Wednesday, October 24, 2007

Sperm Banks

A blurb about today (10/24/07)

Woke up today feeling pretty good - I slept through the night without waking up and actually got up at a reasonable hour (around 9:30am). Finally had a couple of bowel movements yesterday (hee, hee, he said poo), though I'm not sure everything's quite awake down there. Really each day the pain seems to get less and less, as I suppose it should, but it's much more noticeable than I anticipated. I almost feel like I'm cheating somehow to have gotten off so easily from the surgery. Almost.

And now to the sperm...

One of the big problems with removing the prostate is that it makes you sterile. So basically, the doctor recommended I bank as much sperm as possible before the operation. Afterwards there's still the possibility of removing sperm directly from the testicles, but once chemo or radiation therapy starts, even that option goes away.

I really hadn't anticipated through all this having to think about how/when I would want to have kids. I suppose I've always thought I wanted kids, maybe one or two, but with everything else going as it was in my life it seemed like that and any decisions related to it would be a long way off. Now all of a sudden I was having to plan years in advance just to have the chance to have kids somewhere down the line.

So I had my first appointment at a local sperm bank on the Friday (10/12/07) before the surgery was supposed to happen. This whole process has been surreal, but never did I think I'd be walking into a sperm bank with my mom, my sister, and my girlfriend. Luckily, they're quite professional (not that I really expected less). At this particular place, you go in and talk to the person who helps you with the paper work, and the lab is actually across the hall. So I guess there's that barrier of privacy set up already. So we sat down with the receptionist/agent/account manager (?? what do you call that person ?? sperm banker?) and described the situation. Since I had just had the TURP (transurethral resection of the prostate) surgery a week or two before, there was some question in my mind as to whether I'd be able to give anything at all, so before doing all the paperwork and such I guess I had to see if all the equipment was working properly.

The woman led me across the hall into the lab, where there were folks in clean white lab coats and hair nets working at benches centrifuging this and pipetting that, looking in microscopes and such. Then one of the lab techs hands me a cup and shows me to a room, gives me a knowing smile and says, "Take your time, and don't forget to lock the door." So in the room there's a sink and a small TV stand with an integrated TV/DVD player (with headphones) on it. And of course there's a selection of DVDs and magazines of the type you would expect to find. All in all it's like a 14-year-old's ultimate fantasy refuge, but it feels not a little weird to know that outside are people doing their business, down the hall are construction guys doing some remodeling, and across the hall is your family, waiting to know if you can still ejaculate normally or not. So, yeah, surreal.

Turns out I was able to do the deed and produce a sample, though it was a bit bloody from the surgery, and it certainly didn't feel normal. I closed the cap on the little plastic cup, walked out and gave it to the lab tech. We had to fill out some paperwork, so I started doing that while we waited for the prelim results. About 20 min later they were able to tell us that unfortunately my motility was very low (3% - normal is more like >40%), even though the count was pretty high (40 million). Lots of possible reasons for this, but most likely the cause was the disease itself and/or the trauma that the area had sustained through the TURP procedure. A couple days later we found out there were no moving sperm after a test-freeze of part of the sample. There are of course ways to have a baby without swimming sperm (as long as they're still alive), but the techniques are pretty advanced and involve harvesting eggs and injecting the sperm directly into the egg.

I guess I can't say I was enormously upset by this news. The idea of having kids seemed like such a long ways away, and since there were options for having a baby with my own genetic material, it didn't seem like the end of the world. I guess if I were married already and thinking about kids when all this started happening, I might feel a little more distraught. For now, though, it feels like a future inconvenience (though I know when the time comes it will be a much larger challenge to overcome than the word "inconvenience" implies) and certainly with the surgery still looming it was not really a hurdle I was prepared to put energy into. Still, it was upsetting to know that even this, something that I had taken for granted would be straightforward and natural in the future, was not going to be so simple after all.

We decided to try another sample the following Monday, to see if Friday was just a fluke. After that turned out about the same, we went to discuss the options with the fertility clinic. The motility results were basically the same, and after consulting with a urologist who specializes in fertility, we found out that even drawing samples directly from the testicles would not necessarily result in better motility rates. Everyone said to bank as much sperm as possible before the operation, and so, giving two days rest, we went back one more time on Wednesday to give a final sample.

All in all, I now have 7 or 8 vials processed and frozen in the bank, which will be at least that many attempts at a child. Depending on the treatment plan moving forward, we may even be able to take more directly from the testicles. I suppose we'll have to consult with the docs on that. Certainly through this part of the experience, I have a new appreciation for what a sperm bank could mean to a family, as opposed to what juvenile imaginings might paint it to be.

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