There are couples with unconsummated marriages, who never had successful intercourse even once in 3 to 5 years after marriage. Detailed history will indicate the cause of childlessness in some couple relate to problems with intercourse. This includes Inability to obtain or maintain an erection, premature ejaculation, lack of ejaculation, retrograde ejaculation, lack of appropriate timing of intercourse, excessive masturbation and homosexual tendencies. Many men will have difficulty with erection under the pressure at trying to achieve conception. Undue anxiety to coincide with ovulation periods result in ' Performance Anxiety ' in many men. Sex has to be initiated by desire and not on demand. Some couple have infrequent intercourse missing the egg on ovulation.

    Thers is an erroneous opinion that vagina is tight for intercourse. It is often not true. There is no need to cut the vaginal opening (Vulvoplasty) to make it larger. In all these cases it is the problem of men to have sufficient erection adequate for penetration.

    The treating physician should spend adequate time with the couple giving them the necessary confidence to come out with their sexual problem.