Fertility Section: Handling Unplanned Sexual Intercourse, Male Contraception, and the Influence of Sleeping Position

**83. What are some common "unexpected sexual encounters"? How should they be handled?**

Everyone desires perfect sex, but unexpected events are inevitable. If these unexpected events are not handled promptly and effectively, they can negatively impact future sexual life. Common sexual accidents include:

(1) Patients with congenital anatomical abnormalities such as phimosis are prone to repeated infections and affect their sex life because they cannot thoroughly clean their penis; patients with short frenulum experience pain when erect and are prone to frenulum rupture during sexual intercourse. These patients need to seek medical attention in a timely manner and undergo surgical treatment to correct the anatomical abnormalities.

(2) Insufficient preparation for sexual intercourse: When sexual intercourse is not adequately prepared and is relatively sudden, it is easy to cause accidents during sexual intercourse. For example, the most common case is that the male penis gets stuck in the zipper of his pants. In this case, you can apply lubricant to the zipper to help open it.

(3) The most common consequence of overly vigorous sexual activity is muscle cramps, caused by excessively strenuous movements, overstretching of muscles, dehydration, and fatigue. To avoid this, ensure adequate foreplay and gentle movements. If cramps occur, stop immediately and wait for the symptoms to subside. Have your partner massage your muscles to relax them. Another common consequence is head bumping, most likely during passionate face-to-face encounters. Applying ice can reduce swelling. Appropriate sexual movements can often reduce the occurrence of accidents. Maintaining one position for a long time can cause neck muscle stiffness and pain; changing positions and adjusting accordingly can alleviate this. Also, during sexual arousal, a large amount of blood rushes into the pelvic tissues, causing congestion and potentially inflammation. Elevating the hips with a pillow can help with blood flow back.

(4) Contraceptive Accidents: Almost all married couples have experienced condom breakage or diaphragm slippage. The correct course of action is to take two emergency contraceptive pills within 72 hours. If the condom slips off inside the vagina, simply pinch the base and pull it out. If the diaphragm cannot be removed, squat down, hold your breath, and contract your abdominal muscles. The diaphragm will be pushed outwards to a reachable position, allowing you to remove it yourself.

Besides the situations mentioned above, there are many other unexpected sexual encounters, but these are generally rare. Regardless, when an unexpected sexual encounter occurs, remember to seek medical attention promptly if you are unable to resolve the issue yourself, and seek appropriate treatment. Don't let embarrassment lead to irreversible consequences.

**84. How is male sterilization surgery performed?**

Currently, the main male contraceptive surgery is vasectomy. This involves cutting and ligating the vas deferens, or using methods such as electrocoagulation, embolization, or chemical occlusion to block the vas deferens, thereby preventing sperm from being released and achieving contraception. The failure rate of vasectomy is around 1%, due to reasons such as spontaneous recanalization, double vas deferens, and surgical errors.

Some people mistakenly believe that men who undergo vasectomy will become eunuchs. Eunuchs are those whose testes are removed, preventing the production of sperm and the secretion of androgens, resulting in infertility, decreased libido, and feminization of secondary sexual characteristics. Vasectomy, however, only ties up the ducts that transport sperm; it does not impair testicular function in any way. After a vasectomy, there is no impact on sexual life; the sensation of ejaculation still occurs, only the semen does not contain sperm.

The current national policy promotes male sterilization because, compared to female tubal ligation, male vasectomy is simpler, more convenient, safer, and more reliable. Furthermore, vasectomy leaves no sequelae, does not affect physical strength or sexual function, and men undergoing the procedure tend to be more open-minded and straightforward, rarely exhibiting the anxieties and concerns often experienced by women after tubal ligation.

For patients in the following situations: remarried individuals seeking to restore fertility, those who have changed their fertility plans due to the loss of a child, or those with unresolved complications after tubal ligation, such as epididymal congestion, vas deferens recanalization can be performed. Currently, with the application of microsurgical procedures, the success rate of recanalization has significantly improved, approaching 100%, but the pregnancy rate is only around 60%. If the interval between tubal ligation and recanalization is less than 2 years, the possibility of pregnancy is higher; if it exceeds 5 years, the pregnancy rate drops to only 40%. Of course, sperm can be frozen before ligation as a fertility reserve, but currently, it is expensive and difficult to promote.

**85. Can sleeping position cause infertility?**

Infertility is a problem that plagues many families. As the saying goes, "details determine success or failure," and we can only achieve our goals by paying attention to every detail. A healthy sleeping posture also plays an important role.

For men, the fast pace of modern life often leads to a habit of resting while hunched over at work. However, this posture is very harmful. Prolonged hunching not only compresses internal organs but also the scrotum, penis, and other reproductive systems, affecting blood circulation. The metabolism of the testes and epididymis is affected, and harmful substances cannot be eliminated through blood circulation, naturally impacting sperm quality. Furthermore, this posture hinders scrotal heat dissipation, easily raising testicular temperature. The optimal temperature for the testes is 34℃; exceeding this temperature significantly affects sperm quality. Simultaneously, prolonged scrotal compression and penile stimulation can easily cause frequent nocturnal emissions, leading to dizziness, fatigue, and poor concentration. In severe cases, it can affect normal function and daily life, even impacting sexual activity and thus fertility. The best sleeping position for men is supine with legs apart.

For women, we know that a normal uterus is anteverted and anteflexed, but prolonged supine sleeping can cause the uterus to change position, becoming retroverted and retroflexed. A retroverted uterus not only compresses surrounding tissues, causing poor blood flow and pelvic venous congestion leading to excessive menstrual bleeding, but it can also pull the cervix upwards, pointing it towards the anterior vaginal wall, making the external os of the cervix significantly higher. Therefore, semen has to "travel a long way" to enter the uterus, often making conception more difficult. Therefore, the best sleeping position for women is the right lateral decubitus position.