THE MALE FACTOR – INSTANCE
Some infertility tests such as the postcoital test, or the need to have intercourse on specific days, can result in varying degrees of impotence. Longer lasting episodes have been seen to occur following the discovery of azoospermia. Ambivalence about the wish for a baby, which has already been described in women and in couples, may lie at a deep level in the man. Contraceptive decisions are frequently affected by such mixed feelings, but changes in contraception can also expose previously unsuspected and hidden ambivalence.
Miss A. and Mr Ò., both professional business people, had lived together for 13 years with no intention of having any children. Miss A. had suddenly decided in her mid-30s that she wanted a baby and had stopped taking her Pill. Mr T. could no longer ejaculate, and from having a very satisfying and full sex life, they had resorted to intercourse at midcycle only, using masturbation and injection of semen with a syringe, as had been suggested by a sex therapist.
At the infertility clinic they expressed their desire to proceed quickly with achieving a baby because as Mr T. said, ‘We are getting quite old for babies, but we have the rest of our lives to deal with the sex problem.’ He did not want to be seen separately for his problem.
The doctor decided to press on quickly with an examination of Miss A. She seemed to be the most anxious and to be doing most of the talking. Sex really was not much fun now since the problem started and she had not had an orgasm either. She felt that she had put pressure on him in the first place about not having children and it seemed so sad, now that they both wanted a baby, that it had to be conceived in such a cold manner. The suggestion that she could relieve some of the pressure and enjoy sex again if she wanted to seemed a revelation to her.
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