What's on my mind?

What's on my mind?

Every morning, I'm reminded - I stumble out of bed and into the shower, and I have to wash carefully to avoid hurting myself due to the lingering effects of November's surgery. I'm reminded when I get out of the shower, because I have to be careful drying off for the same reason. I'm reminded when I look in the mirror before I get dressed, because I see that 4" scar that will never go away. I'm reminded when I get dressed, because I have to pass over a drawer full of underwear that I can't wear anymore, to find one of the pairs I've bought since my surgery that I can wear without pain. I'm reminded when I have breakfast, as I make my 1/2-caff coffee, because I know why that container says 1/2-caff. Or I'm reminded, if I drink regular coffee, that I can't drink as much. I'm reminded when breakfast is over, because it's time to go take my first two vitamin pills for the day. I'm reminded throughout the day, sitting my chair at work, as I try to make sure to keep my legs spread wide to keep the temperature down on my groin as much as I can. I'm reminded every time I visit the men's room, as I see the scar again, or have to be careful adjusting "things" to avoid hurting myself again. I'm reminded whenever I hear a co-worker pop open a can of Coke, because that's a caffeine luxury I can't afford to drink. I come home, and I'm reminded when I boot up my laptop, because I can't use it on my lap anymore. We have dinner, and I'm reminded, because I have to drink water or Sprite or lemonade. After dinner, it's time for two more vitamin pills, and I'm reminded again. I'm reminded every time I get undressed for bed, because it hurts to walk around naked for too long, and there's the scar again. I'm reminded every time I want to have sex with my wife, because I have to keep track of when the last time was. Less than 36 hours? Can't do it, gotta "store up." 36 hours or more? Okay, it's go time. Up to 72 hours? MUST get off, whether on my own or otherwise, or else counts start going down again. Then I'm reminded whenever we finally lay down to sleep, as I have to be conscious of my leg position, to make sure "things" aren't trapped between my thighs and to keep those "things" as cool as possible overnight. Then I wake up the next morning to do it all over again.

One Saturday recently, my wife had an out-of-town volunteer gig that would keep her particularly busy all day, so I offered to go run through the McDonald's drive-thru while she was getting ready, to give her a good breakfast that would help her hold out until dinner. I left the house happy for the opportunity to do something nice for my wife, to get her day started on a good note, but as soon as I pulled into the parking lot at McD's, I found my mind in an unexpected argument. I'd pick up breakfast for myself while there, too, but in the past, I've always ordered my drive-thru breakfasts with a large coffee. Immediately I felt guilty if I should do that, but I tried to tell myself that we don't eat breakfast out very often anyway, so one big cup of full-caff coffee wasn't going to hurt our chances for a baby. I drew my line in the sand and refused to let infertility win this ground - I just wanted to feel normal for a few minutes - so I ordered my large coffee and determined not to feel bad about it. But once I got home, after my wife left, I'd finished half the cup and felt guilty about drinking any more, so the rest of it got poured down the kitchen sink.

I share my office at work with a man whose wife just gave birth to their third a year ago - some 12 years after their second - so I get to listen to one-sided baby-related phone conversations every day. My boss at work has five kids with his wife, and they got pregnant within short months of getting married; he told me once that he wished he and his wife had had more time to be "just the two of" them. I work with two other men who coach the girls' softball and basketball teams for their respective daughters, which they talk about all the time. The road to our pharmacy (and the shopping center that contains it) is a wide two-lane street that becomes a narrow two-lane street this time of year, as both sides of the road are often lined with parents parking their cars to take their kids to the Little League parks on the left. I dearly wish we could be in the shoes of any one of them.

I don't regret any decisions that I've made. I don't regret that my wife and I decided to wait two years after getting married to be "just the two of us," before we decided we were ready to start trying to expand our family. I don't regret even one minute of the time I get to spend with my wife now; I didn't marry her to have kids, and even if we eventually do have them, I don't need kids to make me feel content in my life with her. Kids will never replace her or overtake her place as first in my heart. But I WANT kids, I WANT to be a father as well as a husband, I WANT my wife to be a mother too. I WANT the chance to try and be the best dad ever, just as I strive now to be the best husband ever every day. I WANT my wife to have the chance to be the best mom ever, because I know she absolutely will be. I don't regret all of the doctor visits, or the surgery, or the supplements I'm taking now, or the lifestyle changes I've made, or the drugs I may have to take in the future, all in an effort to fulfill that deep desire for both of us. Even if we never end up with the end result we hope for, I don't regret the trying. Because I couldn't live with myself if I gave up without trying, and I am NOT ready to stop trying now.

The road may be damned hard, but I've said from the time that I began dating my wife, and I still believe it every whit to be true today - there is NOTHING that we can't face together. We've been through hell together already, and came out stronger on the other side. We don't know where this road will take us next, and we don't know if it will ever take us where we hope to be at all. And that's maddening, and that's heartbreaking. But it's still a road I'm determined to walk. It's still a battle I'm determined to fight. I'm determined to carry on with my wife at my side, determined to help her through this in every way that I can, just as I know she's determined to help me likewise. Infertility has wounded me in many ways, but IT WILL NOT TAKE ME DOWN.

Male infertility book reviews

Back in October when we were first diagnosed with this, I soon began looking for infertility resources from and for a male perspective. I found a recommendation for one book, and came across a couple of blogs, but that was it. So I bought the book - "Overcoming Male Infertility" by Leslie Schover & Anthony Thomas - and while it's a great clinical book for potential diagnoses and treatments, the chapter on coping could be summed up as, "This is tough for guys to deal with. Do something about it or else you'll go nuts." I had already read a lot of the medical info online, so the coping portion was what I was most interested in, and that part was sorely disappointing. Fast forward to two months ago, and I joined Resolve's online forum, making an introductory post there. On that post, I mentioned the lack of resources for guys I had encountered, and a few folks recommended a few books I had never found or had overlooked. All told, four titles were mentioned, and I've now read all four.

First up is "Maybe Baby" by Matthew Miller. Miller writes for a living (newspapers), so he writes very well; his book is largely sourced from his relatively popular blog of the same name. His book is much more in line with what I was looking for when I first began searching for resources; rather than clinical, it's a first-hand personal account from the male half of a couple on their journey through infertility. However, even though Miller states "I am an infertile male" in the opening pages, the diagnosis for him & his wife is really more unexplained infertility than anything, so their situation differs from ours. Some of the emotions he expresses are very much things that I can relate to, and it's obvious that he loves his wife very much, so those are both points in his favor. But ultimately the book was much less helpful than I'd hoped it would be, because I mostly didn't relate very well to Miller, as I don't think we'd have much in common. First, he's an extrovert (which I'm not), and it seems he didn't have much trouble at all talking to others about their infertility struggle (which I do), so he never expresses the loneliness that many men in this situation often feel. Second, his personal life story is very unique - from being a 500-lb. teenager to a 30-something health nut & workout addict. Kudos to him for taking charge of his health, but I have never been in either situation, so I cannot relate to either extreme, and those are defining characteristics of his life. Third, he's openly and completely non-spiritual, whereas I am very spiritual, so he offers no helpful perspective at all in that regard. And finally, the book just seems unfinished; it ends as he & his wife are gearing up for their first round of IVF. I understand that not every infertility story necessarily needs to end with a baby, but regardless of the ending, I think Miller's book would have benefited from being written later on in their journey. He talks in the book about signing the book deal that would become the book, so the impression given is that it was published when it was due to publisher deadlines, rather than when the manuscript was actually ready, mature, and complete. Final word: "Maybe Baby" is not without value, and others may benefit from reading it more than I, but it was ultimately disappointing and could have been better.

Next is "What He Can Expect When She's Not Expecting" by Marc Sedaka. Sedaka is a notable writer for television, which explains how they had the money for the 10 rounds of IVF, 10+ rounds of IUI, and all of their other infertility treatments listed on the back cover. Unrealistic availability of funds aside, Sedaka writes a book that aims to give men a better understanding of what their women are thinking and feeling as they deal with inferfility. This is a great idea and an important topic to address, but it came up a bit short for me in a couple of ways. First, while the diagnosis for Sedaka and his wife is again "unexplained infertility," the book seems to be primarily written for dealing with cases of female infertility; it says virtually nothing about male infertility, and nothing at all about how that particular diagnosis can and will affect your wife. Second, while I'm certain that some men will benefit greatly from reading & heeding the advice in this book, it strikes me as mostly "don't be a dick!" common sense. And relationship common sense. "Be open and honest with her, listen to her, be patient with and supportive of her even when she's dealing with emotions that you don't or can't understand." All good reminders, but nothing that years of striving to be a good husband hadn't taught me already. All in all, it's a very quick read (I finished it in one 2-3 hour sitting), so it's worth a look if you can find a cheap copy or (as we did) find it in your local library. Just don't expect life-changing insight.

Third is "How to Make Love to a Plastic Cup" by Greg Wolfe. Let me start by saying that this one is funny. VERY funny, in places, even though I at first resisted Wolfe's attempts at humor, as infertility is not a topic I've found myself often able to laugh about. Wolfe is a comedian by trade, so he's well suited to the kind of off-color, off-kilter take you'd expect from a book with a title like that. The book is not all laughs, however, as Wolfe knows first-hand just how difficult dealing with an infertility diagnosis can be. This is the first of these books in which the author's diagnosis is actually male factor infertility, so it's therefore unsurprising that the chapter entitled "Real Men Don't Cry (However, They Do Sometimes Quietly Sob into Their Pillows)" is one of the best bits of writing I've yet read about how men are affected by all of this stuff. He gets insightfully personal in many other places, as well, but it should be noted that this book's purpose is primarily informational, like "What He Can Expect..." but unlike "Maybe Baby." It should also be noted that a majority of this book's real estate is devoted to discussing the IVF process, which is great if that's what you're facing, but less helpful for couples who aren't there yet or who may not get there at all. I would say this is the best book of the three discussed thus far, especially for men dealing with male factor issues, but it still isn't entirely what I had initially set out hoping to find.

Saving the best for last, we come to "Swimming in Circles" by Michael Barr. Barr is another writer by trade, and he tells the story of the four-year road that he and his wife walked together in their quest to start a family. Like "Maybe Baby," this is a personal book, but unlike "Maybe Baby," this book hit home for me in areas where that one missed: Male factor diagnosis. Flawed, but relatable, protagonist. At least a touch of a spiritual view. And resolution to the story on the book's final pages. Like "Plastic Cup," this one also has a healthy sprinkling of gallows humor, which serves well to even out the heart-wrenching scenes when bad news inevitably arrives. Barr wrote the book as a means of coping with the struggle himself, and in an effort to impart hope to other guys like him - like myself - who may be facing similar struggles. It is an excellently told true story that I had genuine difficulty putting down, transporting me to see life through his eyes and leaving me feeling I had just watched a profoundly personal, first-rate film. This is the book I would recommend without qualification to any other guy on this infertility journey, and to the women who love them and who might want to understand their guys a bit better. It's a great story and a great read even if you're fortunate enough that you never have to deal with infertility a day in your life. I had given up hope that a book like this existed, but I'm deeply grateful to Michael Barr for proving me wrong.

On donor sperm

If you asked the average Joe or Jane on the street about "sperm donors," they would most likely think of the slang usage of the term for deadbeat dads who "hit it, quit it, and forget it." The vast majority of men out there have never given a moment's thought to "donor sperm" in the clinical sense, because they've never had to... unless they themselves have donated, in which case they'll think of it in positive terms. Until the last few decades with all of the advances in reproductive medicine, "donor sperm" was not even a clinical term, so it's only the few most recent generations of men that have ever had to consider the issue at all. Those advances have allowed infertile couples now to have children that were previously impossible for couples in their position even just a few years ago. But those positive developments have brought along with them new, hard questions that have to be answered. Like this one.

Fortunately my wife and I are not at the point right now that we have to make a decision on this. My semen analysis stats, while not good, are good enough at least that I'm hopeful we'll never have to seriously consider the option of donor sperm at all. We're doing all we can to improve those chances even further, and from what I've read, we've got a legitimately good shot. But the question of donor sperm HAS already come up - my mother-in-law has asked my wife about it. Apparently others have, as well. And every time the topic comes up, it seems to stick in my brain far longer than I expect it should. So, if for nothing other than my own peace of mind, I'm writing this now to try and lay my own thoughts to rest.

I have to be honest: I don't like the idea. I don't believe that ANY man does, even though some are quicker to accept it than others, if they accept it at all. But the question that burns in my mind, knowing that I don't like it - why? Beyond the obvious, primal, procreational urge of wanting to pass on one's own genes, what is it about this particular issue that causes my brain to freeze up and run in circles every time it's been brought up? And if I don't like it, and no man likes it, then how do some of those men still reach the point of acceptance?

The first brick in the mental block wall is the idea of your wife being impregnated with another man's seed. I know that it's not at all the same thing as her having a secret tryst with the milkman - there's no emotional betrayal or breaking of vows involved - but the physical result is the same. It doesn't feel like cheating. But it DOES feel like admitting ultimate failure as a husband and a man. "I'm sorry, my beloved wife - I have failed you in my duties as a husband. Please go find another man who can give you the children that I cannot, the children that you so deeply desire and so richly deserve." Yeah. It's like that. And then you spend the next nine months walking her through a pregnancy that you know you couldn't create.

Second, and maybe this is trivial, but I have serious concerns about the character of the kind of men who would donate sperm. I know that they put these men through an extensive screening process, so Joe Hobo on the street can't just show up at the sperm bank, make a deposit, take his check and leave. I know that many men, like myself, are capable of altruistic motives - "I want to do ______ so that I can help others who need it." And I don't doubt that many or most of these men make these donations with that motive as at least one of the reasons on their mind. But let's be honest - screening process aside, it's really easy for men to "donate" sperm. I would trust donor eggs from women much more, because a woman has to go through physical hell to do it; yeah, they still get paid for it, but the physical obstacles to the process are going to weed out the large majority of the women who are only in it for the money. You have to really WANT to donate your eggs if you're a woman who is willing to put herself through that, and that desire is probably most often driven by a desire to help others out. For men? Eh... not so much. I imagine that most of them are driven by the payday and/or the ego boost ("I've got women PAYING to get my sperm!") at least as much as any more selfless motive.

I also don't have a real great history in my life with "sperm donor" and non-biological dads - and "sperm donor" here IS used in the negative slang sense. My own biological dad was essentially a sperm donor - NOT in the clinical sense - as he and my mom divorced while she was pregnant with me, his son. I'm now 32 and I've never met him, never talked to him, never received any form of support from him at all. My mom remarried three more times after that, but none of those step-fathers worked out too well: the first was still married to another woman, the second was an abusive slacker, and the third seemed great at first but ultimately tried to rape and kill my sister. My grandmom never had anything good to say about my cousin's step-dad after her biological dad - my uncle - died. I knew a great adoptive dad living down the street from where I grew up, and one of our closest friends now was likewise adopted and has a beautiful relationship with his adoptive parents. But I never met a good step-dad until after college, and with donor sperm, a step-dad is essentially what I would be... just one who was there for the child's entire life, instead of coming along at some time later.

I don't even think that those are the biggest obstacles about this in my mind, though. It gets more emotional than that. Like, how would we ever tell the kid where he or she came from? You wouldn't tell them when they're too young to understand, of course, but never telling them at all is NOT an option, either. Eventually they would be on their own, talking to their own doctor about whatever, and that doctor is going to ask about family medical history. In such a situation, they would NEED to know that any health issues from me or my side of the family would be irrelevant to them, because they would not be biologically related to me. Letting them think they were related to me and then pass on incorrect health information could lead the doctor to an inaccurate diagnosis or unnecessary (potentially harmful) treatments, and I couldn't live with myself allowing that to happen. So you HAVE to tell the kid sooner or later. But even if you do wait until they're old enough to understand, I can envision the tear-stained conversation now: "Mommy is your real mommy, but daddy isn't your real daddy." "What?? What you mean that daddy isn't my daddy? Who is my real daddy?? Why isn't he here?? Why can't daddy be my real daddy?? You lied to me!! You always lied to me!!" Even somehow getting past that, I can imagine the teenage rebellion now, too: "I DON'T HAVE TO LISTEN TO YOU!!! YOU'RE NOT EVEN MY REAL FATHER!!! YOU'RE NOBODY'S FATHER!!!" The idea of ever having either one of those conversations slays me through the heart.

I've always vowed, even before I got married, that if I ever did get married and had kids of my own, I would NEVER abandon them and do to them what my father did to me. Cruel irony, then, that if we're forced into using donor sperm, my resolve won't matter and they'll still end up wounded much the same. They'll be haunted by the same questions I was, and still am: "I wonder what my dad was like? I wonder how much of me comes from him? I wonder what we would have done together? I wonder what I missed out on?" Even though I would be there every step of the way, raising them with love, doing everything in my power to be the best damn dad that any kid ever had, my best efforts wouldn't matter and they would be left with a father wound regardless. That's not fair to any child.

All of that being said... if we ultimately can't get my sperm to work, our options for having a child come down to adoption or donor sperm. Adoption is noble, in that you're giving a chance to a kid who otherwise might have had none, and maybe because of the positive association I had early on with an adoptive father, that's a more positive path in my mind than being a step-dad. But my wife is not keen on the idea, and in truth, I'm not either; I'd much rather have a child of our own... or at least half our own. Going forward with a decision that neither of us are keen on seems to be an inherently bad idea, so that puts adoption last on the list. But the complicating issue for me is that, whether we adopt or go with donor sperm - the result for me is the same. I wouldn't be biologically related to the child in either case; there would be no "bone of my bone, and flesh of my flesh." At least with a donor, the child would be related to one of us, and it would allow my wife the experience of pregnancy that she so desires. It would allow me to do many of the things that normal dads-to-be do, too, like caring for my pregnant wife and welcoming that beautiful new life into the world. In a sense, it would be fully both our child, in that it's a child that otherwise wouldn't exist if it weren't for the two of us together. It never "belonged" to anyone else. But, going back to that question of acceptance and how dads-via-donors reach that point, there's an issue of grieving. A BIG one.

Most dads say that the proudest moment of their lives was the moment they first held their child, that "little me," in their arms. But to accept donor sperm, I'd have to accept that there would never be a "little me." There would be a little baby, a "little me" for my wife, an "our child" for both of us, who would make us "parents" and would call me "Dad." But there would be no "little me" for me. I have no doubt in that situation that I would still love that baby to pieces, I would love my wife then as not only my wife but also as "mother of our child," and I would strive every day to be the best damn dad that anyone ever saw, just as I strive (and would continue striving) to be the best damn husband now. I have no doubt that, taking that child to Little League or to soccer or to ballet or to whatever they were into, I would be that proud father standing by, saying "that's my girl!" or "that's my boy!" But whether they were wonderful or terrible, I could never be proud that they were wonderful or terrible because of me. Every time someone said, "Oh, he has your eyes!" or "Oh, she has your smile!", I would smile and nod, but it would be an arrow to my heart inside as I thought, "No... they don't." I could never say, "She gets her art ability from you, but she gets the music from me," because she or he wouldn't get ANYthing from me. I wouldn't love the child or my wife any less if we had to go donor. But I would be forever wounded inside.

The $1,000,000 question, then: Would you do it? I can't answer that question right now, but fortunately we don't have to make that decision yet. I'm still very hopeful that we won't have to make that decision ever. But would I consider it? If it came down to it, yeah, I believe I would. I would have to say that I would want to exhaust every possible option to make it work with my own sperm first, because I don't think I could accept opening myself up for the inevitable wounds and living the rest of my life wondering, "What if we had tried just once more?" Donor sperm is not a shortcut and should never be used as such, and while the waiting sucks now, it's not gonna matter when we're watching our kid walk across the stage at graduation, or walk down the aisle at their own wedding, that we had to wait a few months longer now to reach that point. I realize that there does have to be a decision eventually if it's not working on your own; you can't keep trying on your own forever, or eventually time runs out. I've read about IVF and I really, REEEEEEEEEEEEEALLY don't want to put my wife through that; I don't know if I could accept that either. So would that decision point be before IVF, or after, or...? I don't know. I really don't know right now, and it's not only my decision anyway, so it would have to be something my wife and I decide together. I'd have to be convinced that we were both fully on board with any of these tough choices before I'd accept making them.

But I'm still hopeful. And grateful that we have good reason to be hopeful. The waiting and trying and failing and picking ourselves back up and dusting ourselves off and waiting and trying again all sucks - no doubt about that. But the end result is worth it. So we carry on. Together.