Fertility problems are not the best dinner conversations because they involve intimate issues behind closed doors. That is exactly why you can feel free to speak to your fertility specialist about what is really troubling you as a couple, because he/she would be able to talk to you frankly about making babies, with or without sex.
But to get the correct answers, it helps to ask the right questions. Here are answers to some of the most embarrassing questions every couple wants to know – but may be too shy to ask!
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1. Is position xyz more effective in getting pregnant?
Unfortunately not. There is no scientific evidence that any particular sexual position can improve pregnancy. There is, however, a link between frequency of intercourse and chances of pregnancy. Higher frequency relates to a higher probability of pregnancy.
2. My husband always gets erections, so how can he be sterile? Can I get pregnant if I do not achieve orgasm?
Having an erection does not indicate that the semen ejaculated contains viable and healthy sperm that is necessary for conception. Chances of pregnancy increase when the sperm count is high and sperm motility (energy levels) is good. With good sperm, a woman will still get pregnant without an orgasm, as they will travel up the uterus for fertilisation to happen.
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3. I had a sexually-transmitted disease in my younger days before marriage. Can it cause infertility?
Yes, certain STIs such as chlamydia and gonorrhea result in Pelvic Inflammatory Disease (PID), which causes pelvic, ovarian, and or/fallopian tube damage if left untreated. Untreated Chlamydia may also cause permanent male sterility by spreading to the testicles.
Human Papillomavirus (HPV), a sexually-transmitted disease that is the main cause of cervical cancer, does not affect fertility directly, but its ensuing treatment has a lasting impact on your reproductive health.
The problem with STIs is that they often have no symptoms and can lie undetected for many years. As such, safe sex is important not only to avoid STIs but also to protect your fertility.
4. For IVF treatment, can my partner collect sperm specimen with oral sex?
It is not advisable as the sperm collected may get contaminated with the bacteria and enzymes from saliva that will impact sperm quality.
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5. What can be done if my partner has trouble collecting his sperm specimen?
The collection room is equipped with magazines and a television screen with the appropriate content to assist him get ‘warmed up’. However, there have been cases where the sperm cannot be collected on the day of the embryo transfer because the partner is under too much pressure. If there are concerns that this may happen, it would be advisable to seek your doctor’s advice in advance. In rare cases, eggs collected will be frozen if no sperm obtained from male partner.
6. Is it normal to get heavy vaginal discharge during IVF treatment?
Vaginal discharge may be heavier than usual due to the hormones that are being taken as part of IVF treatment. However, seek your doctor’s advice if the discharge smells bad or you experience discomfort or itching, as that could indicate an infection.
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7. If I had an abortion before, must I inform the doctor? I don’t want my partner to know.
This is a critical piece of information to be shared with your doctor, as a previously successful pregnancy is a factor the doctor needs to know to plan your treatment protocol. Speak to the doctor privately, and indicate that the information should be kept confidential.
8. Can we have sex during the course of IVF treatment?
Research on this has been inconclusive. Some studies state that semen helps increase pregnancy rates by improving embryo implantation. Other studies caution against vaginal intercourse for at least two weeks after embryo transfer to avoid potential infections or complications from orgasms. From experience, we know that most couples would prefer to abstain to be on the safer side, considering how much time, emotion and finances have been invested into an IVF treatment.
Dr. Agilan Arjunan
Obstetrician & Gynaecologist (infertility)