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Very often a perfectly fertile man may not be able to ejaculate. Since he can't make love he can't make babies. Some men can't have an erection (impotence) and some cannot achieve an erection sufficient for intravaginal penetration or ejaculation in the vagina.
An older theory held that 80% of impotency problems (which are very common) were rooted in psychological inhibition and fears which could respond to sex therapy and counselling. However, modern research has lowered this figure and estimates that 50% are due to physical causes ranging from inadequate blood flow to the penis, diabetes, neurologic defects, and hormonal problems.
How does the doctor suspect a physical problem? By asking a simple question --- Do you have wet dreams? If men have nocturnal ejaculations (wet dreams) this would suggest that the physical apparatus is sound, and that the problem is psychological.
Testing includes nocturnal penile tumescence (NPT) testing, which monitors for normal night-time erections; and measuring blood flow through the arteries of the penis (using Doppler methods).
Treatment that may be prescribed includes:
The sperms can also be collected by masturbation and used for artificial insemination. This has a very high success rate, because there is really no fertility problem as such for these patients.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
