We decided to start trying again around his first birthday. We hoped it would be a straightforward process, as it had been the first time, but were mindful of the fact that my body had changed and I was still breastfeeding, so were initially prepared to give it a little more time. My impatience grew rapidly, however, and as the months went by with nothing happening, we tried everything we could think of to help. I peed on countless ovulation sticks, took my basal temperature each morning and charted my cervical mucus – a job which is a horrible as it sounds, but one that somehow seems such a small thing if it brings you the positive pregnancy test you crave. We tried sex every day, sex every other day, all through the month or only around ovulation. You name it, we probably tried it. My breastfeeding journey came to end when we’d been trying for around nine months, but even that wasn’t the magic solution. The arrival of my period each month was a bitter blow that became progressively harder to accept.
Meanwhile friends who had not been anywhere near ready to try for another child when we began trying fell pregnant in their droves, or so it seemed. Whilst I’m mindful of the fact that you never really know anyone else’s story, or the struggles they might have encountered on their own journey to conceive, I couldn’t help but feel angry, frustrated and bitterly jealous. Why were they able to achieve what I so desperately desired?
The problem with trying for your second child is that there is a still prevailing belief that it is somehow less important, or less emotionally challenging than trying for your first. To a degree I understand this mentality. I’m sure that I was guilty of it myself when trying for Thomas – thinking that those who were trying for a second child couldn’t possibly be as desperate as me. After all, they already had a child and had experienced all the joy that becoming a parent can bring. But now on the other side, I know how untrue that belief is. I detest the implication that longing for a sibling for my son means that I feel he is somehow “not enough” or that I am not grateful to have been blessed with him. That simply isn’t true, and in fact I want another child as much for him – to be a playmate and buddy – as for me.
There is also a widespread assumption that if you’ve had one child you must be able to have another. In reality, all that your first child proves is that as a couple you were fertile at the moment when that conception happened. As we now have the bitter experience to know, things can, and do, change.
When we had been trying for a year, we dutifully trotted off to see the GP for some tests. By this time I “knew” (call it women’s intuition) that something was clearly wrong. I know it takes time to conceive, but when our first conception had happened so easily, the odds seemed good that something had altered. I assumed it was me. After all, I have a somewhat complex medical history, including pituitary and gynaecological issues. I already had scar tissue in my pelvis, and especially affecting my right tube, as a result of adhesions which came about following the removal of my appendix some twenty years ago. I’d had a caesarean delivery that obviously had the potential to damage my other tube. The odds were on that something had gone wrong somewhere in my body.
We started on the fertility treadmill. Blood tests and a scan for me. And almost as an afterthought, the GP arranged a semen analysis for my husband. We laughed about how men’s fertility isn’t subject to quite the same age related changes as women’s. How, if anything, my husband is healthier now that when we conceived before. It was just routine, but couldn’t possibly be the cause of our difficulties.
When we returned to see the GP, she delivered the news gently, with practiced professionalism. My husband’s sperm count was not just low, but virtually undetectable. We were given a number in single figures of sperm found. And that was not a figure to be multiplied by millions. That was it. We were gobsmacked.
In all my research on secondary infertility, I had not yet come across any discussion of male factor secondary infertility and so it hadn’t really crossed my mind. But even when I began looking for it, there was nothing much out there. Secondary infertility is still, it seems, rarely talked about in much detail, but the leading causes seemed to be scar tissue affecting the female organs, increased female age or the decision to have further children after sterilisation surgery. I couldn’t find a single personal story about someone who’d previously fathered a child and then gone on to discover an extremely low sperm count. This itself is part of the reason I’ve decided to share our experience.
Given the tiny number of sperm found, we knew from the moment we heard that our only option for another biological child was ICSI. The benefit of self-funding treatment (having a child of course means we don’t qualify for any help) is that within just a couple of weeks we were sitting in the smart consulting rooms of a private fertility clinic. Even to the fertility specialists, our case is a bit of a puzzle. Hormonal testing on my husband revealed nothing out of the ordinary, and there were no illnesses, no trauma, and no lumps or changes to suggest what may have happened. We made the decision pretty quickly to try to freeze some sperm, worried that the count may drop even further.
Sadly that worry was not unfounded. All attempts to obtain sperm by the traditional means yielded nothing. Officially the diagnosis is now azoospermia.
We had one last resort. The last ditch option to try to find some sperm was a surgical sperm retrieval procedure. Without a reason why his sperm count had dwindled to nothing, we couldn’t be sure that there would be anything to retrieve, even at source, but the decision to try it was a no brainer. We had to know that we’d tried everything we could to have another child before we would be able to give up on the dream. The waiting, although it was only a few days, seemed interminable. We’d discussed briefly the option of donor sperm but knew it would not be for us. Who knows if this decision would have been different had we not already had a child, but we were certain that we wanted a full biological sibling (or perhaps one who is not biologically related at all) for our son. I knew, therefore, that a failure to find any sperm would mean the end of the line. It seemed strange to think that the end of the line may rest under the microscope in an embryology lab, rather than in a negative pregnancy test or the heartbreaking process of a miscarriage.
Waving my husband off to theatre was surreal. The last time I had done the same thing I’d been heavily pregnant with Thomas and he’d had a wisdom tooth removed under general anaesthetic. As a dentist myself, I’d had no worries at all about that procedure and had taken it all in my stride. But this time, the moment he was gone, I let out the sob I’d been holding back in front of him. So much seemed to rest on this procedure and the skill of our consultant. The result would make the difference between moving forward as a family of three or potentially having the chance at another child. This was our chance at a chance.
It was over quickly enough, and I’m grateful that the embryologist gave us provisional information as soon as she saw sperm. We didn’t know how much, or whether it would survive the test freeze, but in the moment that I heard that news I let go of the breath I didn’t realise I had been holding.
Ultimately the news was fair. Not brilliant. We didn’t get a lot of sperm, but we got enough for at least one cycle of ICSI. We have our chance and we’re currently taking it. One way or another, this story will be continued…