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The following is a summary of “Female sexual function and distress and time-to-pregnancy in a prospective preconception cohort,” published in the April 2025 issue of American Journal of Obstetrics & Gynecology by Bond et al. 

Fertility success in mixed-sex couples depended on sexual intercourse frequency and timing, yet the link between preconception sexual function and time-to-pregnancy remained understudied.  

Researchers conducted a retrospective study to analyze the impact of female sexual dysfunction, distress related to sexual functioning, and painful intercourse on time-to-pregnancy.  

They tracked 2,500 participants from Pregnancy Study Online with self-identified females attempting pregnancy without fertility treatments. Enrolment occurred between 2021 and 2024. Within 30 days, participants completed a supplemental questionnaire assessing sexual health, including a modified 6-item Female Sexual Function Index (score range 2–30, sexual dysfunction: ≤19) and the Female Sexual Distress Scale (score range 0–48, distress: ≥20), reflecting experiences over the past 4 weeks. The questionnaire was completed within 6 months of conception attempts. Time-to-pregnancy was estimated using self-reported pregnancy status from follow-up questionnaires completed every 8 weeks for up to 12 months. Proportional probabilities regression calculated fecundability ratios and 95% CIs for associations between sexual function and time-to-pregnancy, adjusting for prespecified confounders. An exploratory analysis examined individual sexual function domains (interest, arousal, orgasm, lubrication, satisfaction) in relation to time-to-pregnancy.  

The results showed that population was primarily non-Hispanic White, high-income, and had a college or graduate education. Female sexual dysfunction was present in 20.1%, distress in 8.8%, and pain with intercourse in 29.6%. No association was found between female sexual dysfunction and time-to-pregnancy when using a clinically validated cut point (adjusted fecundability ratio 1.00, 95% CI [0.89, 1.13]). However, those in the first, second, and third quartiles of function scores had delayed conception compared to the highest quartile (adjusted fecundability ratios: 0.90, 95% CI [0.76, 1.06]; 0.88, 95% CI [0.75, 1.04]; and 0.90, 95% CI [0.77, 1.04]). Sexual distress was linked to an 18% reduction in fecundability (adjusted fecundability ratio 0.82, 95% confidence interval [0.69, 0.98]). Participants experiencing painful intercourse had a longer time-to-pregnancy than those without pain (adjusted fecundability ratio 0.81, 95% confidence interval [0.62, 1.06]). Exploratory analysis indicated lower orgasm and lubrication function, but not interest, desire, or arousal, was associated with prolonged time-to-pregnancy.  

Investigators concluded that preconception sexual dysfunction, particularly distress and frequent painful intercourse, was linked to delayed conception. 

Source: ajog.org/article/S0002-9378(24)01048-2/abstract