There are times when some people just know there could be a problem. Call it worry, intuition, or education — occasionally, fertility patients are people whose strong first suspicions are confirmed by physician diagnosis. For them, getting to the point of choosing fertility treatment can often provide a sense of relief.
Take, for example, Chris.
“We knew there was a problem… I knew there would be a problem. I just didn’t know to what extent,” the man in his mid-thirties says, describing the time before his own worries were confirmed at Shady Grove Fertility. After a few years had passed, Chris and his wife, Ronda, had done all the investigating and soul searching they needed in order for Chris to decide “Let’s just do this.”
The Problem
Chris was diagnosed with diabetes over 15 years ago. He admits that his response to the diagnosis was like that of many young men. “I wasn’t too on top of taking care of it.” In addition, Chris eventually learned that he needed treatment for hypertension.
Over time, diabetes and hypertension both take a toll on several of the body’s systems. According toDr. Frank Chang of Shady Grove Fertility, “Patients can have a higher risk of retrograde ejaculation, possibly as the result of the disease process itself or resulting from medications used to treat the disease.”
Retrograde ejaculation occurs when sperm cells enter the bladder rather than being propelled through the urethra during ejaculation. Other conditions that could lead to retrograde ejaculation are multiple sclerosis, spinal cord injury, back surgery, and the most common cause, surgery of the lower bladder or prostate. Chris was knowledgeable about the potential reproductive system damage from his diabetes. By the time he and Ronda wanted to start a family, he believed from the start that fertility treatment may be warranted.
The Cautious Approach
The couple, who have known each other for 17 years, had always wanted children after their first two years of marriage. As time passed, they found themselves surrounded by family and friends who were having their own children. Speaking together, the couple echo each other’s sentiments:
Chris: “We always wanted kids…”
Ronda: “… but we never put a time limit on it…
Chris: “Well, maybe, like, 35 [years] when you start doing the math. The big factor was everyone around us was having babies, so you start wondering ‘why not us?'”
About their first attempts to conceive naturally, Ronda remembers, “We realized something was going on here, and we needed to get it checked out.”
“I didn’t need a doctor to tell me that it was me,” recalls Chris.
They went to Shady Grove Fertility for an initial consultation. Then the couple stopped pursuing treatment for reasons that are only now vaguely clear to them. “We hadn’t known anyone back then who gone through fertility treatment. It sounded like the cost would be too much. It was all just too much information at once,” Ronda explains, “ It was overwhelming”.
Five years later, things fell in place. A family member had successfully achieved pregnancy with the help of fertility treatment. A friend who had recently been successful with fertility treatments recommended they try again. Ronda reflects on how timing isn’t always predictable. “It was a different time, things were better as far as the treatment options Shady Grove told us about… maybe we just hadn’t been ready up to that point.”
Chris feels like his health issues prompted a sense of mild urgency to have a child. He’s been in and out of the hospital more than once recently to combat his Stage 3 kidney disease, a consequence of diabetes. “My brother had a daughter, I’d always wanted a child. It was time,” he says assuredly.
The Decision
After a few rounds of blood work to get at the root of the couple’s infertility causes, the decision was made to pursue IVF using Chris’ sperm after trying to alkalize it. Dr. Chang explains the retrograde sperm recovery process. “Sperm cells can be retrieved from urine following ejaculation. Sometimes the result is cells that are too acidic so we administer an alkalizing agent.”
In Chris’ case, that would mean drinking a lot of Alka Seltzer. “I drank that stuff on two different occasions,” he describes. “I started to wonder if this was a waste of time. The second time, drinking it made me ill, so I said ‘no’ to their request for a third attempt.”
Though he spent his younger years mostly ignoring his diabetic condition, a more mature Chris followed up regularly with his primary care physician. He knew from those visits that he’d always had too much protein in his system. His sense of urgency combined with knowledge of his own medical conditions translated to decisiveness, which he communicated to his Shady Grove treatment team. “They were trying to deter me from surgery. I think their primary concern was the pain involved. I told them that the pain wasn’t a problem; we want a child. I said ‘let’s just do this’, and they heard me.”
The Resolution
While the couple’s cause of infertility was male factor, treatment required full participation of both partners. Any time IVF is the chosen therapy, much of the time and discomfort is placed on the woman’s shoulders because of preparatory drugs used and related monitoring appointments.
“All the shots I had to go through… it wasn’t too bad,” Ronda recalls as she and Chris both laugh.
“Well,” he jokes, “you know hindsight.”
But Chris went the extra mile, something Ronda says he does in lots of situations. “He was more involved in our wedding than any man I’ve known.”
“I don’t know about other guys,” Chris modestly reports, “but being involved in this whole thing makes you appreciate it so much more.”
He describes how he would sometimes be one of the few men in attendance at Shady Grove Fertility’s IVF education classes. “I could see from the information they were giving on the whole process — from the egg retrieval to embryo transfer — that it might seem there’s no reason for the men to be there. But there was at least one woman who was texting her husband back and forth during the class, and it became apparent how much Ronda needed me to be there.”
Ronda concurs, “There’s so much information to absorb, it was incredibly helpful for him to be there, hearing it from the staff just as I was so we could compare notes later.”
The couple gives high marks for instructive and empathetic support to both Dr. Chang and their IVF nurse, Kavitha Fernando RN. As for the doctors’ concerns about painful sperm retrieval surgery, Chris says it was a breeze. He was under intravenous sedation, during which time sperm cells were aspirated directly from his testes with a special needle, and the entire procedure took around 15 minutes. “I may have psyched myself out or something,” Chris offers as an explanation for why he had no pain at all, before, during, or after the procedure. “Or it may be because they only had to go in with the needle one time.” Meanwhile, Ronda was undergoing egg retrieval at the same time.
“The whole process, for both of us, took only 45 minutes,” she reports. The physicians retrieved 18 eggs, and lab technicians fertilized 15 of them. The couple conferred with their treatment team and, because of Ronda’s petite size and related concerns about potential multiples, the choice was made to transfer only one embryo of very high quality.
The result: Ronda is due with the couple’s first child in December.
The Future
“We don’t care if it’s a boy or a girl,” Ronda and Chris agree. “We’re just happy to be having a baby.” If they choose to try a subsequent pregnancy with their remaining three frozen embryos, it will be soon. Chris’ kidney disease is manageable right now, controlled with nutrition and medication. Still, he’s a realist.”Age-wise, I want to be fair to my children,” says the newly expectant father. “I want to be young enough to really enjoy them.”
While he admits, like so many of us, that if he knew then what he knows now, “I would’ve done things differently and taken care of myself more.” That slight regret, though, recedes further into the background as the time for his child’s arrival approaches, thanks to technological advances in fertility treatment and to his own clarity of decision.
