Coming to terms with the fact that I will not be able to have a child with my own sperm   

 

I always had this nagging thought at the back of my mind that I would not be able to sire children via my own seed. This ill-founded fear dated back to childhood, as I was brought up in a female sibling dominated house, was never the alpha male in the pack and was never especially successful at charming women or sport. So in a strange way this sense of foreboding helped to prepare me for the negative diagnosis long before it came to fruition.

That said,  I always dreamt of having my own children via traditional means and never sincerely doubted there would be any issues: there was never anything obviously physically wrong with me (I now know that infertility issues can strike down all sorts of men, no matter how ostensibly virile) and for a long time I naively assumed it would be a case of settling down with “the one” and letting nature take its course.

How wrong I was – getting the initial bad news from our GP (who had a woeful bed-side manner at the best of times) was genuinely “ball-breaking” and for several weeks my wife and I told no-one as we awaited the results of a confirmatory second semen analysis. But the reality was I (and my wife) was already starting to prepare (both mentally and practically) for the worst outcome so, once the sorry news was confirmed, we actually did not lose much time looking into what our options were.

We did not immediately give up on me: two microtese procedures followed during the next year, culminating in a near miss second time around, when our amazing urologist (Dr Amr Raheem) somehow retrieved 9 sperm from deep within my testicles, 2 of which went on to form good quality embryos with my wife’s IVF harvested eggs, only for neither embryo to take once inside the uterus.

After this we knew that achieving success with my sperm had to be put to one side so, from a timing perspective, we moved onto the process of looking into using a sperm donor within a year of my original azoospermia verdict: and whilst this may sound almost dispassionate and a little rushed, we had plenty of time to grieve and (over) think our options during these 12 months.

Ultimately each personal circumstance is different and there is no right or wrong about how long it may take a man to come to terms with an infertility diagnosis and what options may be deemed acceptable alternatives for having children. For us we were blessed that my wife was able to carry our two donor sperm conceived children full-term and using donor sperm also came with the huge advantage of eliminating the wretched BRCA 1 cancer gene I had inherited from my father.

To sum up, I would say it took about a year to come to terms with the news and, like a typical male, suspect I was helped by at least knowing I had done everything I practically could do (including eating walnuts and cranberries galore and cutting out alcohol before the two microteses), before refocusing on the so many positives donor sperm can bring into the lives of a couple in need.

 Did you feel a disconnect towards your wife? 

 

Good question and one which I can honestly answer with a “no” but, again, I am conscious that other males going through something similar may feel something very different to what I experienced. In my case, I was lucky to have a very supportive wife who, in a strange way, had always been understanding of my “alpha male” insecurities. Mrs Silver is literally “the girl from next door”, so we had known each other (albeit not dated for) a long time before we got married, and we very much bought into the loving each other unconditionally concept, including whatever issues we both may have brought into the marriage (both known and unknown).

I would, however, be lying if I said it has always been peaches and roses between Mrs Silver and me. Both of us are capable of saying cruel and insensitive things in the heat of the moment, especially when the chips were down as they so often were in the early days of my diagnosis (in 2014). But we also massively benefited from having the most amazing of fertility counsellors, who we were visiting at least once a week back at that time and who we still frequent occasionally now. This lady is one of the most kind, special and patient people I have ever encountered, a wonderful listener and, most importantly, calm mediator whenever my wife and I needed to “talk through” some fertility or other domestic issues.

 

At the time most definitely “yes” but, ironically, as we come to the present day, we have two of the most wanted children ever, two we would not swap for anyone else. Taking a step back, I suppose one of the fundamental concepts of marriage is that the husband will “give” the wife at least one child that is physically strong and healthy. But in our unique situation, fate had already dealt us a rather deadly blow, as only a year earlier we had found out I had the BRCA 1 gene (which claimed the life of my older sister via an aggressive form of breast cancer late in 2013). It was with that in mind that we had first considered fertility treatment of the type (PGD) that might allow us to create embryos that did not have the BRCA 1 gene inherited from me. The only problem was that, for us to do PGD, I needed lots of healthy swimmers, something which we were soon to discover I had none of!

So whilst I do to this day continue to feel a degree of shame, the guilt has most certainly now passed, as I was already feeling guilty about (unknown at the time in 2012) bringing the BRCA 1 gene into our marriage. Therefore, in a strange way, my subsequent azoospermia discovery meant that we soon started down the path of using donor sperm and eliminating our original fertility problem of BRCA 1.

I have written several articles for IVF Babble that touch on the subject of how being infertile does not necessarily make you any less of a man, as I look to help reduce the unmerited stigma associated with this “taboo” subject, as well as raise awareness of this fundamental evolutionary concern (with male infertility statistics rising alarmingly during the last few decades).

But the sad reality is that, whilst my wife and most others have been incredibly supportive of the issues I have faced, there are always some people out there who will not be so accepting or will revel in another’s misfortune. Therefore, whilst I have written at length about why men in similar situations to me (i.e. infertility caused through no fault of my own) really should not be ashamed,  I do continue to feel some shame, albeit this is a feeling that I have managed to live with, taking positive steps to move on, maintaining as thick a skin as possible and being able to offload to close friends and family (and our counsellor) as and when the need has arisen.

I think my answers above have already part answered this question but, in summary and no particular order: counselling; taking time to consider our options; supportive family and friends; being practical and thick-skinned; hard work and patience; a giant leap of faith!

 

 

In connection with the last part of my answer above (“a giant leap of faith”), that is the stark reality of the modern world you and I and others are experiencing our infertility issues in. The first IVF baby, Louise Brown, was born just over 43 years ago. So, If we had been living at a time before 1978, fertility treatment would not have been an available option, with adoption the most prominent alternative. Men such as ourselves may have also found it even harder to maintain a long-term a sexual relationship (as unable to provide a child) and, within certain societies, faced social ostracism.

We are certainly blessed to be living at a time when there are some amazing medical solutions to our problems but, at the same time, it would be a highly unusual fertility journey that did not throw up a lot of challenges, including some big moral dilemmas. In our case these have included whether to tell other people we were using donor sperm (“yes”), whether, when and how to tell our own children of their miraculous conceptions (“yes, from an early age, via books”), what to do with our one remaining frozen embryo (“probably donate to research”), whether to seek out any of our children’s donor half-siblings (“probably never”) and how to prepare for if/when our children want to meet their sperm donor when they reach adulthood (“yikes!”).

In my latest article Speed Dating Sperm Donors  I discuss how we have lost count of the number of people (friends and strangers) “not in the know” who have commented that one or both of our children look just like their daddy. This makes me feel very proud but I don’t mind also admitting that something does still (and probably always will) niggle at me deep down inside when given this type of feedback, as it is a painful reminder of my damaged manhood.

as mentioned above, I would not swap them for anyone else and I love them with all my heart: we specifically picked a sperm donor who shared many of my and my wife’s aesthetic qualities and, whilst I do think this has helped with the bonds we have strongly formed, I have no doubt that even children who bore no passing resemblance to me would have been as equally loved.

This is because I was mentally ready to embrace the option of donor sperm due to my strong desire to be a father, no matter how: so yes it came with a giant leap of faith but I also know from chatting to other daddies who have also conceived via sperm donor that there are no regrets, just a whole lot of love and happiness, as well as open-mindedness and acceptance for whatever tests may lie ahead, both those of a normal parenting variety and those unique to a donor conceived family!