Effect of depression and anxiety on sexual functioning in couples trying to conceive with and without an infertility diagnosis

Psychol Health. 2023 Jan;38(1):37-54. doi: 10.1080/08870446.2021.1955115. Epub 2021 Jul 19.


Objective: This study examined the effects of anxiety and depression on sexual functioning in couples trying to conceive, and tested the moderating role of infertility diagnosis on this association.

Design: An online questionnaire was completed by 1453 individuals in a heterosexual relationship for more than one year. The final sample had 107 couples who were actively attempting a pregnancy (63 had an infertility diagnosis; 44 were presumably fertile). Data was analyzed with the Actor-Partner Interdependence Model (APIM).

Main outcome measures: Depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS), and male and female sexual functioning were assessed through the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI), respectively.

Results: Actor effects were found between depression and sexual functioning in both men (β= -.28, p= .003) and women (β= -.43, p < .001), with no significant partner effects. The moderation analysis showed that the relationship between depression and sexual functioning is stronger in infertile men than in presumably fertile men (β= -.29; p= .002).

Conclusion: Psychological interventions with couples trying to conceive should address the role of depression in sexual functioning, particularly in infertile men.

Keywords: Infertility; anxiety; depression; dyadic; sexual functioning.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety / diagnosis
  • Anxiety / psychology
  • Anxiety Disorders
  • Depression* / diagnosis
  • Depression* / psychology
  • Female
  • Humans
  • Infertility* / psychology
  • Male
  • Surveys and Questionnaires