Fertility Specialist Dr. Bastuba explains male fertility and treatment options for men who are struggling with infertility.
Dr. Martin D. Bastuba:
There is a large overlap between sexual function and fertility. The first thing I’d like to do is clear up the distinction between those two topics. Sexual function, at least for this discussion, on the male side, would involve three things. One is the ability to obtain a hard penis known as an erection; the next would be the ability to have ejaculation, which would be fluid coming out of the tip of the penis; and the third thing is orgasm function what I describe as that warm, fuzzy feeling that males experience typically at the time of ejaculation when the fluid is squirting out of the tip of the penis.
So that is sexual function for the male. Fertility would be the ability to have a baby or to initiate a pregnancy in a female. So two quite different things, but typically we need a hard penis that’s able to penetrate and release the sperm inside the female body to be able to achieve fertility, and so they are very closely related.
In many males, when they learn that their sperm counts are decreased or having difficulty initiating a pregnancy, getting their family started, it’s deeply upsetting to them and it’s one of the things that drew me to this particular field. It’s a very powerful factor in terms of quality of life for a couple to be able to have children together, to be able to have that very intimate part of their relationship.
And when fertility is threatened, oftentimes a male will have difficulty with sexual function, just when their partner needs them the most, especially if they have to perform on a stopwatch, that they know that they have to perform at a given period of time. And so it’s important for the couple to be aware of that issue, for both people to be aware and sensitive to that issue, and to try to approach that in a reasonable fashion.
For instance, a lot of couples don’t realize that sperm stays alive inside the female body 36 hours, sometimes up to 72 hours. What I tell couples is that when the female is ovulating, for that part of the month to have sex either everyday or every other day is adequate. If the male is too tired to function, if he is just not able to for whatever reason, it’s okay.
It doesn’t mean he doesn’t love the female. It could be that he is just tired, but that it’s all right. You can pick up things on the next day and that will help decrease some of the pressure on the guy that he has to perform on a stopwatch, as many guys describe it to me. So that’s an important thing I think for couples to understand.
For many couples, the use of an oral agent such as Viagra, Cialis, Levitra – any of these available agents, can be very helpful. All of a sudden the man knows, even if he has some negative feelings at the time about being able to perform that he is going to be able to, and a lot of times that will put some zing back in the relationship so that he knows, no matter whether he is tired or whatever, he is going to be able to perform and so that’s a typical thing that as a urologist we might offer for the male. I
In fact I would say in the majority of males I don’t even ask if it’s an issue. I ask if you’d like some samples of one of these agents and the great majority of patients say “absolutely” and it may get a chuckle out of the couple, but I can just see the stress decreasing for the couple, and I think that’s a good thing if we can decrease stress.
About Dr. Martin D. Bastuba:
As San Diego's leading subspecialist in male fertility and male and female sexual dysfunction issues, Dr. Martin Bastuba gives hope to couples who have been unable to conceive, and to men and women who are experiencing the anxieties and frustration of sexual dysfunction. He offers complete diagnosis, treatment, prevention techniques and education for his patients.
Visit Dr. Bastuba at his Web site