The Mom Who Did IVF — for Her Husband’s Infertility
“Male infertility is almost never talked about — and when it is, it’s a joke. There’s zero nuance.”
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Source: The Cut
Sep 13, 2018
Dana didn’t think much about motherhood one way or another, until she met Todd. The man she eventually married had always known he wanted to be a parent and, gradually, Dana began to feel the same way. When the couple confronted an unexpected diagnosis, her desire only deepened. She discusses hearing her husband’s results over the phone, the moments she felt lucky, and her frustration with how male-factor infertility is discussed.
On considering motherhood. It’s hard to look back with total clarity, but I don’t think I thought much about it. I’m the youngest and we have a small family, so I wasn’t really around children very much. I didn’t babysit; I wasn’t a nanny. I didn’t dream of being a mother, and it wasn’t part of my goals. At one point, I said I didn’t want kids because I didn’t feel maternal and didn’t think I would be a good mom.
But then I met a man I knew would be a wonderful father. We got married when I was 30 and Todd was 31. The closer we got to our mid-30s, the more we thought about having kids — like when we got an apartment with an extra bedroom, we thought about it being “the baby’s room.” We hadn’t really seen anyone struggle through parenthood, either. It just seemed like it could be this wonderful, exciting next part of our lives.
On pursuing pregnancy. I went off birth control when I was about 32. It was a conscious decision, one we made together. Todd had always known he wanted a family — that was a lot more of a constant for him than it was for me.
I’d been on birth control for pretty much my entire adult life, from about 18 to 32. I was excited to get off — it felt like we were doing something. But three or four months went by, and I never got a period. So I went to my gynecologist, who ran some tests. She also suggested something that I remain so grateful for — that she order some tests for Todd as well, because she always recommends that male partners be tested along with women.
On an unexpected diagnosis. I was the one who got the call about Todd’s test results. I remember I was in my office, and I closed the door. The doctor wanted to know if she should give me the results, or if we should try to get him on the phone as well. I told her it was fine to tell me, that he was okay with that. The first thing she said was “I’ve never seen this before.”
She told me that his sperm had zero motility and zero mobility. That means, essentially, there’s zero sperm. Not that there’s low sperm, or bad mobility. But that there was literally no sperm to be seen in his semen. She said that this was really where her expertise ended, that he needed to go get more testing.
I called Todd immediately and told him to close the door to his office. It was still in the middle of the workday. He was stunned.
On figuring out what to do next. Throughout all this, there have been moments where I’ve felt incredibly unlucky, and moments where I’ve felt incredibly lucky. One lucky thing is that one of Todd’s best childhood friends is a urologist who handles these kinds of diagnoses. He was able to call his friend and ask him what to do, and this friend was able to get us into see a specialist who’d been his fellowship supervisor. This specialist confirmed that he has azoospermia, which affects about one percent of men. It can be caused by things like testicular cancer, chemo, and radiation from other cancers, or even injury — none of which applied to my husband.
My husband is a pretty stoic person. I can think of three times when he’s been really emotional, and two were when he was coming out from being under anesthesia. This time was one of them, though: I remember, once we got home, we hugged and both cried, and he said, “I think I’m going to have to go to therapy to deal with this.” It was really one of the only times he broke down.
On surgery, IVF, and another unexpected phone call. For some types of azoospermia, there’s healthy sperm in the testicles that’s just blocked from getting into the semen. That would be best-case scenario: A surgery would retrieve sperm and then we would be able to do IVF with my eggs. But there are some forms of azoospermia where no healthy sperm is produced, or even none at all. The diagnosis had come in June or July; the surgery was scheduled for October. We moved really fast. All of a sudden, I was told that maybe I couldn’t have children. That made me want to do everything we could to try.
It was a four-hour surgery, under full anesthesia. I remember sitting there waiting, wanting to know what exactly we were dealing with. The doctor came out and told me that he’d found one healthy sperm. There should be thousands. But still, the doctor said that one meant that there was probably more — essentially what they do is pull out what they can but don’t examine everything during the surgery because that would take too long. They took what they could and froze it, and recommended that we go forward with me doing IVF.
A few months later, I did a full egg-stimulation cycle. They retrieved 36 eggs, which was another one of those moments where I felt incredibly lucky. The day of the retrieval, they were going to unfreeze Todd’s sperm and try to fertilize my eggs with them. We headed home from my retrieval so happy with our 36 eggs. About an hour later we got a call: They’d unfrozen the sperm, and none of it was healthy. Later, we were told it was “destroyed.” We don’t actually know if there was any healthy sperm there to begin with, but we’ll never know.
We were freaking out. We had to go all the way back to the clinic in Manhattan from our house in Brooklyn. I was still recovering from the anesthesia and the procedure, and then we had to turn right back around and spend another hour in the car. They hadn’t taken into account the possibility that we’d need to freeze my eggs, that there would be no sperm to fertilize them with. We hadn’t filled out the proper consent paperwork to make that happen, and we had to do it right away because the eggs would only be okay for a few hours. I was hysterical; my husband was so angry. It felt like his surgery had been for nothing. It even took us a while to find someone who could help us — we were running around the hospital and the clinic until we finally found the on-call doctor.
That night, I locked myself in our bathroom and called my mom. I broke down, telling her we couldn’t have babies, that it was all over. Then we had to figure out what to do next, again.
On the question of malpractice. I’m an attorney, so I also had some questions about whether there had been medical malpractice, and if so, who committed it. We supposedly had healthy sperm, and we’d been told “an unknown contaminant” had destroyed it. Did the lab mess up? Did the doctor mess up? To complicate things further, the doctor who had done the surgery was that same doctor Todd’s friend connected us to. We didn’t want to accuse him of malpractice and destroy their relationship.
We’d done almost everything out of pocket, and we were so lucky to be able to afford it. Neither of our insurance covers IVF; no insurance covered Todd’s surgery. In the end, we spent $15,000 for Todd’s first surgery, $25,000 for his second. Each round of IVF was around $14,000, but that doesn’t include the drugs, doctor’s visits, and hospital fees. I felt like I just wanted the money back for that first surgery, no other damages — I just want everything that we’d spent that had gone to waste, back. All of the medical malpractice attorneys I spoke to were sympathetic, but none of them took cases for such a low, relatively speaking, value. Which I totally understand.
One attorney recommended using my professional skills to advocate for myself. What was happening was that the doctor blamed the lab, the lab blamed the doctor. I remember having a call with the doctor and saying that we still owed the last third of the payment and that we were not going to pay it, and if they wanted to chase after us for it, they could, but I thought it was completely fair. I mentioned that I could file a complaint, that I could hire an attorney, but we were not going to do that — we just weren’t going to make the final payment. He said, “I can’t believe you’re doing this to me.” And I was like, “You can’t believe I’m doing this to you? Do you have any idea what we’ve been through?” I went through IVF at his recommendation. I wouldn’t have done that otherwise. So I told him, fine, send a collection agency after us. There was a follow-up call where the surgeon did back down a bit.
We decided to switch doctors after this, to a urologist that worked in conjunction with a reproductive medicine clinic. The doctor we switched to had basically invented a low-invasive version of this surgery, and he recommended my husband try the surgery this way, one more time. He also thought that we should have a donor prepared and ready, in the event that no sperm was retrieved or that none of what was retrieved was healthy enough.
On choosing a sperm donor. This was obviously not something we ever hoped to need. But I’m lucky that I have several friends in same-sex relationships and have gone through using donor sperm. It felt like I had a community of experts, who were able to refer me to a donor bank.
Choosing a donor became my project. Todd didn’t really want to know the details. We decided that I would choose my top three, and then he would weigh in at that point. Our thinking was that I would first look for my his general physical type, and that then I’d look at intelligence. Other characteristics — like humor, having strong interests — would come next.
It’s like Match.com. You don’t get to see current photos, but you see baby photos — you learn weight, height, hair color, SAT score. You could even choose celebrities as a frame of reference, and get donors who looked like them. That really didn’t work for us (my choices were maybe a bit aspirational). I was also prioritizing donors who would be open to connecting with any children created using their sperm, once that child turned 18. It narrowed the pool considerably.
We ultimately chose a donor who essentially matched Todd in terms of height, weight, hair and eye color. All donors have to have good health histories, so he had that, and he had high test scores and seemed ambitious in his career. The staff at the sperm bank also provide reports on the donors — this report mentioned that the donor seemed very thoughtful in his decision to become an open donor.
This donor is Ashkenazi Jewish, and so are we. There are genetic concerns with being Ashkenazi Jewish, so I made sure to ask the counselor whether this was advisable. She said that we were even better off, in certain ways: Because I had gone through an extensive carrier screening (to detect genetic mutations that, when matched with other carriers, can cause genetic disease) before IVF and because Ashkenazi donors go through such extensive carrier screening.
I told her that we wanted to go forward with that donor and were wondering whether we needed to purchase the sperm right away. She said she had to check to see how many vials they had left. The donor had been a donor since 2013; it was two years later. But there was no concern about running out; this donor was not particularly popular, she said. But to me, that was perfect: I didn’t want the most popular donor. I wanted the donor who’s the best for us.
On figuring out the math. We decided Todd would have another surgery to try to get sperm to fertilize the frozen eggs. We agreed that we would use 30 eggs with the my husband’s sperm, and save six for the donor. That was our math: the bulk of it for Todd, and six for the donor. During this surgery, they were able to retrieve some sperm — and they used what they could to try to fertilize 30 eggs. Two or three fertilized that first day, and for the donor, it was six of six. Most clinics will only do a transfer on day five — five-day-old embryos are much stronger than three-day-old ones. But because we had so few, the clinic agreed to transfer an embryo — the only one that had made it, with Todd’s sperm — on day three. By that point, five of the embryos from the donor had fertilized.
Because of our odds, I pushed for them to transfer one embryo fertilized with my Todd’s sperm, and one with the donor sperm. This was something the clinic had to speak with an ethicist about; it’s not a typical situation. But they eventually agreed, and did the transfer. And then we waited. And after ten days, I was not pregnant. And we had no more embryos with Todd. He was out of town at the time, at a bachelor party in another city, so I had to tell him over the phone. It was really rough.
There were three day-five embryos fertilized with the donor’s sperm. So we went through another round, with just one this time. I got the result at work, where there were no private offices, except my boss’s office. But even that had glass walls, so it’s really no privacy at all. She knew everything that was going on, and had gone through this herself. She stood outside and waited for me to give her a thumb’s-up or a thumb’s-down. I gave her a thumb’s-up, and then I called Todd. It was great news, it was wonderful news, even if a little bittersweet. Our son is now 2 years old.
On life with two kids and IVF misconceptions. My husband really wanted kids, and I really wanted kids. We love and adore our children. We’re in awe of them and we feel incredibly grateful to have them — this is something we talk about every day.
We went through it all again for the birth of our daughter earlier this year. After his surgery, Todd had post-op appointments to check in on the recovery. At one of those, the doctor mentioned that there was one more vial — they hadn’t used all the sperm when fertilizing those 30 eggs, apparently. So when we wanted to have another child, we decided we would try the entire IVF cycle one more time. A full egg-stimulation cycle, all over again.
This is another time I felt lucky: I got 40 eggs, this time. But I was overstimulated and my hormone levels were so out of whack that we had to freeze and wait to do a frozen transfer, instead of a fresh one. This time, none of Todd’s sperm fertilized the eggs. We were disappointed but it wasn’t nearly as traumatic as before — we knew what to expect, this time. And we ended up with four embryos with the donor. We transferred one, and I did not get pregnant. For the next round, we transferred two embryos, and this time, one stuck.
When you’re in your 30s and doing IVF, people assume it’s because of an issue with the woman. And that’s fine. People can make that assumption about me. It’s not that I have prideful feelings about the issue not being with me. It’s that male infertility is almost never talked about — and when it is, it’s a joke. There’s zero nuance. I’ve never seen a single portrayal in culture that’s not a joke or an aside. Your ability to procreate is considered the measure of your masculinity. Todd is by no means a bro; he doesn’t define himself this way, but I think our culture does. My husband is an amazing father and a strong person. I think other men might decide not to have children, if they had to use donor sperm. I’m so glad that wasn’t the case for him.