The finding of an abnormal semen analysis in the evaluation of an infertile couple can be disheartening to the male, but sometimes for some men the news is devastating. Feelings of inadequacy and failure can creep in and affect, not only the male himself, but the couples’ relationship.
Add to this that erectile dysfunction can appear during the evaluation and even before. This problem can be situational, affecting the male particularly when his partner is ovulating, but then disappear just when it’s “less important”.
ED in this setting is often a manifestation of performance anxiety. It is no different than failing in other stressful situations where one would normally be successful. Often times, partners are not aware of the pressure the role they play and the pressure they apply. Phrases like “it’s time…” or “I’m ovulating…” can make the difference between success or failure.
Treatment involves facilitating the male being able to overcome his anxieties. Short term treatment with medications used commonly in ED such as viagra (sildenafil) , Cialis (tadalafil) and others may be helpful.
Separate from this, though is the angst over the diagnosis itself and its affect on the male’s state of mind. In my personal experience, it is not uncommon for men to be embarrassed, anxious or depressed when they come in for a fertility evaluation. Depression and or sadness is usually, by my observation, triggered by a feeling of “failing” their partner. One of the paradigms that is important to keep in mind is that the goal of therapy is to start one’s family. There may be several different options or pathways for doing that.
