INFERTILITY ASSOSIATED WITH SEXUAL PROBLEMS
Sexuality & Sexual Problems :
Sexuality serves core reproductive function of creating off spring, & also corebio/psycho/social funtion of bonding couple.Impairment & difficulty in either of these core funtions can cause infertility.
At the most biological level sex exists as a means of reproduction and it binds couple together. The presence or absence of sexual intimacy among couple is a powerful indicator of the health of relationship. However, sexuality is ‘fragile’ and sexual problems end up having negative impact on partner’s psychological status or some time physical status. For a small percentage of infertile couple, sexual problems are the cause of infertility. These problems can be physical or psychological. For e.g., in frequent intercourse, vaginismus, dyspareunia, lack of libido, erectile dysfunction etc. Sexual problems causing infertility needs a medical attention and first line of treatment is Counseling. Through Counseling, couples are encouraged to express their feelings, thoughts about sexuality and to share their difficulties. After the Counseling couples must be aware of their reproductive health and sexual problems.
Treatment for sexual problems associated with infertility.
|Men Problem||General Problem||Women Problem|
|a) Loss of libidoErectile problems|
– Inability to have an erection
– Partial or weak erection
|Drugs & alcohol||Vaginismus|
|Inability to sustain an erection|
Long enough to penetrate
|Retarded ejaculation||Urinary tract Infection|
Retrograde ejaculation or ‘Dry’ orgasm:
In this, at orgasm, the ejaculate is expelled back into the bladder rather than from penis and this can be checked by examining past ejaculatory urine sample for the presence of sperm. Under fertility treatment, sperm can be collected from urine through centrifugation and can be used either for IUI or for IVF.
Erectile problems or Impotence:
Impotence, from the point of view of fertility, defined as the inability to have a satisfactory erection and discharge or ejaculate into the vagina at the desired time during the wife’s ovulation days.
Psychogenic impotence is due to environment, depression, fear, guilt or a thought of inability to perform. Sex therapist and counselors can solve the problem.
If couple is undergoing fertility treatment either IUI or IVF, use of vibrator will help men to produce semen sample with ease. Vibrator works by providing a high intensity stimulus to the penis and triggers the orgasmic reflex.
Some times Viagra helps to get over the difficulty of erection. Once the erection occurs, with masturbation men can collect the semen sample and it can be used for fertility treatment either for IUI or for IVF.
Back up frozen semen sample:
If men cannot produce semen sample on demand when his wife is undergoing fertility treatment, he can either asked the fertility clinic to freeze his semen sample, which can be used at the time of IUI or IVF, if he cannot produce fresh semen sample on that time.
In this condition intercourse is painful, because vaginisms is an involuntary spasm of the voluntary muscles surrounding the vagina that closes the vagina. Most of the time this problem is psychological and couple has to decide about their priority, that sex is to have the baby. Or couple can seek help from sex therapist or counselors. Women can use the vaginal lubricant and can take help of books, websites, films or video etc. women can use sex toys and learn the masturbation to overcome the problem.
Once women is overcome this sexual problem and couple’s other fertility tests are normal like patent fallopian tubes, healthy uterus, regular menstrual cycle and a normal semen analysis. Couple can follow the method of TOC [Timing of Coitus]. That is intercourse on and around ovulation days. Generally ovulation occurs 14 days before the next cycle is considered as “fertile period”. It can be either checked with cervical mucus or with use of ovulation prediction kit or through ultrasound scan to check follicles.
Ovulation days can be counted by the length of menstrual cycle. You can take help of our ovulation calendar to check your ovulation days.
Dyspareunia [painful sex]:
- Medication [if there is any infection]
- Use of lubricants
- Psychological counseling
- Insertion of graduated set of dilators into vagina to treat vaginismus