Dashed

Test results - round 2.

Saw the GP this morning to learn about my second semen analysis and blood test results.

That small ounce of hope that I held that my balls are working is dashed - the semen analysis reads 'No spermatazoa present' (exact words, I have the results printed out...).

My blood tests are mainly ok, I have elevated bilirubin, and slightly low blood sugar (but that may be due to the fact that I spent all my energy riding my bicycle before the blood test!). Thankfully my testosterone levels are ok, but intriguingly, my LH and FSH levels are slightly above that expected. So does this make be a ladyboy?!? Hmmm...

The GP assures me that the referral letter to the specialist has been sent. I asked for a private referral, to try and get things moving sooner. Infertility testing and treatment isn't exactly a quick process; I want to know what options are available to me as soon as possible.

If I have obstructive azoospermia, there are surgical techniques that could work (as there's a good chance I am producing sperm that just can't get out.) If I have non-obstructive azoospermia, similar surgical techniques might be possible. In both cases, it's likely that intracytoplasmic sperm injection (ICSI) would be used during in vitro fertilisation (IVF).

If my balls are really not producing anything, then we could look for a sperm donor, or take the adoption route. There are so many kids who are without families, or whose families cannot look after them - and I don't see why I can't be a good parent to a few of them.

Blinder of a Weekend

It was my sister-in-law's joint Hen/Stag party this past weekend.

It was the start of England's World Cup campaign.

It was the start of Argentina's World Cup campaign.

Smashing.

Blood, Sweat and Tears?

A day after seeing my GP for referral to a specialist, I was due to provide another semen specimen and have blood taken for analysis.

SWEAT: So I duly knocked one off, bombed down the cytopathology unit at the local hospital on my bicycle (and I wonder why I have no sperm, all those years spent sat in a saddle can't be doing the ol' goolies any good...!)

BLOOD: I headed to the GP surgery immediately after (again on my bike, probably not the best idea on a warm, sunny morning) for the nurse to take blood samples. Now, I've had bloods taken many times in my time, but I swear the nurse took a dozen tubes of my blood. I hope it's worth it. (Random thought: have you noticed how these days they say "You may feel a scratch" when they insert a needle - I'm old enough to remember when they used to say "You may feel a sharp prick"! Guffaw, chuckle, chuckle ;o) )

TEARS: I haven't had any since I had my initial semen analysis. But I expect there'll be more.

Referral and Further Tests

So, I saw the GP again today. Managed to get an appointment through a sneaky route, bypassing the (dumb?) system of making an appointment on the day.

The next steps now include me providing another semen sample (I have been abstaining from sex and masturbation for a week, and my God has it been difficult!), and a blood test to check my hormonal levels. (This PDF by the American Society for Reproductive Medicine explains quite nicely the diagnostic tests for male infertility.) Apparently hormone (endocrine) evaluation should be performed if there is 1) a low sperm concentration (so for me, read none!); 2) impaired sexual function (I do have a problem ejaculating during intercourse, but otherwise I get really good wood); 3) other signs of endocrine disease. Basically my follicle stimulating hormone (FSH), testosterone, luteinising hormone (LH) and prolactin levels will be checked.

FSH and LH are important hormones for females (they're important for ovulation, and changes in their concentration in the blood makes them the main reason for the lovely monthly lady problems...) but as they're produced by the pituitary gland, they also have an effect on the male bits. LH acts on specialised cells in the testes to stimulate the production of testosterone, and FSH acts on other cells in the testes to stimulate the production of sperm. So my lay deduction from this is that if I have an endocrine problem, it would probably be related to FSH.

My GP also conducted a physical examination. To add to my woes, she thinks I have an undescended right testicle, and a small left testicle. If I'm honest, I actually think I do have two balls, but they're a bit small. This is also a possible contributing factor to azoospermia! Hoorah! Any more ways to help dent my masculinity?

Anyhow, my GP is referring me to the local Reproductive Medicine unit. My medical insurance covers investigations and tests, but if we (the wife and I) wish to pursue fertility treatment this will not be covered. So fingers crossed we get to see a specialist soon and start to figure out a way to deal with this.

I think counselling would be useful at some point too.

Range of Emotions

So it's been a few days to mull over the news now.

My wife and I went through a whole range of emotions. First shock, then disbelief, then the real gut-dropping sensation that you my never have your own children. Throw in anger, confusion, panic. And then the questions.

"Why me?", "How did this happen?", "What can we do?", "What's the point of being alive then?" Ok so it's just the beginning of a possibly arduous journey, but you just want to know if you fix it right now. My mind is awash with self-doubt, anxiety, fear; it's the same for the Mrs, if not worse (she's been looking forward to having kids since the day we first met.) It would be quite easy to stick my head in the sand, in fact I'd like to do that, but this won't go away. I know that's no way to deal with a problem (is this a problem??), but it's hard not to in this case.

On a scale of 1 to 10 on a personal level, this is a pretty big deal - 9 or 10. But then I rate it against a host of other ailments, and it's 1 or 2.

Infertility increasingly a problem for men?

I'm aware of infertility. But I've never really had to think about it.

There are plenty of resources on the Web. It's interesting to find out that infertility may be becoming more of a man's problem than a woman's. There are heaps of possible causes for infertility, both male and female.

It's reassuring to know that I'm not a freak.

Male infertility

My wife and I have been trying for a kid. Although it's early days, we thought we'd get ourselves tested for fertility.

Now I don't know how many guys go through life thinking, "Piece of piss, I get jiggy, I do the biz, and Bob's your uncle - my woman has a bun baking in the oven." I certainly have.

It's only when your GP opens with the dreaded "I'm sorry how to tell you this..." that you know something's up. And then you find out that your fertility test found zero, nada, nil sperm. That's right, absolutely bugger all of those cells that are involved in creating a zygote. First thing in the morning, before you're headed to work. Just imagine how that feels. Oh, and to cap it all, your wife is with you, who like you, has really set her heart on having a baby.

Apparently, I suffer from azoospermia, a rare condition where there is a complete lack of sperm in the ejaculate. I've Googled it. And I've found stuff. And so I'm going to try to locate as many resources and share them, and maybe timeline my progress in dealing with this condition.