Many couples who may have earlier developed a satisfactory sexual relationship may find that their sexual pleasure and performance can be impaired by the stresses of attempting conception and the pressures of the infertility evaluation. These pressures are often accentuated by well meaning physicians who erroneously instruct their patients as to sexual position, timing and frequency.
Mid cycle male impotency (since ovulation is understood by many couples to be the most fertile time of the cycle, this problem may present as a mid cycle pattern of sexual dysfunction. In these circumstances, the couple ceases to “make love” and instead attempts to “make a baby”). Inability to perform coitus for a post-coital test, or inability to submit a semen sample is frequently noted. Under these conditions, it is not surprising that a husband might have doubts that will he be able to perform adequately once he has experienced his first episode of sexual dysfunction. These pressures are further amplified by either the inability of the couple to admit to the dysfunction, a form of denial or by the feelings of shame, guilt and inadequacy that may evolve.
In males : Erectile Dysfunction
In females : Dysperunia, Frigidity
Effluvium semenis
The difficulties due to the above problems are generally treated with counseling primarily along with medication as and when necessary.
Counselling
Counselling is done by both the doctors and counsellors.
Fertility has three major aspects
The physical , sexual and functional. In physical aspect, we evaluate the egg, tube, hormones (Thyroid, prolactin, progesterone etc) and sperm by tests. Problems in these areas can be identified and progress can be assessed. These factors are evaluated individually and treated with medicines and procedures.
Sexual problems are addressed
In functional aspect, all these factors work together and conception (Fertilization, Implantation & Maintainance of pregnancy) occurs. Immune and hormone factors are responsible for this Fertility issue is like iceberg. Physical factors are the tip. Sexual and functional aspects are submerged part of iceberg. There are no tests to detect these functions in normal course. (Except in IVF). When it functions conception occurs.or else she gets periods. Conception depends on egg & sperm quality (immune function) and emotional state of mother (Hormone function).
