • Affection
  • hugging
  • kissing

It can also mean emotional intimacy, such as having a deep conversation together.

Some research suggests that showing affection, whether verbal or physical, can be an effective way to increase the likelihood of sex.

Turn up romance

If you have kids, a responsible job, high stress levels, or all of the above, finding time for romance can seem impossible. But if your sex life isn't where you want it to be, rediscovering your romantic roots is a powerful tool.

Consider having a date night, going on a weekend trip, or just lighting candles at home. Romance can also be brought into everyday life: love notes, cute messages or small compliments.

Think ahead

For some couples, scheduling sex on the calendar is a useful tool for maintaining a sexual relationship.

You are busy. They are busy. And it's easy to let weeks of mismatched schedules go by without sex.

Knowing the idea ahead of time can not only get you more sex, but anticipation can also serve as a form of foreplay between you and your partner.

Even if you're not in the mood when the time comes, sexual contact can help boost your libido and make it more likely that you'll want to jump into bed (or the counter) next time.

Spice it up

When you're in a long-term relationship, it's easy to fall into a routine. Instead of mindlessly having regular sex, try something new, whether it's a new place to have sex, a different position, or a fun toy.

Learn more