Thursday, 26 May 2011

Guest Blog - Overcoming male factor infertility

The struggle with conceiving my family is not the usual one you read about in infertility stories.  As women, we generally reach out for others to talk to, confide in, and cry with.  We openly share our feelings and emotions with like minded others and our close friends.  So when my husband and I struggled to fall pregnant, my girlfriends were all diagnosing the cause of my infertility- we all knew of someone who had been in that situation.  My story read a little differently...

My first marriage ended just after I lost my first baby to an ectopic pregnancy at 7 weeks.   It happened the day before my first scan to see the heart beat, my HCG levels were high – so high we thought it may have been twins, and we never expected something could go wrong.  So when I was rushed to hospital, doubled over in pain, I argued with the OBGYN, on weekend call, that after an inconclusive ultrasound that he did not have to do a laparoscopic exploration to see what the problem was.  What he found was the embryo that had burst from my left tube (reason for pain), floated across my stomach and had attached itself to my right ovary, heart still beating!!  The doctor removed the embryo (to this day I’m still unsure how I feel about that) and luckily my tube was saved.   What was exciting was that another embryo was still in-utero, but not for long. A week later I miscarried that too.  I’ll never be sure whether it was due to the decline in hormones from taking one away but what was most devastating was that it was our first attempt at IVF. You know you go through the devastating diagnosis, all the injections and hormones and anxiety and finally fall pregnant...the very first time...what a miracle...only to lose it so quickly.  I remained optimistic, everything happens for a reason. I believed that God had a plan for me and as it played out, it may have been a blessing in disguise with the ending of my marriage too.  I can only imagine how children would have complicated that.

So I convinced myself that I could be...would be a fabulous 30 year old single woman.  I could have the best of everyone’s world; a career, the doting Aunty that could whisk her nieces, nephews and God children away for an exciting day of spoiling and then return them, still being able to sleep in and do as I please.  I believed that if I couldn’t have children of my own I would involve myself in children’s lives and never miss out on the precious moments.   I was lucky on two accounts, to have beautiful friends that understood and allowed me to be a second mum to their bundles of joy and to be a primary school teacher, given the privilege of working with children every day.  Indeed my life was blessed with the many children around.

Of course being single didn’t last forever, and when my Mister Right came along, we knew that children would be a big part of our lives.  But after being together for a year I knew something wasn’t quite right.  I had never been able to take the pill, it made me chronically ill, and although we practised contraception by timing the days of my cycle, I didn’t think I could be that clever, to never even have a pregnancy scare.   My first encounter with IVF occurred as a result of Male infertility.   A workplace accident and some chemical mishap we believe was the cause of my first husband’s low sperm count, low motility, mobility and morphology. Oh yes, the wonderful world of male infertility is just as complicated, confusing, frustrating and emotional as a woman’s journey. Yet so little is known about the causes and there is even less you can do to fix it.  In many cases IVF is the only solution. 

So having “been there before” so to speak, when Mr Right proposed I knew that our dream of 4 kids would not be easy.  Adam had spoken about his testicular issues as a teenager – 3 torsion operations, one with severe complications, and it was this information that confirmed my suspicions. So it was off to my OBGYN fertility specialist for tests.   You can imagine the poor man’s confusion when I arrive – Same woman...different name...different husband...same infertility problem!  He even asked if infertility was a prerequisite for my choice in husband.  We found out that not only was Adam’s sperm count (number), mobility (movement) and motility (speed) low, but 99% had abnormal morphology (shape).  Our only choice...the most complex form of IVF, Intra Cytoplasmic Sperm Injection (ICSI), where they take the sperm sample, wash all the bad ones away, pick the good ones and inject a single sperm into the egg.  Of course this news came as a huge shock to my husband and his family.  He wanted someone to be accountable, talked about taking legal action out against the Dr that did his testicular surgery.  He was embarrassed, belittled and felt less of a man.  His parents refused to believe there could be a problem. He was one of 6, his mother one of 8, and father one of 15, clearly there were no fertility issues in his genes.  But through his faith, Adam quickly learned to accept the cards he was dealt. He chose not to sit and wallow in self pity, blaming the world for this speed bump but to find out what we needed to do and keep our dreams of a family alive. I still loved him, wanted to marry him. I certainly didn’t blame him for us having to do IVF and was happy to go through with whatever was needed to fulfil our family dreams.  God sent this challenge to us, not him alone, so together we would face it.  So as well as ceasing to drink coffee and alcohol, Hubby also started speaking openly about his infertility, something his fertile friends found uncomfortable, but other infertile men found inspiring.  I was proud of his honesty, courage and conviction to stop the secrecy and shame that surrounded male infertility.

With the financial help of Adam’s sister, who had recently had fertility assisted triplets and understood our desperation, we set off on our IVF journey.  While I turned into a crazy woman on all the drugs, put on weight, suffered mood swings and had the most severe nausea, I never lost hope that our miracle would happen.  If my fertility was ok and the scientists at Monash played Mother Nature to combine the egg and sperm then all I had to rely on was my body doing what came naturally and carry that embryo to term.   But of course my age came into play – at 36 and rapidly declining fertility rate, we were warned about our decreasing chances of success.  Who would have ever thought a young virile 24 year old man and a 36 year old woman (yes that’s right, 12 years difference) would have so much trouble.  Of course we had all the advice in the world from fertile couples... “Get drunk and forget about it, it will happen if you stop stressing about it”...if only it were that simple.

Over a period of 3 years I was lucky enough to only have to go through the full IVF drug cycle twice.  Both times I produced between 17 and 21 eggs, between 10 and 15 fertilized and resulted in 4 to 6 healthy 5 day old blastocysts.  And the rest of our journey was fairly easy. After each drug cycle, our fresh embryo transfer never worked, but we seemed to have luck with our frozen embryos. What can I say, our babies are icicles!
In January 2007 our first miracle arrived. A bundle of pink and an absolute joy to our hearts.  But as a first time, older, IVF mum, motherhood was not all smooth sailing when she arrived.  A reflux baby, and bad sleeper sent Mummy into a tail spin.  I was at the GP weekly in tears, terrified I had Post Natal Depression. I was always reassured I was fine and it was normal to feel this way, but in hindsight, I know it wasn’t.  In years following I believe I did suffer from Post Natal Anxiety Disorder.  Belmont private hospital speaks quite openly about it but it is not often recognised and it was a beautiful midwife at Sunnybank Private Hospital who counselled me and acknowledges the difficult time I must have had.  Zélie Ava was the only successful pregnancy from our first IVF drug cycle. Hard to believe out of 17 eggs that only 1 full term pregnancy could be achieved!
When Zélie was 10 months old I returned to Monash to begin my next IVF cycle.  At the time I was far from ready to have another baby, but didn’t know whether we would be lucky enough to fall pregnant as quickly again.  July 2008 saw the early arrival of Lacey Addison.  Both Adam and I felt that she completed our family. We were so much more relaxed with baby number 2.  It allowed me to enjoy being a mum to a tiny baby and breastfeed, as I missed out on that the first time.  So our decision to proceed with our dream of 4 children was in question.  At this stage I was 38, we only had one embryo left (yes again out of 21 eggs only 1 baby and 1 embryo) and until now each time we had a frozen transfer, embryos had died in the thawing process. So we held our faith, and believed if it were meant to be it would happen.  To our surprise the final embryo thawed successfully and our bundle of blue arrived in June 2010. All 3 babies were born by C-section, so nothing seemed unusual with his birth.  It wasn’t until he was whisked away for his bath that things went downhill.  It all seems a little bit of a blur now, but I didn’t see Tate Alexander for 12 hours.  When the nurses sent a photo of him to my room I knew things were serious.  Tate’s lungs had not fully developed and he had an infection in them, all very fixable, in time, but to a Mother who cannot hold her child after everything they have endured through IVF it is heart breaking.  I was happy for God to put me through the trials of becoming a parent, but to make my child suffer was terrifying and inexcusable. How could he make us suffer again?  I could not hold Tate for 3 days, although it felt like a life time.  His arrival was traumatic for his sisters – seeing him all wired up, for his Daddy, who was overjoyed at the arrival of his son and whom protected me from the truth as to how sick he was.  But he was a trouper and from the time I held him he went from strength to strength, making it home a week after his birth.  Now as his first birthday approaches, the pain of that time is washed away by the joy he brings to our lives.  

Three beautiful children in 3.5 years.  I never would have believed it possible when we first heard our infertility fate.  How blessed we are, how incredibly grateful we are to the team of specialists at Monash IVF Sunnybank, how eternally indebted we are to my awesome OBGYN/fertility specialist who transferred my babies into me as cells and delivered them into my arms 10 months later.  It has been a truly amazing journey. One that I will never look upon as a burden. I loved my baby making process.  The medical team who assisted us are a part of our family forever.  For my journey I am stronger, more humble and protective of what we struggled to achieve. I have 3 miracles and I thank God everyday for giving me the chance to be a Mother.

To all of you who read our story…thank you for taking the time.  We simply pray that our journey will help you find some hope, and faith.  We pray that you too will realise your dreams and be as blessed with the family you have dreamed of.

Our love and strength are with you all,

Adam and Christine


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