My husband and I decided to pursue as much testing as possible before deciding to try getting pregnant again. I had already had a few doctors blow off my two miscarriages as “not statistically significant” citing that until you have three there really isn’t a real indication of a problem. It infuriated me. Every woman who has had three miscarriages must have been told at two to just keep trying, and that she likely didn’t have a problem, I thought. I couldn’t bear the thought of getting to three. Luckily my OGBYN understood that emotionally we would not be able to take the leap of faith to start trying again until we had done everything we could to discover if we had an issue. We had both received good news on our blood karyotype, and felt like with every normal result we would have just a bit more peace of mind.
At my husband’s urology appointment, we hoped for the same “normal” results. We sat in the doctor’s office, answering a bunch of questions when finally it was time for my husband’s exam. “Oh, here are the results of your husband’s SA,” the doctor said to me casually, handing me a piece of paper, and exiting the room with my husband. I took the paper, quickly scanning through the numbers and percentages until finally my heart stopped. I felt the room start to close in on me as my breathing constricted and my hands began to shake. Prognosis: Poor fertility potential. I sat alone in the office, knowing I had terrible news in my hands, knowing that my poor optimistic husband didn’t know yet.
I wanted to scream and cry and protect my husband from this news. I worried about how he would feel, knowing he would be worrying how I would feel. I couldn’t believe the doctor left me to digest this news with no explanation, no context, and alone. I started taking deep breaths to steady myself and keep the tears at bay. Part of me was not surprised, because of a diagnosis my husband received as an adolescent, I had suspected this might be contributing to our issues. But normally it would prevent someone from even getting pregnant and we had gotten pregnant twice in the last six months. We just couldn’t stay that way.
My husband could see my distress immediately when he walked in the room; my expression quickly caused his face to fall. The doctor explained our results and our options. My husband had a varicocele, and it was affecting his sperm production. It came down to two options, my husband could undergo a small surgery that may help increase his fertility, or we go straight to IVF. He explained that if we were of “advanced maternal age” and didn’t want to waste time we should do IVF, if we were young and had plenty of time the surgery was worth trying. “I’m 33,” I told him “I’m not young or of advanced maternal age.” “You have some time,” he told me. It didn’t feel that way.
Both my husband and I experienced a complex avalanche of emotions. “You look mad” my husband would say to me, likely projecting his own fear of how I was feeling about him. I wasn’t mad. I felt heavy. I felt sad for my husband, having to carry the burden of feeling like the miscarriages were his fault. But at the same time a part of me was relieved it wasn’t something wrong with me, although I had yet to see our fertility specialist and have my own onslaught of testing. My husband was finally feeling how I had been feeling all these months, that something was wrong with me, that somehow I had caused all this distress. As normally a hugely communicative couple, we were suddenly quiet. I didn’t know how to console him while grappling all my feelings and heartache. I was overwhelmed with the giant question mark with what was before us. I wanted to cry, but something had shifted in me through this struggle. I was either pushing the feelings inward, or had started to become hard. Or perhaps I was just adjusting to this new reality, and finally accepting that this was going to be our struggle.
When we spoke to other OB’s about the varicocele we received eyerolls. Urologists love to tell you that you have a varicocele, and that you need surgery, they said. You get pregnant, you’re fine. It didn’t make sense to me. Wouldn’t having 97% abnormal sperm morphology contribute to a higher likelihood of genetically abnormal embryos? When I researched, I read conflicting opinions. Abnormal sperm won’t fertilize an egg, I read….but by those accounts it should have been incredibly difficult for us to even get pregnant.
In the end we decided he would undergo the surgery. I had to stay true to my promise to myself – that I would do everything in my power to decrease our risk of miscarriage before trying again. In two-thirds of men the varicocele repair improved sperm production. We scheduled the surgery, spent a lot of money on fertility supplements, and crossed our fingers. In three to six months we will know if the surgery worked.