Zero, zilch, nada, nil, nothing.....azoo what?

Starting the Summer of 2011, my wife and I tried to get pregnant. By the time Spring of 2012 came around, we figured we should both take some fertility tests. Since a fertility test for a guy is pretty simple (basically semen analysis performed in a lab) I decided to go to the doctors first near the end of March 2012. By early April 2012, my life felt very different.

When my doctor called me to discuss the results of my semen analysis, he admitted that he was confused by the sperm count. He was a fairly young general practitioner (GP) and, as such, he had never encountered someone with a sperm count of 0. Zero, as in zilch, as in nada, as in none, as in no sperm whatsoever in the ejaculate that I supplied the lab.

I can still remember very clearly the feeling I had as I was walking from the building housing the urology department to the large parking structure at Good Samaritan Hospital in San Jose. I could feel the sun on my face, the cars passing me, people chatting......and I felt as though my life had come to an end, while the world kept turning. I didn't even know what to think as I made the drive home after my doctor's appointment. What would I tell me wife? How would I tell my parents? My brother? My in-laws?

One week later I went in for an appointment with a urologist (also known as an andrologist to some). He further educated me on what I had scoured the internet over in the days leading to my appointment. He gave me what seemed like an overwhelming battery of tests and analyses that needed to be performed on me. A short list includes:
1. Blood sample analysis for FSH (follicle stimulating hormone) levels
2. Blood sample analysis for LH
3. Blood sample analysis for prolactin
4. Micro-deletion testing
5. Karyotyping for any chromosomal or genetic disorders
6. Doppler Ultrasound for analysis of my testes
7. Specialized Semen Analysis with pelleting
8. Urine Analysis

It seemed like there was a never ending string of tests that required me to go to 3-4 different test centers.  All the while, I could barely get a grip of my life.  Holding a thought became challenging. These tests were essential to determine the extent of my diagnosis known as non-obstructive azoospermia (NOA). It is a form of infertility in men which is extremely rare, and results in zero sperm count due to primary testicular failure.

Several weeks after all the tests had been completed, my wife and I were dealt another extremely devastating blow as we learned my condition was looking more and more irreversible, and less and less likely that we could have biological children.

The next step, as it turned out, was also the last line in the hopes of bearing our own biological children: surgical procedures to determine if there was ANY sperm being produced at all, and in vitro fertilization (IVF) for my wife. In the next post I will discuss the procedures and follow-up medical examines we undertook, but for the remainder of this post, I would like to focus on some of the feeling (perhaps you are feeling yourself) that my wife and I experienced.

During this battery of medical tests, there was something else happening inside of me that was far worse than the stress induced by the idea of not being able to have biological children. I started to become massively depressed. Embarrassed by my medical condition of azoospermia, I could hardly look myself in the mirror, felt guilty each and every time I watched my wife sleep next to me. I shut down socially as I hardly interacted with anyone I didn't absolutely have to. I isolated myself from my family. And in the late night hours, watching my wife sleep next to me, I could feel the guilt overtake me to the point where I could hardly breath. For those of you that are fortunate enough to have married a woman as patient, loving, kind, caring, sweet, and beautiful as mine - you can understand the feeling of inadequacy that can result when you aren't able to get pregnant together. Where because of a condition that you have now discovered, the path to parenthood and a family has and could forever change.  Till this day I feel indebted to my wife for having chose to marry me, and to endure this painful and life-altering diagnosis.

Then there was the whole idea of sharing and dealing with telling my condition to my family and friends. This took nothing short of 8-10 months, and even till this day the majority of my friends are in the dark about this. I felt no one would understand, no one would say the right things, and that people would view it as something short of what it actually was. I remember my doctor saying "azoospermia and infertility as a whole has the same stress and emotional patterns as those that are diagnosed with cancer or for someone that has just loved a very close loved one." It sure didn't seem like that as I started telling a few of my closest friends, as they soon forgot about my condition, never came around to hang out, and basically left me feeling like I had told them about something that was at the level of gossip rather than something extremely personal with a topic that is possibly one of the hardest to discuss as a man.

However, those that came thru, and did hang in there and checked in on me, not just to see how my infertility progress was coming but just to see how I was holding up and would just sit next to me and keep me company knowing I wasn't in the mood to talk......that made ALL the difference in the world.

It is because of those friends and my wife, as well as the some support from my family that I was able to gain enough zeal and courage to continue on in pursuit of a better life for my wife and I. It was a dark 6 months, and the 2-4 months following when I started to open up was just as difficult. But I got through it, and my wife got through it with me. And in the middle of that shitty mess, we somehow came out together with the ability to still smile at one another and feel a genuine sense of love. We were forever changed. And our smiles, while nowhere near as bright and carefree as those on our wedding photos, remained. I knew that things would get hard (though I had NO idea how hard they would get), but I now knew that we could persevere....and that even in the worst of scenarios we would find comfort in each other: our small silver lining.