Mr. Jem's business

This post is all about Mr. Jem and his man-business.

Two years ago when we started TTC Mr. Jem had his first SA. The doctor's first question when the results came in where, "Has Mr. Jem had any chemotherapy?" The answer was "No, why?" His response: "Because there are virtually no sperm in the sample."

Yes, dear readers, the results were that bad. 100 thousand swimmers. Too little to check morphology. Bad, especially as 25 million are the minimum amount to be considered normal.

Mr. Jem was in a sucky job and tho we had "pulled the goalie" he wasn't really in a good place to even talk about having a baby until Summer 2009. He retested. 600K.

The Diagnisis: Male Factor Infertility. The treatment: IVF with ICSI.

We had been doing acupuncture as soon as we decided to do IVF. The acupuncture clinic didn't really take his low count very seriously. They had him on special vitamins, Chinese herbs and only did acupuncture right before the SA. They (and our RE, Dr. W) said: "It only takes one sperm." Well, actually, it takes more than that!

The week before ER, his SA came back with zero sperm.

***Sounds of tires screeching to a halt***

Because of this, he had a testicular biopsy the day of retrieval to get sperm for the IVF with ICSI. After cutting into both sacs they were able to extract enough to fertilize my eggs AND freeze some for next time, if necessary. The silver lining from all this is that Mr. Jem found a urologist he really trusts.

Since the IVF, the urologist, who I call Dr. Johnson, did blood work on Mr. Jem. Mr. Jem had low testosterone. His FSH was normal. The way Dr. J. described it was, "The brain is sending the signal to the factory, but the factory isn't making any sperm."

In December Mr. Jem's Free Testosterone was 35, well below normal. Dr. Johnson put him on Test.im. After 4 weeks, Mr. Jem's level rose to 75, within normal. Dr. Johnson switched him over to Clom.id for two reasons: 1) to produce more better sperm so we can see if we can get PG naturally (we are MFI, after all, and if we can avoid another IVF cycle, that would be WONDERFUL) and 2) there's a generic equivalent to Clom.id (unlike with Test.im) so it costs $35 instead of $200 per month.

There are also other medical benefits of a normal testosterone level: it protects bone density, protects against heart disease, can help him lose weight and gain muscle mass, as well as raise his libido (always good!). Mr. Jem's sex drive has always been lower than mine, which has been the source of a lot of conflict over the 11 years that we have been together.

So, with the addition of Clom.id and more testosterone, I hope Mr. Jem's energy, libido and sperm count climb.

I just wish that Dr. W had told us to see the Urologist BEFORE we started IVF. He didn't. He said, "Don't bother." I disagree and urge all of you who are MFI to make sure you check out all the options. Oh, and freeze sperm when you get the chance, rather than relying on getting a good sample the week before retrieval. If I could spare anyone the heartache and worry of that, I will have done my job here.

I'd love to hear anyone else's (or DH's) experience trying to increase sperm count. What did you/he take? How did it work?

Jem

Urology Report

Mr. Jem went to see "Dr. Johnson" on Thursday and we got the results of his blood tests. Mr. Jem’s testosterone level is very low and his FSH is very high. His brain is telling his testicles to produce sperm, but the “factory” has shut down. Actually, the right testicle has shut down production and the left one is on partial strike. Thus the low, low, low, low sperm count.

Dr. Johnson prescribed testosterone gel.

The good new: the Rx should help Mr. Jem’s testosterone level, increase his libido (yay!), his energy level, and core muscle mass.

The bad news: He’ll need to apply the gel every day for the rest of his life. It will not do anything to increase his sperm count.

The other good news: We still have the 3 embryos and a bunch of tissue from Mr. Jem’s testicular biopsy.

We still haven't made a decision on which doctor to use or when to have our FET. More discussion needed.

Jem