Born WITH a vasectomy? Huh?!

Today, I want to explain exactly what we are going through with Nathan's medical condition that we were not aware of until the fertility testing began last month (November 2011).

It was a bright weekday and I was on my way to pick up some lunch.  My cell phone rang and that isn't that common.  I usually just get text messages anymore.  It was the RN calling with the results from Nathan's semen/sperm analysis.  She said we found the problem, Nathan has zero sperm.  None.  She was stern.  She said something about urology, infertility, a specialist.  I instantly started to think of so many different things, my eyes welled up and I pulled into the Home Depot parking lot.  I was so shocked and confused.  I knew nothing about the possibility of zero sperm.  What did this mean?  The information we were given was interpreted as quite negative.  I was devastated.  I asked a few questions and it did not sound promising.  Did I just hear that I would need a sperm donor?  Was this really happening?  The next few days were horrible.  We did get an appointment set up with two doctors: a Urologist and a fertility doctor whose name I kept hearing.  Nathan either has obstructive or non-obstructive azoospermia.  Azoospermia is the complete absence of sperm in the semen.  The volume was also lower than the norm.  Obstructive means he is producing sperm but it is being blocked somewhere.  Non-obstructive could mean something as serious as testicular failure where no sperm is even being produced.  Now, there are other medical conditions where there is little sperm or low mobility- we had none of this.  There was no sperm whatsoever in the first analysis.

After having our first visit with Dr. Maud Doherty at 192 & Dodge Street in Omaha, we felt so much better.  Whether we needed a donor or could 'find' sperm, there were choices.  She did explain what was needed to be done and in what order.  We needed to start with blood work.  Then possibly a biopsy of testes.  What?! Nate's mouth drops to the floor, he starts talking a lot- obvious sign of his anxiety.

Next, testing for retroactive ejaculation where sperm escapes into the bladder instead of with the semen and out of the body.  Nate went in and still- no sperm in his semen, low volume even after extended days and no sperm in his urine which was also analyzed.  We had completed the hormone tests for Nathan and his fructose levels were low, his testosterone was normal.  He appeared to be a healthy man at 34 years old.  This made Dr. Doherty believe that Nate had obstructive azoospermia.  So, it was time to find the exact cause.  This would be slightly scary for Nate at this point.

I brought Nate to the Methodist Women's Hospital that also helps men by having the wonderful urologist and booked up Dr. Morton.  Talk about the nicest and most helpful person in an uncomfortable situation.  Nathan was given a local anesthetic in an in office procedure to biopsy his right testes.  His left would remain untouched in the case of later sperm retrieval for IVF.  Nathan was given a 'block' so he wouldn't feel the biopsies.  (nathan gives me full permission for OUR fertility journey, he's so damn cute!) we hope this helps another couple out there.

Dr. Morton was able to tell by a physical evaluation that Nathan was born with Congenital bilateral absence of the vas deferens (CBAVD). There was a needle like gun that made one click noise each draw, filling a very large test tube with pink like fluid.  Poor Nate.  He looked ok.  Eee.  I allowed him to decide if he wanted to attempt this and I am so thankful that he did because 15 minutes later we were told there was SPERM! Yay!  This would be IVF depending on my CF screening.  And again, we wait.   It was a rough few days for him as he healed and he was prescribed percocet / Oxycontin.

Nate recovering from testes biopsy

See the image below re: Vas Deferens

Nathan was basically born with a vasectomy.  In the case of a vasectomy the vas deferens are snipped and thus the sperm can not travel to the semen and out of the body.  Nathan was born completely without those vessels that transport the sperm out of the testicles where it is produced and to the semen.

Now, why was Nathan born this way?  We were about to find out but had more tests and more waiting to do.  Next, the CF gene test.  We were gonna screen him for the Cystic Fibrosis gene in many of its mutations.  He was positive.  This is why we were having this problem of infertility, obstructive azoospermia.  The CF gene that Nate carries isn't even the most common mutation per Dr. Doherty but that is what has caused this/ medical condition demanding medical intervention and assistance in having a child.  If I have the CF gene and Nathan has it we know, then we are at a 1 in 4 chance of having a child with the Cystic Fibrosis disease.  This is a tragic disease.  Dr. Doherty fully recommended we not use Nathan's sperm if the case is we both have the gene.

I called a couple times to see if my results were back on the CF screening.  It had been exactly a week.  I can't wait.  I need to know.  But, during a conference call- I got the call I was waiting for.  I tested negative for the CF gene.  We would proceed with the IVF (in vitro fertilization).  We have Aetna insurance and are allowed up to $30,000 in fertility treatments.  So... here we go.

That brings us to today's date:  12/19/2011