A. Impotence
Sexual dysfunction stemming from low libido or impotence is a frequent cause of infertility. The male hormonal evaluation can detect organic reasons for such problems. Most cases of situational impotence, in which the stress of attempting to conceive results in poor erections, are treated with sexual counseling.

B. Hypospadias
Anatomic problems like hypospadias can cause inappropriate placement of the seminal coagulum too distant from the cervix and result in infertility.

C. Timing and Frequency
Simple problems of coital timing and frequency can be corrected by a review of the couple’s sexual habits. An appropriate frequency of intercourse is every 2 days, performed within the periovulatory period, the window of time surrounding ovulation when egg fertilization is possible. Charting of basal body temperature by the female partner allows for the calculation of that period for the next ovulatory cycle. Home kits that detect the LH surge in the urine before ovulation are also helpful. Couples should be counseled to avoid lubricants if at all possible. It is also wise to discontinue any unnecessary medications during attempts to conceive. Other coital toxins include heat exposure from regular saunas, hot tubs, or Jacuzzis and the use of cigarettes, cocaine, marijuana, and excessive alcohol.