A week later I went to my primary care clinic and some labs were ordered to check my testosterone levels. About two weeks later I gave a blood sample and the results came back after 4 days and showed low levels. I was at 187 ng/dL where the normal range is 348 to 1197. A nurse practitioner said that testosterone supplements can actually make it more difficult to conceive so he suggested I talk to a fertility specialist before trying anything.
Around the same time we had an appointment with her gynecologist and he said that I had to do a semen analysis first before artificial insemination could be tried. He told my wife to come back the following week for a blood test and I went back to the reproductive lab to pick up a sterile condom. She got her results back which suggested low levels of progesterone and so the doctor put her back on the pills that help with the irregular period. My wife helped me a few times to try and get a semen sample with either the cup or the condom. Finally on her birthday we were able to get a sample with the condom.
Now it was my first time using a condom and so she helped me to put it on but my erection wasn’t really hard so we weren’t able to get it on all the way and some of the semen sample spilled out on the bed. When you do an at home sample the lab wants you to bring it in within an hour and we just made it on time. The lab said my sample was not properly sealed and I’m not certain of what they are referring to but they were able to get enough fluid with a syringe to run an analysis.
The results came back showing that no sperm was detected and that I may have a problem with the vas deferens. One month later I went back to the urologist and he was surprised to see me again because he thought my issue had been resolved. I told him about no sperm being detected and so he checked my testicles and my prostate and said they both seemed normal. I then took another blood test to check my testosterone levels. He told me to come back in after the results were ready with my wife and the semen analysis report to discuss our options.
12 days later my wife and I went to a urology appointment. My testosterone results were low at 285 with 348 and higher being normal. He said that my sexual inexperience could be causing my erectile dysfunction and that it should resolve eventually. He also gave us the name of a reproductive endocrinologist and I got an appointment. 19 days later I visited him and he gave me a prescription for Clomid to boost my natural levels of testosterone. I also had four vials of blood taken for genetic testing. My insurance company requires prior authorization for the medication, which is frustrating to me. 9 days later I was able to pick up my Clomiphene Citrate pills. I called the pharmacy line for the insurance company and they said the prior authorization was approved and they had already sent the information to my local pharmacy. Next, I called the pharmacy and they said my medication was ready so I picked it up. I also placed an order for FertilAid online.
I started taking a half pill per day of Clomiphene the next day. I started taking 3 pills per day of FertilAid two days later. After 9 days I talked to a genetic counselor about my results. Fortunately I don't have any genes that cause Cystic Fibrosis, but I am a recessive carrier for three other diseases: Phenylalanine Hydroxylase Deficiency, Pseudocholinesterase deficiency, and Smith-Lemli-Opitz Syndrome. The next day I had my blood taken again to check on my levels of SHBG and Albumin. The doctor had actually requested 6 labs, but I had already done 4 of them. 9 days later I had my blood drawn again to check the testosterone. I got my results back the next day and it showed I was at 737, which is the normal range, although I don't really feel any different.
5 days later I had an appointment in the urology department of the University of Utah Hospital. Two doctors came to my appointment. Both of them examined my testicles and said there is definitely a vas deferens. The first doctor also measured my testicles and said they are in the normal range. Although, they weren't previously measured, he suggested that the medication could have caused them to get bigger. He also said that a new semen analysis might be a good idea. The second doctor said that he wanted me to have a procedure done that is known as Testicular sperm extraction (TESE). He also said that there is a hormone/chemical/protein that can be checked to see if the body is producing sperm. A high number means it is not, but he said my number is low which is good. Based on what the doctors said, it seemed like three possibilities: 1) I am back to normal because of the medication 2) There is a problem with the plumbing so the sperm can't be ejaculated properly. 3) The body is not producing sperm. The last one seems unlikely.
Two weeks later I had the TESE procedure and the doctor said he found sperm in my testicles. Four weeks later I did an at home semen sample into a sterilized collection cup. I received my results in the mail after 12 days. I received a digital copy on the night before, but I wanted to wait until I got my paper results before logging in. The good news is that my sperm count is high, but the bad news is that the quality is poor. The sample had a decreased motility, borderline viability, and low morphology. Artificial insemination might be the best method, but I'm going to ask my doctor about it. I also paid $527 to store my sperm sample from the TESE surgery for the full year of 2017.
My doctor wrote me back with this: "We have seen your semen analysis results. There was no obvious cause for lack of sperm on your previous semen analysis just as there is no obvious cause for sudden return of sperm to the ejaculate. This semen analysis has an excellent number of moving sperm (>160 million progressively motile sperm with goal >20 million progressively motile sperm). That is great! The only abnormality here is decreased morphology which may not prevent pregnancy. With these results, you should be a great candidate for artificial insemination or even natural conception. You could also consider banking a few samples of motile sperm. This banking could be used for future insemination whereas your current tissue storage would have to be used for IVF."
8 days later I finished the Clomiphene. Four days later I finished the FertilAid pills. I restarted the disgusting FertilAid pills after 20 days because my wife asked me to. A month later I had my blood drawn again to check my testosterone. 11 days later I had a urology appointment. My testosterone is low again at 175. My doctor gave me a new prescription. He also said that low testosterone can lead to bone problems. I picked up my prescription of Clomiphene Citrate the next day and took half of a pill.
We went to a gynecology appointment two weeks later, but I was unable to produce a semen sample. The next day I was able to provide a sample at home and we did our first session of artificial insemination. 20 days later my wife took a urine test at a hospital and got a positive result for pregnancy. We can now obey the command in Genesis 1:28 to "Be fruitful and multiply and fill the earth". 40 days later she had her first doctor's appointment. He gave her a sonogram of the baby which is about the size of a strawberry and did some blood tests and gave her the due date, which is earlier than I expected. I didn't realized that the 40 week period is calculated based on last period rather than conception.
8 days later I had to get blood drawn to check my testosterone levels. Three days later I had a DEXA scan, which stands for Dual Energy X-ray Absorptiometry. The scan is used to check bone density levels, because hypogonadism can lead to osteoporosis. It only took about 5 minutes. A week later I had a urology appointment. My testosterone is at 618 which is good. My bone density is at -1.7, which is the midpoint between healthy and osteoporosis. The urologist recommended I start taking a supplement called Citracal-D3 to boost my calcium and vitamin D levels without causing kidney stones. He also wants me to meet with a primary care doctor, and to get another scan in 6 months.
Two days later I met with a primary care practitioner to discuss the bone density results. He told me to take calcium and vitamin D pills, but I think I'll stick with the ones the urologist recommended. He also said jarring exercises like running or weightlifting can help bone growth. I also did some blood tests. Today I got my results and everything was normal. My wife had another appointment and the baby is now about the size of an apple.
Update 1 (March 2, 2019) - I'm glad to learn that the conservative Christian website Got Questions endorses
artificial insemination. I've heard that the Catholic Church and other conservative churches oppose fertility treatments and think conception should only happen through sex between a husband and wife. However, infertility can be a sign of other health problems that need to be addressed. There are examples of infertility in the Bible. If a man died without children, then his wife was supposed to marry his brother to carry on the family line. There are also examples of men using mistresses when their wives were infertile. I exchanged e-mails with this conservative Lutheran woman in New Mexico. She wanted us to date and seemed like a good woman and we even had a long phone conversation, but I wasn't ready to try another long distance relationship so we stopped communicating. Anyway, if I had married her I wonder if I would have any biological children. I think Christians are sometimes too eager to declare that adoption is always a good thing. I agree if the birth parents are neglectful, or abusive, or druggies, or if the children are orphaned or to avoid an abortion. However, it seems like adoption is sometimes just for convenience. If you give a child up for adoption and then have more children, you could have just raised the first child with his or her siblings. Before a child is put up for adoption, both the father and the mother should consent to it.
Update 2 (September 21, 2019) - My wife got pregnant for the second time, but it didn't last. We tried sex for 3 months but that didn't work so then we had to do artificial insemination twice. The first time I ejaculated quickly, but there were only a few viable sperm. The second time it took me about 80 minutes to ejaculate and about half of the sperm was viable and it worked. She used an at home pregnancy test and got a positive result. However, at her first doctor's appointment no heart beat was detected and it appeared that the fetus had stopped growing at 5 weeks. Then her period returned making her follow-up appointment unnecessary. When my wife first told me that there was a problem, I thought that the baby was still alive but there were major health problems. I then started wondering if the option of abortion would be brought up and how we would respond to that. Normally I am opposed to abortion so I'm surprised I even thought of it. I guess it's the difference between theory and reality. My wife and her dad both say that a person is dead when there is no brain activity and that a baby should be considered alive when brain activity can be detected.
Update 3 (December 28, 2019) - My wife's third pregnancy ended in miscarriage, 7 1/2 weeks after her last period and 5 1/2 weeks after insemination. She had an ultrasound and the gestational sac was visible, but appeared empty. She started bleeding before her next appointment and it was probably due to a blighted ovum. We did artificial insemination twice and both times my sperm sample was good. I was able to ejaculate in a timely manner the first time, but for the second time my wife had to help me which was fun. Her male doctor performed the first one and a female doctor performed the second one.
Update 4 (January 17, 2021) - During the first month only 25% of my sperm was viable and we tried artificial insemination (IUI) on the first day of ovulation and it did not take. In the second month I was unable to ejaculate in time for the appointment. In the third month we tried on the second day of ovulation and the doctor said there was a lot of good sperm. My wife had a period 15 days later and we decided to pursue IVF. The following week we had to get some blood drawn. 10 days later, I took a generic Viagra pill and with my wife's help I was able to ejaculate into the specimen cup. I felt hot on the pill and it was easier to get an erection. Four days later we both started taking Azithromycin tablets. 18 days later I took some more blood tests. A week later my wife had the egg extraction surgery and the doctor was able to retrieve 8 eggs. The next day we found out that 7 of the eggs were mature and 5 of them were fertilized. Four days later we found out that 1 embryo was healthy enough to be frozen; and 2 would wait for another day to see if they were still growing, and the final 2 didn't make it. The next day we found out that 2 of the embryos were viable and they were sent off for genetic testing. 8 days later we found out that both embryos had good test results and we learned the sex of both of them. 26 days later an embryo was implanted into my wife. She had blood tests 9 days later and her pregnancy hormone was high. A week later she had more bloodwork and everything was normal. Two weeks after that she had an ultrasound showing that the baby was alive and healthy and we got the due date. I let my parents and siblings know. 90 days later we went to another ultrasound which showed that the baby is healthy. The next day we posted the good news to Facebook.
There have been some court cases involving embryos between a divorced couple. Davis v. Davis in Tennessee where the ex-wife wanted them implanted and the ex-husband wanted them destroyed and he won the case because she was capable of doing future IVF treatments with a new husband. J.B. v. M.B. in New Jersey where the ex-husband wanted to implant the embryos into his new wife, but the ex-wife wanted them destroyed. The couple previously had a child together which may have been conceived naturally and the court ruled that the embryos could not be implanted. A.Z. v. B.Z. in Massachusetts where a couple had twins through IVF, then the wife had another embryo implanted without telling her husband but it did not lead to pregnancy which left one more. The husband filed for divorce and wanted the embryo destroyed. The court ruled in his favor saying that forced procreation was unconstitutional. Kass v Kass in New York where the ex-wife claimed the embryos were her only shot at genetic children, but they already had an agreement saying the embryos would be donated to research and the court upheld that agreement. Probably because of previous cases like these, my wife and I had to sign a written agreement. We both believe that divorce and the destruction of viable embryos are sins. In the event of divorce, she gets to implant them. If I die, she gets to implant them. If she dies, they will be donated to another couple.
