In my previous two posts about this topic, I advised women who want to get pregnant to relax and trust their own bodies. Unless, of course, their bodies were over age 35, in which case they should stop relaxing and just get to it already. Unless, of course, they happen not to have a male partner, in which case we do have sperm donors and egg freezing.
In this post, I would like to address that afore-mentioned, often overlooked male partner, whose role in this whole business has up to now been taken for granted. That’s right – taken for granted. C’mon – do you seriously ever hear men worrying if they are going to be fertile? Hanging around with their buddies throwing a few beers back after the game talking about their deep-seated fear that they won’t ever be someone’s baby-daddy? Correct me, guys, if I’m off-base here, but I don’t think so. You all assume the plumbing works, don’t you? No inner fears, no doubts. Every one of you. Your baby-daddiness is a given, you just need to choose the time and place (and lucky baby-mama.) And if I read one more article about Tony Randall…
Doctors are not immune to this sort of blind thinking. Case in point: My friend Kathy (not her real name) who visited Famous Infertility Doctor after she was unable to conceive a third child, despite trying for five years after her second child was born. The (male) doc just assumed that it was her problem because she was now 33 years old. At the first visit, when she asked if perhaps it was her huband, the doc said it was highly unlikely because of course hubby had fathered her first two children. Oh, I get it, she says. A man fathers a baby, his studliness is assured for life, whereas a woman’s ability to conceive is what? Beginner’s luck? Just do the semen anlaysis, doc! (Did I tell you she has a forceful personality?) Of course they did test her husband, but really only to prove their point. (He was fine, but so was she, it just didn’t happen again for them.) But just so you know, about one-third of infertility is due to a male factor, and another third to a combination of male and female factors. So don’t assume he’s fertile just because he’s studded before.
Well, this is one doc who doesn’t make any assumptions. Which means that when my husband and I decided to start our family, I for one was not going to waste my time trying to get pregnant if he was shooting blanks. Of course, I knew I was fertile, not only because my cycles were clockwork regular, but because I resembled my mom, who had had nine kids in a row starting at age 28, without a single miscarriage. I was sure I had the gonads that went along with my rosy complexion. But my husband gave me no such assurances (other than his major studliness, of course). So what if he looked just like his dad, and his parents had had three kids, which for a liberal Jewish family is practically a population explosion ? This was one book I was not going to judge by it’s cover.
So what did I do? (And I swear that what follows is true…) Well, like any reasonable female gynecologist worth her salt, I brought my microscope home from the office. And that night, after the deed was done, I jumped up out of bed, naked, and did my own post-coital test using the microscope right there on the bedroom floor. For you non-gynecologists, a post-coital test is when you take a sample of cervical secretions from the woman shortly after intercourse, smear it on a slide, put on a cover slip, and count how many live sperm you see in a high power field. Sort of a field test for the sperm, to see how they do out there in the real world, as opposed to in a plastic cup in the lab.
I am happy to report that my studly husband passed our little test right there and then, and with flying (or should I say swimming?) colors. And, I became pregnant that very night. Since that night was also the first time I had ever had sex in my life without birth control, I believe I more than validated my assumptions about my own inherent fertility (thanks, Mom!). And since I had always used the diaphragm for birth control, it was a testimony to just how effective that under-appreciated method can be when used reliably (and obsessively…)
“You’re Nuts!” I hear you saying. Yeah? More like Ahead-Of-My-Time is what I say. Because do you know that they now actually sell do-it-yourself home semen analysis kits? I have no idea if they are reliable, and I’m not sure who buys them, but I’ll betcha’ it’s not the men. If the rest of the female sex is in any way at all like me (you know, control freaks), they’re the ones buying the tests, and asking hubby to ante up a specimen so they can check him out.
“So, what are you saying?” you ask. “First you tell us to relax and trust our own bodies and forgo the high tech, then next thing you’re telling us you went and checked your husband’s sperm count before you had barely started to try to get pregnant!! Make up your mind! Which is it, relax or go high tech?”
Good point. And the answer is – you can do both! I did. The whole post-coital test thing was a real hoot, and my husband and I had a great time with it. Here’s what I say – If you can embrace the technology and still enjoy the process, please, by all means, go ahead. As Mr Science says, “Science can be fun!”
But if the technology only breeds anxiety (which I find is what it does for many women), don’t use it. Ignore this post and go back and review Part I. Because making babies is supposed to be fun – not a chore and certainly not an anxiety-producing experience.
Now, get out there and have a good time!
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Read Part 4 in the “How to Get Pregnant” series- Mom’s Medals
I’m a man who always figured he was infertile until he had proof of the contrary. Why did I question my fertility? Because I question all of my abilities. This is just what I’m like. I lack confidence in myself. I’m a pessimist. I agree with Woody Allen that life is made up of the miserable and the horrible and that you should be glad to be just miserable. My life is one big bundle of “inner fears and doubts.” Ever read Kafka? He was a guy too. Some of us are like him.
You’re right that men often don’t tell people about their worries. I certainly haven’t talked about stuff like my fear of infertility with my male friends. But do women sit around and talk like that?
Yep, we do.
And other stuff. We even talk about reproductive stuff on blogs, look: http://philobiblion.blogspot.com/2005/11/menstruation-why-is-it-so-hard-to-say.html
Bardiac:
Thanks. That was an intersting read…
Hey dod, don’t mislead your female readers out there with the comment that you knew you were fertile because of the regularity of your periods and your mother’s fertility!
I had my period every fourth Saturday from age 16, minimal symptoms if any; my mother had five live births, two miscarriages over twelve years time.
So, at 28, after finishing my residency and fellowship, we decide we can handle parenthood—and two years later, I’m in the office of my friendly Infertility GYN. Just a little tweaking–Clomid and HCG.
But those nice regular periods were not markers of fertility then, nor from 35 to 41, when we moved on to bigger guns for a third and it still didn’t happen. (No antibodies to hubby’s sperm either.)
Bottom line: do NOT–repeat NOT make assumptions about anyone’s fertility!
Anonymous is of course completely correct, that assumptions should never be made about one’s fertility, male or female.
But at the starting gate, with no abnormal history and before even trying to get pregnant, what’s wrong with a little belief in oneself (and one’s mother)? If we all started the process assuming we were infertile, well that would just be no fun for anyone.
Maybe you feel that the let down of infertility is worse if one does not expect it, and perhaps you are right in that regard. I’m truly sorry for your disappointment.
BTW,
“you’re nuts”
but it’s a great post anyways.
I agree that you can make certain assumptions about family history. My wife’s mother got pregnant on her wedding night. Her two sisters both got pregnant first time without contraception. So we had a good reason to believe the same would be true for us. While I would have loved the additional “trying”, we have been blessed three times with quick and easy pregnancies. It’s the same for the vast majority of the maternal side of my wife’s family.
I plan on using this history as a means of putting a little fear into my daughter so maybe she will delay her sex life for the sake of her father’s sanity. Not for too long, just until she’s 40 or so…she’s three now, so that
should be enough time…
And the post coital testing is a great idea. Anything more interactive than a plastic cup is most welcomed from the male point of view…You can use it with a sports analogy. Just tell the potential fathers that you cannot really test an offense without the presence of a serious defense….
I scoffed when my husband brought home a do-it-yourself semen testing kit, but I was singing a different tune when the urologist confirmed said semen kit’s abnormal results. Four months later, we were doing our first IVF/ICSI cycle due to an unexplained low sperm count. (I got pregnant, but it ended in an early miscarriage.)It would have been great to know about this from the get-go, but as you know, fertility specialists won’t give you the time of day unless you’ve been trying for at least six months, more often a year.
I think the percentage of infertiliy attributable to a male factor is actually closer to 40%, and I find it troubling that this is somehow viewed as more taboo then female infertility…
I started trying to conceive at 30 and thought I had plenty of time. After waiting the requisite three months following the miscarriage (one for my HCG levels to drop and two subsequent menstrual cycles), I am about to turn 32. Suddenly three kids isn’t looking so feasible anymore, even with the aid of ART.
You’ve been extremely fortunate, doctor, but I guess I’m biased toward the “trust your worst instincts” school of thought.
And as to whether women “discuss this stuff,” there are a plethora of excellent blogs (mostly by women, but there are a few by men) chronicling the heartbreaking roller coaster ride of infertility. I’ve often thought it would be enlightening for doctors to have a look at a few of them…
Using a microscope to do your own semen analysis is not that unusual. We bought a microscope and kit with all the supplies and instructions. We got ours from Kokopelli Technologies at http://www.fertilityformen.com. It seems like they sell many of them to vasectomy reversal patients like us. It’s nice to be able to see changes over time.
My husband and I had the first set of tests today and will have the results by tomorrow. I’m 28 and we have been trying for less than an year … its still traumatic. I hope the tests are normal and all we need to do is keep trying.
I have to say this is one interesting read and quite funny at some parts. I wish I had a microscope.