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FAQ

Q. I sometimes have difficulty attaining or sustaining an erection, does this mean I am infertile?
A. The answer to this somewhat common question is "not necessarily". Guys, it’s quite natural to not always be able to "perform" flawlessly. For many men, especially as you get older, your ability to attain and sustain erections declines. Also, a need for increased periods of time between sessions is also common as men age. However, for conception to occur, it is necessary for the male partner to sustain vaginal intercourse to the point of ejaculation. If ejaculation during intercourse is not possible, it is unlikely that conception will result. The important thing to remember is that a decline in your ability to perform like you did in your early 20's does not indicate or correlate to your fertility. Likewise, your ability to attain and sustain erections does not reflect your fertility. Many men with fertility problems experience no outward signs that they have a problem and enjoy a very active sex life.

Q. What are the differences between male infertility, impotence, erectile dysfunction, and premature ejaculation?
A. Infertility is defined as the inability to establish a pregnancy after trying to conceive for 1 year. Impotence or erectile dysfunction is the inability of a man to achieve or maintain an erection. Premature ejaculation is more difficult to define but is generally described as recurrent ejaculation with minimal stimulation before the person wishes. These conditions may be related in some patients or may occur independent of each other. Men experiencing fertility problems may be potent and men with erectile dysfunction may be fertile.

Q. Is it possible to reverse a vasectomy?
A. Vasectomy reversal is not only possible but is highly successful when performed by an experienced infertility microsurgeon. Unfortunately other doctors without these special skills will perform the surgery themselves rather then referring the patient to an infertility specialist. Once again it is incumbent upon the patient to make sure that his doctor performs the procedure regularly and successfully. A good idea is to ask to speak with some of his patients that have already undergone the procedure. Studies have shown that the outcome of surgery is so dependent on the surgical technique and the surgeon that performs it that it is well worth making the extra effort in going to a specialized center. Although failed vasectomy reversals can be repaired, the first attempt at reversal is the easiest and best opportunity for success.

Q. Does using a hot tub affect my fertility?
A. Excess heat applied to the testicles of animals does indeed cause a decrease in sperm production. A study in California showed that men who used hot tubs experienced q drop in sperm production. However, when the heat is avoided for several months, sperm production should return to normal. The production of sperm is a process requiring approximately three months. Consequently, when any condition or factor injurious to production of sperm is removed, a change in sperm quantity or quality should not be expected for a minimum of three months.

Q. Does it matter what kind of underwear I wear?
A. The old wives' tale that tight underwear causes decreased fertility has, perhaps, some basis in the truth. The truth is that excess heat applied to the testicles can decrease sperm production. This has been shown in men using hot tubs. However, the type of increased heat produced by tight clothing and/or underclothing has not been shown to elevate scrotal temperature. Hence, tight underwear has not been shown scientifically to cause any increase in testicular heat and is not thought to have any effect on sperm production. Nevertheless, if you would like to try a change in clothing to see what happens, there is really no reason not to try it.

Q. Does masturbation affect fertility?
A. Masturbation is not different from normal intercourse in that an orgasm causes ejaculation whether it is the result of masturbation or sexual relations. When fertility is a concern, masturbation should not be practiced around the time of the wife's fertile period. Theoretically, this can decrease the sperm reserve in an individual with a low or low-normal count and thus reduce semen quality at the time that the highest quality is needed - when the wife is ovulating.