NIAW

Wow, has it been this long since I blogged? If any of you are still out there reading, I promise that I haven't fallen off the face of the earth. In my blogging absence, my wife and I had another dIUI cycle which sadly resulted in a BFN. I'm embarrassed to admit that we're now at the point of triggering for this next cycle and she's heading in for a dIUI on Saturday morning.

But I'm back.

I was going to brag about my superior injection skills, because really, they are good. And hey, give a guy with no sperm a break. I need to be able to brag about something in the process of getting my wife knocked up, right?!

But this week marks National Infertility Awareness Week or NIAW for short. The blogosphere has been awash with some really amazing and honest posts about infertility. As we come to the end of the week, I thought that I might take a moment to share my thoughts.

To be honest, until my diagnosis, I'm not really even sure if I knew that guys could experience infertility. So to be diagnosed was an unwelcome slap of reality. Over 40% of infertility cases are male-related. Some male fertility issues can be corrected, others aided by medical intervention. Mine cannot. To face the knowledge that there is no chance of me ever fathering my own children naturally and an extremely small percent of a chance that I could do so with even the most advanced medical intervention is still hard to swallow. I won't pretend that I understand the longing that women have to be mothers. But I can tell you the longing that I have to be a father. It's like an unquenchable thirst, a desire to be something more than I am and share a love that I cannot even begin to articulate.

I know that the decision that my wife and I have made to pursue our family with the help of donor sperm would not be for everyone. I'm not wanting us to debate this here. I firmly believe that in this world of infertility we will all make different choices and the choices that we make are right for us. I have been grateful to receive support and not judgement in my brief blogging time. The infertility community has become a special place for me. It is where we lift one another up, cheer each other on, and hold each other close on the days when we feel most wounded.

As we embark on this next dIUI, I know with every fibre of my being that should we be lucky enough to receive positive news in a couple of weeks, that child will be as much a part of me as she/he is my wife's. 100% of my heart and soul goes into our child that could be.

As for our donor, and for all of the men and women who donate a part of themselves to help others achieve the greatest of dreams, on this NIAW I thank you.

Infertility has made me a very lucky man.

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February ICLW

Happy ICLW everyone! I'm glad to be participating again and I hope to do more commenting than I usually do. If you're here for the first time, welcome. If you've been here before, thanks for coming back!

Quick ttc background: I'm 38, my wife is 34. We're trying to conceive our first child and have been on this quest for over four years. My wife has PCOS and I was diagnosed in the last year and a half with azoospermia, or no sperm. After varicocele surgery (ouch), numerous tests and drug therapy with no new results, we made the decision to go forward using donor sperm. I know that this would not be every one's cup of tea but this is what I love about the blogging world. We can all make different choices, but we can still all support each other just the same.

Other background: I'm Irish, born and raised. I came to Canada just over ten years ago when I married my lovely wife. I started this blog to help other guys (and their partners) get a glimpse into male infertility from a guy's perspective. I also blog with my wife over at Conceive so please stop by there too.

After taking a number of months off, my wife and I are back to fertility treatments this month for dIUI #3. She is currently in the midst of a protocol of Femara and Follistim. She is also not a fan of needles AT ALL so I'll be blogging about my experience on the other end of the needle in an upcoming post.

Again, thank you for stopping by. I hope that you'll consider staying a while by becoming a blog follower. I promise to take some time this week to ensure that I'm following all of you new followers back.

Happy ICLW everyone. Please keep your fingers crossed for us this cycle.

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Virgin Territory

Easy now. Not trying to raise any eyebrows but I am indeed in virgin territory. This is my very first ICLW!

If you are stopping by for the first time, welcome. I hope that through ICLW I get off my arse and actually start commenting on other blogs as well. I confess, that is not my strong suit. But that doesn't mean I'm not reading. I do. I promise.

So a little bit about myself. I was born and raised in Ireland and after university spent a few years living and working in Dublin. I met my lovely Canadian wife at a party in the U.S. (go figure!) and after a couple of years of long distance dating we took the plunge and got married and I've been living here in Canada ever since.

We married young. My wife was still in school and wanted to finish that before starting a family. We then decided to wait a wee bit longer as we got established in our careers, bought a house, and got ourselves "ready". That took about 7+ years! Had we known what we know now.... well, you can't go back, so I guess that doesn't matter much does it?

After a year of trying unsuccessfully on our own we started seeking help at the fertility clinic where my wife was diagnosed with PCOS. We thought that was our only fertility obstacle when my semen analysis (SA) came back with zero sperm. You read me right. Zero. We were floored. Since then I have had varicocele surgery in the hopes of producing some swimmers but haven't had much luck. My azoospermia is a result of testicular failure. Not exactly what a guy wants to hear. No man wants to be known as a failure in the 'junk' department.

While there is a very small chance that a testicular biopsy (aren't you glad you're reading all of this?) may produce some viable sperm to use via IVF with ICSI my urologist, who is an awesome and honest guy, has recommended the use of a donor in my particular situation.

While this wouldn't be everyone's cup of tea, my wife and I have made the decision to go forward with IUI's using donor sperm. We've been off treatment for a little while as she focused on some other health priorities but are heading back into it all in the coming month.

So there you go. I'll be honest. Sharing all of this stuff isn't exactly easy. But male infertility needs a voice so I'm hoping that I'm one of them. I hope that my blog provides some solace for other guys out there dealing with IF issues of their own as well as their partners who are maybe looking for a male perspective.

Thanks for stopping by - I hope you will again. Cheers.

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Mantra

I've been putting off this post for a while. It's not an easy to post for me to write. But I think any man or woman who is dealing with infertility will at one point or another experience feelings of guilt and blame. While I in no way wish to diminish what a woman dealing with infertility may feel (please do not misunderstand), I do believe that for men it may even be a little bit harder. Why? Because unlike our wise female counterparts, we tend not to talk about this. We bottle it up. We pretend it isn't there. We don't seek (or sometimes can't find) a community to help us through.

Let me unpack this a bit.

When my wife and I first went to the OB/GYN affiliated with our current fertility clinic it was her who was feeling guilty. She suspected PCOS. She was having issues with a non-existent period. She knew she was not ovulating. It was "all her fault" (her words) that we weren't getting pregnant. She blamed herself. I, on the other hand, was blissfully ignorant of my own issues and assured her with everything in me that there was no need to feel guilty or to blame herself. I loved her and we would figure this out together no matter what.

She was prescribed Clomid. I was instructed to have a semen analysis (SA) as a formality. So I did.

When the results came back that there was no sperm we were floored. None. Zero. Zilch. For me, perhaps unconsciously, the tables had been turned. I was no longer the one to reassure her not to blame herself. With this news, I was left feeling very guilty and I was definitely dealing with a lot of self-blame.

My wife has fertility issues, yes. But with the help of medications among other things, there is still a good chance that she can become pregnant and sustain a healthy pregnancy.

But me. I've got nothing. There's no medication in my particular case that would produce sperm. Trust me, we tried a few options. We tried surgery, but no luck.

For quite a while, I felt really guilty. I blamed myself for ruining our chances of having a baby. There was nothing that could possibly "fix" me. Why on earth would she want to stay with me? I'm broken.

But if I give infertility one thing, I'll give it this. Going through this together has made our marriage stronger than it has ever been. We are a team. It doesn't matter if one or both of us have fertility issues. There's no room for guilt or blame in this relationship.

We choose instead to turn our faces toward the future. We have the courage to say yes in the face of adversity. The courage to say yes to choices that may not be for everyone but that are right for us. The courage to say yes to deal with the lot we have been given with optimism and humour.

To experience feelings of guilt or blame is not wrong. They are, in fact, very normal. The key, in my personal opinion, is to find a way to dig yourself out of the depths of guilt and blame.

Infertility does not define me. And it never will. That, friends, is my mantra.

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New Year, New Look

Now that it's officially 2010, I can wish you Happy New Year! I hope that this is the year that all of our dreams come true. Fertility and otherwise.

With the New Year comes a new look. I'll be honest. I'm not really that creative so I just chose a new template via Blogger. But I'm hoping it's fresh and easier to read. Feedback is appreciated. Or better yet, if you're a blog designer who totally wants to overhaul my blog (for free!), I'm your guy!

As I've mentioned before, my wife and I also blog for Conceive and have a new post up. You can read our latest by clicking here. If you do stop by and read, please leave us a comment saying hello so that we know that you did!

Still quiet on the fertility front here. My wife goes for a glucose intolerance test (aka the test that determines diabetes) on Wednesday morning. Her family has a history of Type II diabetes and with her PCOS and insulin resistance issues, the PCOS specialist wanted her to get this checked out a little more thoroughly. She had to go off of her Metformin for over a month in order to get accurate test results and is eager to get back on it. We'll find out her test results in early February when she sees the specialist again. Keep your fingers crossed for her!

We're also aiming to start fertility treatments again in late January/early February. Here's hoping our third dIUI is a charm. You know I'll keep you posted.

Happy 2010 everyone!

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Happy (almost) New Year!

I hope that everyone had a wonderful holiday. We do the Christmas thing here and I'm happy to report that it was just great. I enjoyed lots of good food, including my wife's amazing cookies (no that's not code for anything dirty!), consumed a good deal of beer, and enjoyed time spent with our family and friends.

With the holidays and a new job my visits to the gym have become a bit sparse but no doubt I, along with many others, will be back come January, resolved to drop some pounds and tone up that body.

It's quiet for us on the fertility front at the moment but that will likely change in the New Year as we embark on dIUI #3. Don't worry, I'll keep you posted. In the meantime, I continue to take all the herbs and vitamins that my ND has prescribed on the off chance it kicks things into gear down in Man Town.

Wanted to wish you all a very Happy New Year now since I likely won't get a chance in the next few days to blog. Busy with work and then off to family for a New Year's Eve celebration.

Here's to 2010! As I posted on Twitter earlier today, my resolution is to become a dad in 2010. Here's to kicking infertility's ass!

All the best to you and yours.

PS - My wife is having a bit of fun on her blog by doing a giveaway (sponsored solely by her!) What's she giving away? Balls of course. Don't worry - they don't belong to yours truly! But they are the most amazing chocolate covered gingerbread bites. Check out the details here and join in the fun!

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On the Side

I probably should have shared this a while ago, but the wife and I are honoured to be blogging together for Conceive. It's a great resource for all things fertility. Definitely worth checking out for great articles, information, and ahem, some great bloggers!

Should you be so inclined, you can read my latest post on there here. Please leave a comment and let me know you stopped by!

I'll try and make a point of noting when we've got a post up for those who are interested.

In other news, I'm in the midst of holiday shopping hell! A shopper I am not. Let me know what your great gift ideas are for this year.

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Dem Balls

Currently my wife and I are on a spawning break until the new year. We're both trying to get healthier and have tried to get serious about exercising regularly, eating better, and keeping up with our acupuncture and TCM stuff.

So this isn't exactly a pressing matter, but as we think ahead to future fertility treatments, I've been wondering about this "small testicular tissue sample" that Dr. Balls is recommending I do should we move on to IVF/ICSI.

Fellow bloggers and good readers does anyone know much more about this? Because all I can think about is OUCH.

I haven't had an opportunity yet to discuss this more with my urologist, Dr. Balls, but I'm curious to know if there are any other azoo/MFI guys out there that have braved this? I'm also wondering what the chances are that this would produce viable sperm that could be used? In other words, is it worth the pain and agony for someone in my situation?

I'm a numbers guy. Anyone got numbers for me?

Advice appreciated. I figure I may as well start my researching now before I stock up on bags of frozen vegetables for post-procedure numbing.

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Answers

Somehow I managed to survive my "no sex" weekend and made it to the SA on Monday.

That alone was a feat in itself! Pat on the back for me.

Was able to do the deed in the lab. Again. It's still awkward and somewhat embarrassing but dare I say it feels somewhat routine since I've had to do so many of these now?

Dr. Balls (my urologist) emailed me with the results the next day. He's good that way since it's a good hour drive for me to get to his office.

Unfortunately, my SA shows no real change from the last post-surgery test. I still only have rare non-motile sperm showing up.

My FSH and testosterone levels are better but Dr. Balls feels that at this stage, this is as good as it's going to get for me.

He recommends me going into the lab once or twice a month over the next little while so that they can freeze any possible sperm that show up in the samples. He also recommends that I arrange for a small testicular tissue sample to be taken as a back up in case there are not enough sperm in the ejaculate. There is a possibility that this could be used with IVF via ICSI should we end up going that route.

Testicular tissue sample? Umm...OUCH!

Even with all of that, it is recommended that we continue with donor sperm as back up. Even if we do move on to IVF.

So that's where we're at. I know it's not exactly great news, but we're actually doing okay with this.

As I've said from day one, my particular case made it pretty rare for any of this to make a big difference for me.

But we've got the answers we need now to move forward and there is still the slight hope that I might be able to take part in biologically creating our child.

No matter what though, I am confident that some day we will have our baby. And sperm or no sperm, I like to think that I'll have a good hand in creating it. Maybe not the biological way. Or even the "traditional" way. But love has got to count for something in all of this.

And that's enough for me.

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What Do You Mean, "No Sex?!"

I know that I probably won't get much support from the ladies out there when I moan and groan about my upcoming semen analysis (SA) on Monday.

Yes, I know your tests are much worse. Yes, I know that your tests are much more invasive. More painful. More awkward.

I will give you all that. And then some. No arguments.

But the SA is no walk in the park either! Even tossing aside the embarrassment of walking into the lab and trying to work up the courage to do the deed with Mr. Righty or Mr. Lefty, the SA is absolutely, positively no fun.

Why? Two words. No sex. The two scariest word to ever be uttered to a man. What do you mean, no sex? You mean for a few hours? Minutes?

Wait. You mean days? As in plural? As in a possible multitude of days?

Yes, I have been banished to the land of no sex until my SA on Monday. This is brutal. I'm a guy. I have needs.

My wife rolled her eyes and laughed when I lamented this news.

But surely someone out there feels a tiny bit sorry for me?

Someone? Anyone?

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Waiting Game

October 26 is the day. Yet another semen analysis (SA) is booked and from there we'll have some sense of what (if anything) we're working with.

Should there be any swimmers in that deposit, I will start doing SA's monthly in the hopes of freezing whatever we can. There won't be much (if any) and ICSI is definitely our only option if we use my sperm.

There's still a really good chance that donor sperm will be the route we have to take. A donor will always have to be on back up in case my boys don't come through.

But it's kind of exciting to think that maybe - just maybe there's a chance.

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An Irish guy walks into the urologist's office...

On Monday I had my visit with the urologist (whom I will call Dr. Balls for reasons that I'm sure are more than explanatory). As usual, we had to wait a bit to see Dr. Balls, he's a busy guy. But he's a good guy, so we were happy to wait.

While waiting, my wife and I played a game we like to call "Balls and Prostate" where we try and (quietly) guess who's at the urologist for what reason. Not that we ever get to find out if we're right. But it passes the time. I highly recommend it the next time you're waiting around at the urologist's office!

It's been just over a year since I had my varicocele surgery. Remember, varicoceles are large blood vessels that can essentially turn your balls into a hot tub for sperm. Not good. Bet your doctor never explained it that way! But you know me, keepin' it real on the male IF side of things.

Anyways, the surgery was always considered - for me - a long shot. To be clear, some of you guys out there may really benefit from this procedure and it could really change your situation so definitely listen and talk to your doctor. But in my particular case, Dr. Balls has not seen any significant changes.

So now my azoospermia has been classified as a result of testicular failure. Yes my friends, I am a failure. Or as my wife so kindly pointed out, "You're NOT a failure honey. Your balls might be, but never you." That's my girl!

I had to do more bloodwork to see where my hormone levels are at and I will have to do another semen analysis (SA) to see if any swimmers are in the pool. At that point, if we find any, we may start freezing them should we decide to go the route of ICSI. But until I do this next SA we won't even know if that's viable.

This probably sounds a lot more depressing than I'm feeling. I actually feel pretty good. We knew the surgery was pretty much a snowball's chance in hell for me, but at least we're not left wondering "What if?" Maybe we'll have one or two of the wee boys to freeze and potentially use to create family. Maybe we won't.

No matter what though, we will have our family some day. It may not be the "traditional" way but who cares. Maybe it's time we start defining new ways of creating family - be it IUI, IVF, ICSI, donor eggs or sperm, adoption, surrogacy, etc. - as the new traditional. Equally valid and full of potential blessings.

Just my $0.01 for the day. Cheers.

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Alone time

Why is male infertility so fantastic?

Easy!

Think of the numerous sperm tests you get to have! Yes, the good ol' semen analyis (SA). You know what that means, gentlemen, "alone time." Just you and "Righty." Or "Lefty." Or both. But I really don't want to know about that.

As a young Catholic boy, I was taught that masturbation was bad. BAD! Thanks to Monty Python, we good catholics remember that "every sperm is sacred." (More on that later.)

But now with all of the trips to the urologist and the fertility clinic you can have as much "alone time" as you can imagine and in public places no less! Who knew male infertility could be so - er - pleasurable?

Now I'll admit, trying to "get things on", by yourself, in some random clinical lab room isn't always easy. But sometimes they even leave "stuff" for us to help out!

Though if you take advantage of that I only have three words for you: hand sanitizer afterwards.

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No sperm for you!

An azoo diagnosis or any diagnosis that suggests that all may not be well in "Man Town" is distressing. But it doesn't mean you can't laugh a little bit.

I promised to look at male infertility with humour - AND - from a guy's point of view.

I will try and make some serious reflections now and again. But if the world loves a good joke about 'da junk, then have I got some for you. Stay tuned.

No sperm for you! Come back, two weeks!

Sounds a bit like my first sperm analysis.

Next!

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The Face of Male Infertility

So what does a guy with male infertility look like?

Well, if you're a guy, take a look in the mirror - he could look like you. In other words, there's no particular 'type' that male factor infertility (MFI) strikes.

You could be short or tall. Fat or skinny. You could be athletic or not. Bald or sporting a full head o' hair. Maybe you wear glasses or contacts. Or not. You might be a little bit country or a little bit rock n' roll.

You get the idea.

What surprised me most about my visits to the urologist was just how many guys were there because of male infertility and how different we all were. No one attribute or characteristic linked us to one another.

I honestly expected to walk into a waiting room full of old men with prostate issues. Yeah, some of those guys were there too and not all of the young guys may have been there for fertility stuff but there were quite a few. Often accompanied by a female partner, looking anxious, just like us. And a little relieved when they too realized that they weren't the only ones out there dealing with this.

The IF guys were confirmed when we all fell into the assembly line of following each other down to the lab for blood work, then back to the urologist's office for further instructions, waiting one at time to be scheduled for ultrasounds and the like.

It was quite comforting in a really weird way. When I first got my azoospermia diagnosis, I honestly thought, "I am the only guy on the face of the planet who has absolutely no sperm."

It was only after that visit to the urologist and my subsequent forays on the Internet into the world of male infertility that I realized I wasn't the only guy out there.

This whole male IF thing wasn't exactly what I had in mind - but at least I know now it's not a club of one. And now you do too.

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Dude looks like a lady

When entering the world of male infertility you have to be prepared for the unexpected.

For example, did you know that Clomid is a drug that can be taken by both female and male infertility patients?

In the months leading up to and after my varicocele surgery, my urologist put me on a drug called Arimidex. It most often is used as a hormonal treatment for post-menopausal women but it is also used in the treatment of breast cancer.

So how does this relate to male infertilty? In short? I have no clue. It relates to a balancing of hormones for sure, but like I said, I'm no doctor and am not about to pretend that I am.

When I first got the prescription and was reading through all of the literature that came with it, I'll admit, I was confused. Nowhere in the information did it say anything about male fertility. In fact, I was so sure that there must have been some kind of mix up, I emailed my urologist to be sure I got the right thing.

He assured me I did. And no, I wouldn't grow boobs. Dammit!

You know, kind of like this, every guy's fantasy...

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One year ago

My title is slightly deceiving. It's just over a year ago, but that didn't sound as catchy so we'll run with the above.

Anyways.

About a year ago, after a few trips back and forth to see the urologist, I underwent varicocele surgery - a day surgery procedure - in the hopes that it might make a difference in bringing some swimmers out of hiding.

To be honest, I don't really remember too much. There was arriving the night before and settling into the hotel with my wife. You see, since we had to travel into a major city for the surgery and travel post-surgery was recommended to be kept to a minimum for a day or two, we opted to stay close to the hospital. The next morning it was an early start that involved lots of paperwork. Then there was the waiting. And some more waiting. And some more waiting after that. I remember that I was starting to get hungry but couldn't have anything to eat prior to the surgery. Finally it was time to go in. But before that, a quick chat with my urologist, then some other guy who had, you guessed it, more paperwork for me.

I remember my wife's face as she tried not to cry as they took me down the hall for the surgery. I remember a kiss or two and some "I love yous." And then that's it. I remember waking up afterwards. I was groggy, but really not too bad. My wife tells me that the surgery took longer than expected (nothing major - just a bit trickier on one varicocele than the urologist anticipated). She said that the waiting was hell. I remember having to eat and pee before we could leave. Yours truly was a pro in both requirements. I vaguely remember the taxi ride back to the hotel and getting back into our room. I do remember the burger I had for dinner that night and how good it was. And also how shocked my wife was that I could actually eat (and not barf) all that food.

I was tender for a couple of days but the pain meds helped. So did all the movies we watched and the TLC from my wife. Within a couple of weeks or so, I was pretty much back to normal and even the urologist was impressed by my healing capabilities when I saw him for a follow-up.

I knew going into the surgery that for my particular case of azoospermia, the surgery probably wouldn't make a difference.

So why did I do it?

Well, for one, we were very fortunate that the surgery was completely covered. So in that sense, money wasn't holding us back.

Also, there would always be that question of "What if?" I would always wonder what could've been.

Mostly I did it for us. And I don't regret it one bit.

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The basics

I realize that not all guys out there are dealing with azoospermia. I'll try and tackle some other male infertility issues in due course. For me, azoo is what I've been dealt with.

What is azoospermia? Basically it's the lack of any sperm in the ejaculate. I can't believe I've just typed this. Boldly going where few guys have gone before, men! So that ultimately means that conceiving naturally is pretty much impossible and believe me, I know. It's not for lack of trying! For me this also meant numerous sperm count/motility tests, plenty of bloodwork, an ultrasound on my testicles (embarrassing, but knowing what my wife deals with each cycle, I'm not going to complain - much!), and day surgery.

Azoospermia can be a result of hormonal problems, testicular failure, or the varicocele. Definition time again. A varicocele is essentially the vein of the scrotum. These veins can become dilated and allow blood to pool in the scrotum which doesn't bode well for sperm production. Yours truly had one hell of a big varicocele (notice I'm falling into the trap of celebrating it's 'bigness'. Just give me that one.) I did have day surgery in the hopes of correcting this and releasing swimmers. Unfortunately for me, it didn't make a difference. But I'll deal with that in another post.

Guys with azoo aren't automatically unable to father their own children. Methods are possible to harvest sperm (ouch!) and use methods such as IVF and/or ICSI to produce biological offspring.

So those are some of the basics about azoospermia. Maybe you've found your way here because you've just had that term put in front of you and your upset and confused. If there's a question that I can help you with, leave me a comment. I'm happy to try and help. Obviously I'm not a doctor. But dealing with it myself, sometimes it's just nice to be able to talk to another guy who gets it.

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Welcome

Look, I'm going to be honest with you. I'm not much of a writer. Usually I leave this kind of stuff up to my wife. But as we've struggled with our diagnoses of infertility, I've come to realize that there aren't many male voices out there to talk about male factor infertility.

I'll be honest. It's embarrassing. We live in a culture that can't get enough fart and penis jokes. We life in a world where male verility and "strong swimmers" are not only celebrated, they're expected. Male infertility is funny for all the wrong reasons. And for those of us dealing with it, well, it might just be easier to fade into the background.

I'm going to try and write about our whole adventure to try and create a family - from my perspective. While it may not be the most eloquently written (I had to ask my wife for that word!), it's going to be honest.

I'll attempt to go back and give you a bit more detail about my diagnosis of azoospermia, details about my varicocele surgery, and our decision to proceed with donor sperm.

I know that our decisions wouldn't be others' decisions if they were in our boat. But I pass no judgement on which path you take so I hope you'll do the same.

So welcome. Maybe there will be one or two guys that find their way here. Maybe you're the female partner of a guy who's dealing with this. Hopefully if nothing else this will help you feel less alone.

Cheers and welcome.

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