Terminology Tuesdays: Intimate questions your infertility doc will ask you!

photo by Stephanie Himel-Nelson

Valentine’s day is the celebration love. In honor of Valentine’s Day, I discuss some of the intimate (if not embarrassing) questions that your infertility doctor will ask you during your journey to parenthood. Hopefully, by knowing what awkward questions you may be asked, you won’t feel uncomfortable about being asked them. It’s ok to giggle at some of these questions! Have a happy Valentine’s Day!

Q – How many times do you have sex per week?

A – Although pregnancy can result from one passionate night with the husband, most of the time the female genital tract must be flooded with sperm during the fertile window in order to catch the egg at the right time to lead to conception. Believe it or not, some couples do not have intercourse enough times to allow for enough sperm to be present when the egg is ready to be released and fertilized.

Plus, the cervix acts like a filter and weeds out 90% of the sperm that gets deposited with ejaculation. So, the more frequent the intercourse, the more sperm that make it to the egg. Thus, a better chance of getting pregnant.

Q – Do you experience pain with intercourse?

A – Experiencing pain during sex may be a signal that other pathology is present in the pelvis. Pain with deeper thrusting may mean the presence of endometriosis or ovarian cysts or pelvic adhesive disease (scars within the pelvis). Pain with insertion of the penis may mean a lack of lubrication of the vagina.

Q – Do you use lubricants?

A – Lubricants such as KY-jelly have been scientifically proven to trap sperm and kill them. Luckily there are some alternatives that are sperm friendly. You can use olive oil. Olive oil has been shown not to be spermicidal. Pre-Seed, an over the counter lubricant, has also been proven to be sperm friendly.

Q – How many partners have you had? Have you had any sexually transmitted diseases?

A – Women who have had numerous sexual partners have a higher risk of having been exposed to and contracting sexually transmitted diseases. Infections such as Gonorrhea and Chlamydia can lead to scarring of the tubes or pelvis. These scars can occlude the fallopian tubes and prevent sperm and egg from meeting. Thus, leading to infertility.

Q – Do you have any nipple discharge?

A – Leakage of fluid from your breasts can be due to excessive production of a hormone called prolactin. Prolactin is the hormone produced by the pituitary gland that allows for milk production from the breasts. However, sometimes prolactin is produced when a woman is not breast feeding. This may lead to inappropriate milk production and leakage of fluid from the breasts. Prolactin has the ability to interfere with the production of hormones necessary for ovulation and menstration. Thus, women who leak milk from their breasts (also called galactorrhea) when not breast feeding may also experience irregular or no ovulation/menstrual periods.

The guys get asked embarrassing questions too!

Q – Have you ever fathered a child with someone else?

A – “Not that I know of” is the most common answer I get when I pose this question to the husbands of my patients. If a man has fathered a child with someone else, his sperm must have been normal at that time. However, fathering a child in the past does not necessarily mean that the husband’s sperm has remained normal. Sometimes many years pass since the birth of a child and the husband’s sperm may have become abnormal. Thus, a semen analysis is still recommended to evaluate for sperm quality.

Q – Do you have any erectile dysfunction?

A – Some men are unable to obtain or even maintain an erection for sex. Sometimes this can be due to a decrease in testosterone production. A low testosterone can also lead to not only a low libido but also a low sperm count.

Source: Clinical Gynecologic Endocrinology and Infertility 7^th edition, Leon Speroff (Author), Robert H. Glass (Author)

Dr. Lowell T. Ku, M.D. is a leading Reproductive Endocrinology and Infertility specialist at Dallas IVF, one the nation’s premiere infertility centers.  Dr. Ku clarifies the many confusing terms used in the world of Infertility using straightforward explanations.