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One of the common reasons for infertility is sexual dysfunction. Sexual failure is often covered in secrecy and guilt, until the subject of children arises. There are many solutions, including self help kits.

We are now seeing many patients who have sexual problems such as vaginismus and erectile dysfunction ( impotence ) who come to us to help them to have a baby. While failure to consummate the marriage will often cause many couples to separate, annul the marriage or seek a divorce, other couples with exactly the same problem do have stable marriages, and are quite happy living together without having sex.

The Infertility Factor 

They often seek medical assistance only because of the resultant infertility. They usually defer visiting a doctor until social pressures and personal biological urges force them to think about having a baby. 
Failure to consummate the marriage is quite a common problem, but one which is rarely discussed, because of the stigma attached to it.

The Delicate Issue 

Because it's such a touchy issue, the normal partner is very reluctant to bring up the topic, as a result of which the issue is often buried deep underground. The partner who has the problem usually has a major guilt complex and often feels inferior and inadequate, because not only can they not perform adequately in bed, they cannot not satisfy either their partner's sexual needs, or get them pregnant.

This shroud of silence often ends up making a bad situation worse. The vicious spiral becomes even harder to get out of, and many of these couples will then sublimate their urges, until the pressure to have a baby becomes unbearable. It's often the woman who can feel her biological clock ticking, and who then initiates the medical

The problem may be in either the man or the woman; and in fact it's quite common to find that both have a problem. The commonest problem amongst men is erectile dysfunction or impotence. This may be so severe that they cannot get an erection even while masturbating; while others can get an erection, but cannot ejaculate during masturbation. Some men can ejaculate while masturbating, but find that they cannot ejaculate during sexual intercourse.

Read more-How Does Male Sexual Dysfunction (Erectile Dysfunction) Cause Male Infertility?

External Stimuli 

For many of these men, using a vibrator will help them produce a semen sample with ease. The vibrator works by providing a high intensity stimulus to the penis. This stimulus is strong enough to overcome any psychological or situational inhibition and trigger the orgasmic reflex. This is what a vibrator looks like. You can buy one from our Online Store !

  • The procedure should be carried out in a room with complete privacy. It is very important to remember that ejaculation will occur automatically as a result of the vibratory stimulation - so be relaxed; do not try and force ejaculation
  • Pass urine, take off your clothes and sit on a bed with your legs apart
  • The vibrator is placed beneath the penis. The penis is placed upon the vibrating head such that the undersurface of the penis (glans and distal shaft) is stimulated
  • Once you are comfortable with the vibratory sensation, press the tip of the penis (glans) upon the vibrator such that you feel the maximum amount of stimulation
  • Keeping the vibrator in place, close your eyes and fantasize sexually
  • Stimulation is continued till ejaculation occurs 
  • This usually occurs in 10 to 30 minutes but some men with anorgasmic anejaculation, who have never experienced orgasm, may take up to 2 hours of stimulation before they reach orgasm the first time!
  • This period shortens during subsequent sessions. Some men require a second or third session before they succeed.

The Problems Women Face

In the woman, the commonest problem is vaginismus, which is an involuntary spasm of the voluntary muscles surrounding the vagina that closes the vagina. This condition causes vaginal penetration to be difficult and painful, or even impossible.

Read more- Making babies without making love

Psychological Quotient 

Most of these problems are of psychologic origin. This means they are much more difficult to solve, and the results of traditional treatment are often disappointing. While the ideal situation would be to solve the sexual problem , so that they can have sex on their own, this may not be feasible in many of these couples, which is why alternative solutions may need to be explored.

It is often a question of the couple setting their priorities, and deciding if they want to work on their sexual problem first, or concentrate on having a baby. The first step in counselling ; and it's important to use books, websites and films to help educate these couples. Sometimes they may not be aware of their sexual anatomy, and asking the doctor to do a gentle vaginal examination can be helpful, because this can help some women to overcome their anxiety.

Some women with vaginismus may not even allow this, and it's important to be patient. It's often easiest if the woman is taught to insert her own finger into her own vagina, after using lots of lubricant.:


  • The best help is self-help, and it's important that these patients learn how to masturbate themselves. Not only does this teach them about how to pleasure themselves and achieve sexual release, if they masturbate in front of their partner, their partner can learn how to pleasure them
  • The next step is then mutual masturbation, and many couples find this gives them adequate sexual satisfaction. Using sexual toys such as lubricant, vibrators and massagers is very helpful, and encourages them to explore their sexuality.

The Best Option 

The easiest option for many of these couples is self-insemination. Self-insemination or DIY (do-it-yourself) insemination is a method in which the woman (or her partner) inserts semen into the vagina herself, without medical intervention. It's surprisingly easy to learn to do, but because most women know so little about their own anatomy, most are very uncomfortable even attempting to try it.

This guide should help you with the basics, but the only way to learn is by doing it. You can also ask your doctor for help and she may be able to guide you in the beginning. Some couples may get turned off by the idea, because it is so "clinical", with a little bit of imagination, and your husband's cooperation, you can make it fun !

So what do you need ? Very little, really.

The most important ingredient is a freshly ejaculated semen sample! Ask your husband to ejaculate in a clean glass or plastic container. Make sure this is wide-mouthed, so it's easier for him to aim accurately - you don't want any of it to spill out! Sometimes getting a sample can be difficult, and you may need to seduce your husband!

  • Using a vibrator, or liquid paraffin as a lubricant, can help enormously. You can also use frozen semen samples from a sperm bank, after allowing them to thaw at room temperature
  • After the semen sample has liquefied (this takes about 30 minutes), you are now ready to perform the procedure
  • Ask your husband to put on disposable gloves and then suck up the semen sample into a 10 ml sterile plastic disposable syringe (without a needle)
  • Our patients find it more convenient to use a sterile disposable plastic pasteur pipette, which we provide in our Self-Insemination Kit, but this may be difficult to find
  • You can even use a turkey baster, which has become a legendary symbol in the lesbian community, but the small amount of semen does not require such a large instrument
  • The semen now needs to be squirted into your vagina, and this is the tricky part
  • You need to lie on a bed, with your knees and thighs bent, and your knees wide apart, so that your husband can see your vulva clearly
  • He then guides the tip of the syringe into your vagina (he can do this just by feel, by inserting the left index finger into your vagina, and using this to guide the syringe which is in his right hand)
  • He can put the syringe in as deep as he wants - don't worry - it won't get lost. He then plunges the barrel, depositing the semen into the vagina
  • You may find it easier to lie on the edge of the bed, so that your hips protrude over the edge
  • Putting a pillow under your hips can make it easier for your husband to perform the insemination
  • You can remain lying on your back for about ten minutes, after which you can resume normal activity. Some of the semen will leak out, and this is normal
  • While using a speculum is not essential, it can help, because it makes it easier to inject the semen at the mouth of the uterus (the cervix)
  • You can use a disposable plastic speculum, and when you insert the speculum, make sure the blades are closed
  • You can slide it in upwards, or else sideways, turning it when it has been pushed all the way into your vagina
  • When the handles are above your pubic bone, squeeze them together, which will open your vaginal walls
  • You will hear a click when the speculum is locked open
  • If your husband holds a torch, he'll be able to see your cervix, which is round and pink with an opening (the os) in the middle
  • The mucus may appear as a clear bubble, or a thread like raw egg-white. You can use a mirror to see what's going on for yourself, if you so desire!
  • After the insemination, make sure that you release the handles and collapse the blades before removing it from your vagina.

Not Everyone's Cup Of Tea 

Some couples may find self-insemination too complex or distasteful, and their best choice is artificial insemination. The doctor monitors ovulation, either by asking the woman to use OPKs (ovulation prediction kits such as Clearplan, which is available from our
Online Infertility Store), or by doing serial ultrasound scans.

Soon after ovulation, the freshly ejaculated semen sample is processed in the lab, and artificially introduced into the uterus with the help of a fine catheter. 
The success rates with these couples is usually excellent if they seek medical attention when the wife is young, since there is usually no medical problem affecting their fertility.


One of the common reasons for infertility is sexual dysfunction. Sexual failure is often covered in secrecy and guilt, until the subject of children arises. There are many solutions, including self help kits.

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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