Premature ejaculation

Premature ejaculation, the hidden cause of male infertility!

It was already 10PM in the night and it was nearly two hours I was waiting for the semen report of a couple undergoing treatment for infertility. I was suspecting male infertility in this case and therefore, told the male partner to undergo semen testing. I was almost sure about a report of less sperm count or mobility issues with the sperms. Finally, the report came and to my surprise, it was absolutely normal. I was in a state of utter confusion and dismay.

However, I called up the couple once again and had detailed counseling sessions and then revealed something that is perhaps the most hidden aspect of an infertility problem. It is premature ejaculation, one of the common causes of male infertility. The male partner in the above-mentioned couple was suffering from the problem of premature ejaculation. I analyzed the root cause and started the appropriate treatment. Very soon the couple departed from my room with a positive report of pregnancy!

What is premature ejaculation?

The process of ejaculation happens after a certain time of vaginal penetration or manual stimulation. It causes the release of sperms along with semen fluid in the form of a powerful jet spray so that the sperms go deeper in the vagina and start the journey of fertilization. Normally it takes one to two minutes for a man to ejaculate.

Pelvic pain

Pelvic pain, the loyal companion of infertility

We can never generalize the symptoms of various problems that females face because every problem has a separate set of symptoms. It is not possible for an infertility expert like me to diagnose only on the basis of a few symptoms. It is compulsory to go for detailed examination to derive a conclusion. Infertility is a complex area and we need to look at every aspect of it before starting the treatment. People come with so many different problems, but one thing is always common among all, the pelvic pain!

Only those women who have experienced the immense sting and discomfort of the pelvic pain can tell about the severity. It is an unbearable pinch in the lower abdomen that just ruins the life completely if it remains untreated.

The faces of the monster

Pelvic pain shows its irritating presence in a wide variety of ways and the severity and intensity varies with the particular problem.

Chocolate Cysts

Chocolate Cysts, treating the bitter problem at IFC

I do not know what is the rationale behind naming endometriosis as “chocolate cyst”? Perhaps it is because of the dark brown color of the old blood that appears exactly like chocolate during the ultrasound test.  It is quite disgusting that the word like chocolate that produces absolutely happy feeling to the females is used to describe the most annoying and problematic disease that becomes the major cause for female infertility.

The diagnosis

I recognize the presence of nasty cysts during the ultrasound examination, but they can be quite confusing and decisive. There is a detailed investigation if I suspect the minutest possibility of chocolate cyst in the ovaries.

Anejaculation

Anejaculation, the ejaculation disability!

In my opinion male infertility has more complex and strange dimensions as compared to female infertility. Strangely, the male sexual anatomy is much simpler and easy to understand. There is no complex structure, no critical balance (or imbalance) of sexual hormones and no menstrual cycle. Still, the infertility aspect is certainly very complicated.

Couples visit infertility experts when they feel they are unable to conceive. We treat them according to the symptoms and suggest the best methods after analyzing the case completely. Sometimes, there is no option other than going for ART (Assisted Reproductive Techniques) where we collect the sperm from the male partner and the egg from the female partner. Fertilization process may happen in the laboratory or in the uterus itself, and there is successful conception!

Sounds great, isn’t it? But, the situation is not that simple and straightforward always! There are a few cases of infertility where the male partner is suffered from such a problem that he can’t ejaculate at all! You can imagine that in absence of ejaculation, he will not be able to contribute by giving sperms for fertilization process. Te problem is known as Anejaculation, typically called as the inability to ejaculate.

5 facts about Anejaculation!

It is fairly uncommon problem and infertility experts hardly encounter with it. Also, it is not very easy and straightforward to diagnose.
This problem is sometimes misunderstood with erectile dysfunction. Although in this case the male is able to arouse, get an orgasm. The only thing is he can’t discharge semen.  In case of erectile dysfunction, there will not be sexual arousal at all.
The problem needs to be explained by the patient explicitly, otherwise the doctors will not be able to diagnose it.
The symptoms of Anejaculation and Retrograde Ejaculation are similar, but in the later case semen does get discharged and goes backward to the urinary bladder. In case of Anejaculation it does not come out at all.
It is extremely impossible to collect the semen sample for diagnosis or sperm donation and we need to collect it directly from the testicles.
The treatment

Well, there is no treatment for this problem and we treat the patient on the basis of symptoms. There are a few patients with situational Anejaculation where they are unable to ejaculate because of surrounding environment. Providing them supporting condition may lead to successful ejaculation. For a few patients we use vibrator or electrical stimulator to achieve ejaculation.

There are some cases where no ejaculation happens at all even after prescribing strong stimulating pills. We collect the semen sample directly from the testicles or the epididymis and use for the fertilization process.