Inspiration

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Medical Contribution By Sharon Covington

Sharon Covington, MSW, LCSW-C, Director of Psychological Support Services at Shady Grove Fertility hears the same question often from patients who are undergoing fertility treatment –“how can I keep the romance alive while undergoing treatment?” She explains that talking openly with your partner on this subject can be crucial to a couple’s relationship.

“When you take your fertility problems to an expert for consultation or treatment,” Covington says, “you’re exposing what’s usually a personal and private facet of your relationship. But those of us who work every day with people going through infertility see firsthand the lasting impact on marriages. When you’re desperately trying to get pregnant, sex becomes about procreation and not recreation.”

Covington conveys a message that must be heard by fertility patients early on: When sex goes from being fun to work, it will play havoc on your relationship — but partners can take the wheel and consciously steer their marriage back on track, and maybe even lead to better intimacy than before.

Redefining “Sex” During Fertility Treatments

One of the places where Covington and her staff discuss sexuality with patients is in their Mind-Body group sessions. Covington explains that intimacy is not all about physical technique. In fact, one entire session is devoted to redefining what “sex” is in a relationship and how men and women think differently about this specific form of communication.

“We talk about the range of behaviors that make up what we refer to as ‘sex’. It’s not entirely new to most of us, but when you’re trying to get pregnant, it’s easy to forget that sex isn’t just intercourse,” Covington explains.

Covington refers to “Nine Areas of Sexual Relationships” as listed in the book Hot Monogamy: Essential Steps to More Passionate, Intimate Lovemaking by Patricia Love, MD and Jo Robinson (1995):

1. Communication about Sex: the ease with which you talk about your sexual relationship
2. Sexual Desire: how much physical desire you experience on a regular basis
3. Intimacy: your ability to share your thoughts and feelings with your partner on an ongoing basis
4. Technique: your skill at arousing yourself and your partner
5. Sexual Variety: your willingness to add creativity and novelty to your lovemaking
6. Romance: your desire to show love for your partner in concrete ways
7. Body Image: your inner image of your outer self
8. Sensuality: your willingness to relax and involve all your senses in your lovemaking
9. Passion: your ability to combine intense feelings of arousal with love for your partner

“Every single one of these aspects is strongly impacted by the infertility experience,” Covington says. “Acknowledging and understanding the basics is the first step in either protecting or renewing your sexual relationship. I suggest to couples that they make a goal of coming back to what brought them together in the first place.”

New, Creative Ways To Be Intimate

Still, she says many couples feel overwhelmed by the infertility experience to the point of being “just too darned tired to even imagine what they enjoyed before.”

Here’s what Sharon Covington recommends:

Plan Playtime
“We often think sex has to be spontaneous, but the reality is different. Since sex starts with our minds, waiting for spontaneity to erupt probably won’t work like we hope. Put time and energy into planning and then doing some fun things, sexually.”

Be Creative
“Most couples, even in the best relationships, can get into habitual ruts. Sparking things up may require changing it up for playtime. Consider different types of attire and surprise your spouse, or maybe try a candlelight dinner with mood-enhancing scents. Try to think outside of your comfort zone with the intention of just giving something a try.”

Recreate Your Early Sexual Relationship
“We forget about the things that really excited us and aroused us early on in the relationship. Take some time to remember those first exciting times. Even just talking about it can help heat each other up.”

Explore Your Surroundings
“When love-making becomes baby-making, try designating one room of your house for one and another room for the other. Consider trying someplace else to have exciting interludes.”

Look to Non-Fertile Times for Making Play & Love
“Try some of the above to get your energy back, and then remember that your sexual relationship is about far more than intercourse. Take time to engage in some non-intercourse pleasuring, particularly during non-fertile times. Plan some playtime for those ‘off-times’ — decide and agree *not* to have intercourse to pleasure each other and show your love.”

The Ginger Jar Technique
“Two jars: one for you, one for your partner. In each, put 4 to 6 slips of paper with ideas jotted down — things your partner could do for you that let you know how much they care about you. These can be overtly sexual or non-sexual, because after all, our minds are what get the ball rolling. For example, surprising some women with flowers might lead to even sexier outcomes. Each of you takes an idea out — try it daily or every other day — but don’t tell your partner what you picked. Then follow through when the time is right and your partner is not expecting it. It’s like planned spontaneity that’s sure to target your lover’s erogenous zones.”

Try A Little Massage
“In one of our group sessions, I’ll bring out some hand cream, and just have the partners apply the cream to each other’s hands and give a little massage. It’s pretty incredible for demonstrating how simple yet thrilling even a mild form of physical intimacy can be.”

Even if they’re new to fertility treatment, most couples have some idea that their sex lives have taken on new meaning. Covington says sometimes it necessary to “commit to taking a few steps toward the outcome you want, and in most cases, couples will find that they can keep their relationship simmering (and maybe even hotter) through the whole journey together.”

To read additional articles about the emotional side of infertility, learn more about our mind/body skills groups or see dates for upcoming support groups, please visit our Psychological Support Services section of our website.

For more information or to schedule an appointment with one of our physicians, please speak with one of our friendly New Patient Liaisons by calling 888-761-1967.

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Most of us have arrived at a point in our lives where we feel confident that we can handle the challenges that life throws our way. At 38-years-old Michele Halvorsen, who works as a research neurobiologist for the University of Maryland, was moving forward with her hard-earned career in early 2007 when at her annual exam her gynecologist suggested she have a baseline mammogram. With no family history of breast cancer she decided to put off the exam for six months.

“There was no reason for the referral other than that I had ‘dense’ tissue in my breast,” Michele recalls. “There was no discernible lump, and I have no family history of breast cancer. So I waited until the appointment fit into my schedule.”
By that September, she’d been diagnosed with cancer. But getting hit with the news didn’t diminish the single, childless scientist’s poise.

“My brain wasn’t wrapped around the fact that I had cancer,” she explained. “The area the doctors initially found was small, that I told the surgeon that I planned to keep my breasts. I just wanted the cancer out so I could get back to work from this small interruption.”

But in November 2007, a lumpectomy showed more cancerous tissue than her oncology team had expected. Michele changed her mind and opted for a double-mastectomy and avoided both chemotherapy and radiation.

“Since their initial testing hadn’t provided dependable results, my ‘science brain’ told me that I’d better not take chances.” The mastectomy allowed her to forgo taking Tamoxifen, a form of chemotherapy that is commonly prescribed for breast cancer treatment. Among its side effects: inducing menopause, which may be temporary or permanent.

She also took a test to determine if she carried the mutated BRCA gene, a dominant gene that’s presence means a 50% chance of passing on to offspring, plus a 45% risk of developing ovarian cancer, and an 89% risk of breast cancer. Michele was given the results after her mastectomy. They were positive for mutation. Her oncologist’s recommendation to her was a prophylactic oophorectomy – removal of both ovaries.

“That’s when I thought, ‘But I want to have a baby’,” Michele says.

She hadn’t had any luck meeting the guy she expected would traditionally show up, and now she had to make a fast decision. A weekend conference sponsored by FORCE (Facing Our Risk of Cancer Empowered) gave Michele the information and tools she needed to proceed with a plan to both fight her disease and preserve her fertility.

Following her surgery and the reconstructive phase, Michele began to wonder what she should do about her ovaries and a baby. “It took some time to give thought to and get okay with having a baby on my own,” she recalls. By now, though, she was nearing 40 and knew that, again, decisiveness mattered.

Michele started looking at donor sperm options. A colleague who’d had two children with the help of Shady Grove Fertility highly recommended Michele consult with Dr. Gilbert Mottla and his team in theAnnapolis office. Since her insurance would provide no coverage for fertility treatment, finances were an issue for her.

Michele credits the Shady Grove Fertility financial staff for doing all of the legwork to connect her toFertile Hope, the non-profit that assists cancer patients with fertility-focused needs, including providing monetary funding for treatment. The decision was made to attempt Intrauterine Insemination with specifically prescribed injectible ovulation-enhancing medication.

Michele’s first IUI was canceled because her ovaries produced six viable eggs. She recalls the phone call with Dr. Mottla on the day before insemination was to occur, a day that typically includes an injection of hCG to trigger the follicles to release the eggs.

“He said I should cancel the cycle because it was too risky; if all six eggs were fertilized, I’d have a litter,” she explains. “But I countered that statistically because each had only a 12 percent chance of fertilization. I asked to have some time to think – Dr. Mottla said I had 1 hour, I called back in 10 minutes.” Michele laughs today when she tells the story about how she pretty soon pondered what life with more than one baby might be like, especially after her recent health ordeal. The cycle was canceled.

Her second cycle went according to plan, resulting in the release of one viable egg. Two weeks following the insemination, an anxious Michele was in Chicago during the winter holidays when she was given the go-ahead by Shady Grove Fertility nursing staff to take a home pregnancy test – but with cautionary advice to realize even the best home tests can render false results.

“I was SO pregnant,” Michele says now.

Her son was born in September 2009 after a pregnancy that included some long-lasting nausea but no other adverse events. She describes it as “an awesome experience, both as a mom and a scientist, to feel this baby go through waking and sleeping cycles inside of me.” In spite of the joy, Michele’s thoughts immediately turned to her ovaries.

“Ovarian cancer is very hard to detect, and I knew that I had this high risk for it looming over me,” she said. But she also found herself wondering why she waited so long in the first place to become a mother. “I remember thinking when he was still tiny, ‘I could have another one right now’. As he’s gotten older, though, I’m thinking ‘Okay, one is good…’” she laughs.

Just a week prior to this interview in September 2010, Michele underwent a voluntary prophylactic full hysterectomy. Her decision was once again based on her being there for her son.

“I’m a mom now, and I need to put him first, even above taking the chances at having another child.”

If it hadn’t been for her heightened health risk, Michele says she would gladly have returned to Shady Grove Fertility to try for a second child. “It’s funny, because I remember thinking ‘No one here is ever in a bad mood!’ They were always just fantastic to me, from the medical to the financial staff. They helped me during a very uncertain time. I hope my story and the success that I had with Shady Grove Fertility is encouraging for other women or couples who may have the same obstacle to overcome as I did.”

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Approximately one in every eight couples will struggle with infertility, yet for many, infertility is isolating – but it doesn’t have to be. Finding other women and men with similar experiences to provide support, encouragement, and celebrate milestones, can help the journey feel less lonely.

Recently, Shady Grove Fertility’s online patient community hit a milestone – 15,000 members! That is 15,000 women and men from all walks of life that have one thing in common – they have or know someone who has suffered from infertility. Established in 2009, our Facebook page has evolved into a patient driven community where couples across the world turn for advice, understanding, and help with their infertility.

Join the online patient community.

In celebration of this milestone, we would like to share what the patient community does best, encourage others. Here are their top 15 ‘If I Had Known Then What I Know Now’ tips.

  1. 24hoursI give myself 24 hours to feel sorry for myself after bad news, and then move on. I refuse to let this consume my life. And if I can’t have kids naturally, I will adopt, so no matter what, I will be a mother!
  2. Don’t put your life on hold, actually live. Do things you love with your partner and treat yourself well.
  3. Be honest with your partner and share your thoughts with him or her! Together you can accomplish amazing things.
  4. Don’t be ashamed…. remember you are strong.
  5. Don’t be afraid to ask questions, even if it seems stupid.
  6. Trust your gut and don’t listen to negative stories. You will make the right decisions for you and your spouse/partner.
  7. just startDon’t plan for the “best” time, just start.Try not to stress and give yourself some me time.
  8. Be patient and don’t put off any hopes or dreams you may have along the way.
  9. Be open minded
  10. You don’t need to keep this journey a secret! You’d be surprised how many people you know are on this path as well.
  11. Remember the moment you are ready to quit is usually the moment right before the miracle happens! I was ready to quit before our final cycle but thank goodness I didn’t cause now I’m 15 weeks pregnant.
  12. Never. Give. Up.
  13. Take breaks when you get overwhelmed – it’s better to make life altering decisions with a clear mind.break
  14. Find someone to talk to. It doesn’t necessarily have to be a therapist but someone who will just listen! For instance, I talked to my acupuncturist while she just sat and listened and I can’t tell you how refreshing it was to have someone just listen and not give me horrible advice like “just relax.” Not to mention that I didn’t feel judged when I talked to her. Oh and my second piece of advice is try acupuncture.

Do you have a tip to share to others? Share it here!

If you have questions about fertility or are ready to schedule an appointment at Shady Grove Fertility, please speak with one of our New Patient Liaisons at 877-971-7755.

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Jessica experienced infertility at 25.

The majority of 25 year olds are worrying about what to wear to the bar on the weekend, or what date kind of date night they should have, or even who they would want to hang out with. My story, on the other hand, was a little different – I was a newlywed with severe baby fever.

My friends just thought I was obsessed with getting pregnant and if I relaxed, had a glass of wine, I would get pregnant. What they didn’t understand was that I was struggling with infertility at 25. My husband knew much more about my menstrual cycle than any man should know. TTC, OPKs, CM, BBT, HPTs, and BFN were all in my vocabulary and used on a daily basis. If you are new to the realm of conception let me translate:

  • TTC = trying to conceive
  • OPK = ovulation predictor kit
  • CM = cervical mucus
  • BBT = basil body temperature
  • HPT = home pregnancy test
  • BFN = big fat negative

I became so focused on getting pregnant that I changed my diet, had weekly acupuncture appointments, practiced yoga for fertility, and when my fertility app said that I’m fertile, I believed it. I didn’t understand why my period would be two to three weeks late and why my ovulation predictor kits would never smile at me. I talked to my OB/GYN and she suspected PCOS (Polycystic Ovarian Syndrome). After I left my OB/GYN, I made the decision to come to Shady Grove Fertility to get checked out.

After meeting with Dr. Michael Levy and getting my protocol to do an IUI, I finally felt like I had answers. When I started pre-screening and was in the waiting room, I noticed one thing: I was one of the youngest amongst the crowd. I felt judged. The patients and their spouses would watch me sign in then pick a chair to sit in. They would look up from their magazines or books and just peek at me from above their glasses. I felt like there were tons of eyes just staring at me and wondering what I’m doing in the waiting room if I’m so young. I wanted to stand up and scream “Infertility Does Not Discriminate!” We went through three Clomid timed-intercourse cycles with the OB/GYN, and three FSH injectable IUI cycles before I finally got pregnant and delivered a healthy baby boy.

Once I started working at Shady Grove Fertility, I quickly figured out that I was not the youngest patient. I have seen patients as young as 18 who have struggled with infertility. I can honestly say, after going through infertility at 25, it has opened my mind about other peoples’ struggles. Every person has their own story and their own journey that they’re going through. All we can do is be supportive and lend an ear.

If you are having trouble trying to conceive, it may be time schedule an appointment at Shady Grove Fertility, please speak with one of our New Patient Liaisons at 877-971-7755.

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Are you having trouble keeping the romance alive while undergoing fertility treatment? You probably wouldn’t be surprised to learn it’s a common topic patients talk about with Sharon Covington, MSW, 

LCSW-C, Director of Psychological Support Services at Shady Grove Fertility. “I hear the same question from many of the couples I work with –“how can I keep the romance alive while undergoing treatment?”.

The first step is crucial to a couple’s relationship: talk openly with your partner; the second step is to find ways  that work for you to re-ignite the spark and keep it from going out. To help kick off your Valentine’s Day Sharon Covington shares some of the tips she gives to couples to not only celebrate the day devoted to love but to also spread it all throughout the year, making everyday feel like Valentine’s Day.

What Is Intimacy Anyways?

While many people associate the word intimacy with intercourse, it’s really not all about physical technique. Before you can start to be more intimate, it’s important to understand what intimacy is and how it is different than just sex, especially since men and women can think very differently about these interactions.

When working with patients either one-on-one or in a support group setting one of the things frequently covered are the different behaviors associated with intimacy. There are a range of behaviors that make up what we refer to as ‘sex’. It’s not entirely new to most of us, but when you’re trying to get pregnant, it’s easy to forget that sex isn’t just intercourse. These behaviors, also called the “Nine Areas of Sexual Relationships”, are outlined in the book Hot Monogamy: Essential Steps to More Passionate, Intimate Lovemaking by Patricia Love, MD and Jo Robinson (1995)

Nine Areas of Sexual Relationships

Communication about Sex: the ease with which you talk about your sexual relationship.
Sexual Desire: how much physical desire you experience on a regular basis.
Intimacy: your ability to share your thoughts and feelings with your partner on an ongoing basis.
Technique: your skill at arousing yourself and your partner.
Sexual Variety: your willingness to add creativity and novelty to your lovemaking.
Romance: your desire to show love for your partner in concrete ways.
Body Image: your inner image of your outer self.
Sensuality: your willingness to relax and involve all your senses in your lovemaking.
Passion: your ability to combine intense feelings of arousal with love for your partner.

Creative Ways to Be Intimate

Using a combination of the nine areas of sexual relationships, try some of the ways Sharon Covington suggests to keep the romance alive throughout the year.

Make Plans
“We often think sex has to be spontaneous, but the reality is different. Since sex starts with our minds, waiting for spontaneity to erupt probably won’t work like we hope. Put time and energy into planning and then doing some fun things, sexually.”

Get outside of Your Box
“Most couples, even in the best relationships, can get into habitual ruts. Sparking things up may require changing it up for playtime. Consider different types of attire and surprise your spouse, or maybe try a candlelight dinner with mood-enhancing scents. Try to think outside of your comfort zone with the intention of just giving something a try.”

Reminisce and Recreate Your Early Sexual Relationship
“We forget about the things that really excited us and aroused us early on in the relationship. Take some time to remember and even reenact some of your first exciting sexual interactions. Even just talking about it can help heat each other up.”

Become an Explorer
“Look around the house and find other locations to be intimate. When love-making becomes baby-making, try designating one room of your house for one and another room for the other. Consider trying someplace else to have exciting interludes.”

Don’t Forget about the Other Three Weeks in the Month
“Try some of the above to get your energy back, and then remember that your sexual relationship is about far more than intercourse. Take time to engage in some non-intercourse pleasuring, particularly during non-fertile times. Plan some playtime for those ‘off-times’ — decide and agree *not* to have intercourse to pleasure each other and show your love.”

The Ginger Jar Technique
“Two jars: one for you, one for your partner. In each, put four to six slips of paper with ideas jotted down — things your partner could do for you that let you know how much they care about you. These can be overtly sexual or non-sexual, because after all, our minds are what get the ball rolling. For example, surprising some women with flowers might lead to even sexier outcomes. Each of you takes an idea out — try it daily or every other day — but don’t tell your partner what you picked. Then follow through when the time is right and your partner is not expecting it. It’s like planned spontaneity that’s sure to target your lover’s erogenous zones.”

Try a Little Massage
“In one of our group sessions, I’ll bring out some hand cream, and just have the partners apply the cream to each other’s hands and give a little massage. It’s pretty incredible for demonstrating how simple yet thrilling even a mild form of physical intimacy can be.”

Even if they’re new to fertility treatment, most couples have some idea that their sex lives have taken on new meaning. Covington says sometimes it’s necessary to “commit to taking a few steps toward the outcome you want, and in most cases, couples will find that they can keep their relationship simmering (and maybe even hotter) through the whole journey together.”

To learn more about fertility testing or to schedule an appointment at Shady Grove Fertility, please speak with one of our New Patient Liaisons at 877-971-7755.

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SGF Nurse


Keeping the romance alive while trying to conceive and infertility treatments can be a challenge within itself. But today is Valentine’s Day! Take today and celebrate the love that has brought you down this path. Celebrate the person that is on the journey with you. If that means no infertility treatment talk today – that is okay. If that means trying to find the passion that was around before regulating intercourse to your most optimal days for conception – do it. Or if Valentine’s Day happens to be the day of your egg retrieval or embryo transfer – know that you child was made with that much more love! Cristen from our Facebook community found that to be the truth and now celebrates today with her young son.

However you choose to make today special, we have found some resources that might help.

From Shady Grove Fertility:

  • Keeping the Romance Alive While Trying to Conceive: “Sharon Covington, MSW, LCSW-C, Director of Psychological Support Services, hears the same question often from patients who are undergoing fertility treatment –’how can I keep the romance alive while undergoing treatment?’ She explains that talking openly with your partner on this subject can be crucial to a couple’s relationship.”
  • Sex and Infertility Treatment: “Listen to your body,” Dr. Melissa Esposito explains. “There is nothing unsafe about having sexual intercourse while cycling, but many women who are using injectable medication for IUI or IVF may experience enlarged ovaries, which might make intercourse uncomfortable. While they’re in that pre-egg retrieval period of a treatment cycle, normal relations are perfectly fine if it’s not pain-inducing.”
  • Enhancing Your Relationship During Infertility: “Most couples enter the path towards parenthood expecting that it will occur without too much problem. After all, they spend most of their lives trying not to get pregnant and assume that when they consciously start trying, pregnancy will soon be achieved. As the months or even years go by without a baby, and efforts to achieve pregnancy are increased—from intrusive testing to high technology treatments—the path turns into the emotional rollercoaster of infertility.”
  • sex position doesn't impact chances of pregnancyTalking to Your Spouse: “Going through infertility may be the first major life crisis that a couple faces together, and it may be the time when you need each other most. Yet sometimes couples withdraw from each other at a time when they most need support because of problems communicating.”
  • Fertility Facts: Sex Position Doesn’t Matter:  “While the goal is to have the sperm as close to the cervix as possible, in general, the sexual position you choose will not have any bearing chances of conception. There are no studies to support that any one position increase the likelihood of pregnancy.”

From RESOLVE:

  • Becoming a Couple Again: “The struggle with infertility presents numerous challenges to couples. Regardless of how you resolve your infertility, it affects your relationship. Your infertility experiences may strengthen your bond as a couple or that bond may weaken or become fragile. Infertility changes us. We make many sacrifices in our parenting quest: personal, physical, emotional, professional and relationship sacrifices.”
  • Low Sexual Desire and Infertility: “Women’s sexuality is a complex issue, made no simpler with the addition of infertility!  In order to understand your own low sexual desire and develop a plan for managing it, let’s take a look at some information from the academic world of sex therapy.”

From Attain Fertility:

  • Sex and Relationships: “After spending so many months and years trying to conceive without success, sex has lost its spontaneity. It often feels like a chore, and it is often on a schedule. How can we make it more fun and pleasurable? Is it possible to keep the passion and intimacy alive when trying to get pregnant?”
  • Sex, Romance and Infertility: “Here at Attain Fertility, we understand the challenges that infertility can bring to your relationship. Know that we don’t just want to help you get pregnant – we want to help you get pregnant while maintaining a loving and fulfilling relationship with your partner.”

If you ready to schedule an appointment Shady Grove Fertility, please speak with one of our New Patient Liaisons at 877-971-7755.

2026 Shady Grove Fertility

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