ORIGINAL RESEARCH—EPIDEMIOLOGY & RISK FACTORS Sexual Function and Fertility Quality of Life in Women Using In Vitro Fertilization Nicole K. Smith, PhD, MPH,* Jody Madeira, JD, PhD, † and Heather R. Millard, MPH ‡ *Office of Population Research, Princeton University, Princeton, NJ, USA; † Maurer School of Law, Indiana University, Bloomington, IN, USA; ‡ School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA DOI: 10.1111/jsm.12824 ABSTRACT Introduction. Women undergoing fertility treatment are likely to report negative changes in sexual function. With the rapid increase in the number of women pursuing in vitro fertilization (IVF), there is a need to better understand how IVF impacts a woman’s sexual experiences and quality of life. Aims. This study has three purposes: (i) test the psychometric properties of the Sexual Functioning Questionnaire (SFQ) in a sample of U.S. women undergoing IVF; (ii) compare sexual function of women undergoing IVF with a nonclinical sample of U.S. women; and (iii) identify the aspects of sexual function most related to fertility quality of life (FertiQoL). Method. A total of 136 women who had recently undergone or who were currently undergoing IVF completed a web-based, cross-sectional survey about sexual experiences and quality of life. Main Outcome Measures. Data were collected on infertility diagnosis, length of infertility, number of IVF cycles, pregnancy, and birth outcomes. Six domains of sexual function as well as the medical impact of IVF were assessed using the SFQ. A validated instrument was used to measure FertiQoL. Results. Reliability analyses for the SFQ indicate sufficiently strong fit (Cronbach’s alpha = 0.79 to 0.89). Compared with a nonclinical sample, women undergoing IVF scored significantly lower in sexual interest, desire, orgasm, satisfaction, sexual activity, and overall sexual function (P < 0.05). A stepwise linear regression indicated that sexual problems predicted FertiQoL scores (Beta = 4.61, P < 0.01). The most common sexual problems included lack of sexual interest or desire (30%), difficulty with orgasm (15%), vaginal dryness (14%), and vaginal tightness (13%). Conclusions. Women undergoing IVF may be at particular risk for sexual problems. Sexual function issues may markedly impact overall quality of life during fertility treatment and should be addressed as an important component of comprehensive care. Smith NK, Madeira J, and Millard HR. Sexual function and fertility quality of life in women using in vitro fertilization. J Sex Med 2015;12:985–993. Key Words. In Vitro Fertilization; Sexual Function; Sexual Problems; Fertility Quality of Life Introduction A pproximately 11% of American women of reproductive age will experience an inability to conceive or difficulties in carrying a pregnancy to term [1]. For those with adequate insurance cover- age and monetary and social resources, an infertility diagnosis may result in a couple pursuing the use of assisted reproductive technologies (ARTs) such as in vitro fertilization (IVF) to achieve parenthood. Funding: This project was partially funded by Indiana University’s Office of the Vice President for Research and the Office of the Vice Provost for Research through the Faculty Research Support Program (VPR: http:// www.iu.edu/~vpr/ OVPR: http://research.iub.edu/; http:// ovpr.indiana.edu/). Additional funding was provided by The Kinsey Institute for Research in Sex, Gender, and Reproduction; and the School of Public Health- Bloomington at Indiana University. 985 © 2015 International Society for Sexual Medicine J Sex Med 2015;12:985–993