male infertility

Let's Hear it for the Boys... & their "boys"... & Lab Director Carole Wegner

So as most of you know, I'm a humor writer. This means that I'm a professional highly-trained in making smart-ass remarks. Look how good I am at it, even my job description to you contained a smart-ass remark. My entire life, I've never been able to help myself from doing it so I finally gave in and made a career of it. That's why I'm no good on Facebook. People beg you for sympathy and support. Look, my friend Shannon whom I adore posted that she lost 133 pounds. Only she accidentally wrote "ponds"instead of "pounds" so of course everyone else wrote: "Good job!" and "Way to Go!" and I had to write: "Was that water weight, Shannon?" instead of letting it go like a normal person. (I've probably been un-friended by more people on FB than anyone else.) So in honor of "Let's Hear it for the Boys... and their 'boys'" month, when it comes to male infertility, I thought it best if I just shut-up and let a medical professional tell you some important stuff with some great links to more important stuff... instead of a smart-ass professional telling you why it's funny... which of course it isn't.

In honor of Father’s Day, I thought I’d tell the story of a little known but highly significant male reproductive organ- the epididymis. It is pronounced Eppie-Diddy-Mus which may sound like an urban rapper but I assure you, it is not.  The epididymis which is attached to and  lies just above the testicle, is responsible for the “detailing” or “fine-tuning” of freshly made sperm just released from the testicle.  Yes, the testicle produces the sperm but without the polishing and detailing in the epididymis, sperm wouldn’t swim and wouldn’t be able to fertilize an egg. So pretty important,  no?

It is important for a male to be able to tell when there are changes in the size or feel of his testicles or epididymides because these may be signs of cancer or inflammation associated with infection. This link, Get to Know Your Testis, explains how to find the epididymis ( which lies to the top and back of each testicle). You should also be able to also feel the tubes leaving from the epididymis called the vas deferens. If a vasectomy is performed, these tubes which normally carry sperm from the epididymis to the penis are clipped inside the scrotum to render the male sterile. Reconnecting the tubes surgically via a vasectomy-reversal procedure can restore fertility if not too much time has elapsed between the two surgeries.  There are two kinds of vasectomy reversal procedures as described in this article from the NY TImes Health Guide. It’s worth reading for those who want to know more about vasectomy and it’s reversal.

  • Vasovasostomy . The severed ends of the vas deferens are sewn back together.
  • Vasoepididymostomy . The vas deferens is surgically reattached directly to the epididymis. This procedure is more difficult to perform and is used when vasovasostomy cannot be performed or does not work.

But this post is about the epididymis, which despite years of research over many decades is still shrouded in mystery. The epididymis has three functionally distinct regions , the caput (or head), the corpus (or body) and the cauda (or tail). What is clear is that by the time the sperm transits these three regions and is stored in the final region, the cauda, prior to ejaculation, it is a fully mature sperm, capable of strong forward progressive motility and has acquired the molecular ability to fertilize the egg. But in spite of decades of research in both animals and humans, we still don’t fully understand all the molecular changes that occur in the sperm membrane within this organ.

The review article New Insights into Epididymal Biology and Function is a highly detailed review for those who want to understand the nitty-gritty scientific efforts to understand the molecular mechanisms responsible for the epididymides’ unique ability to grant life-giving properties to sperm. For the andrologist or reproductive scientist, it has lots of references for further study.

Up to 40% of infertility is due to male-specific causes. Some of these causes are not obvious and may well be due to molecular sperm defects we are incapable of detecting–and may be due to faulty “fine-tuning” of sperm cells in the epididymis.  Much of male-specific infertility can be addressed by the use of intracytoplasmic sperm injection or ICSI, which bypasses some deficiencies in sperm functionality acquired in the epididymis, like the inability to swim. However, ICSI is not without risks and sometimes fertilization fails even with ICSI so ICSI is not the solution for every cause of male infertility.

The original sperm cell produced by the testis looks like a sperm cell, but it is non-functional and can not swim. That is why testicular sperm can only be used with ICSI, not for conventional IVF or insemination, because it can not yet swim, nor fertilize an egg. The lipid (fat molecules) and proteins that are inserted into the plasma membrane of the sperm cell also change while in transit through the epididymis.  Some molecules are shedded and others are added to the sperm membrane to ultimately produce a functional sperm cell which can swim to, attach to, penetrate and fertilize an egg.

Researchers looking for male contraceptives are also interested in understanding which proteins are involved with functional maturation of sperm so that a reversible non-hormonal method to block sperm maturation can be designed. Likewise, if the molecular maturation mechanisms were understood, it might be possible to mature sperm in vitro and be able to use conventional in vitro fertilization, instead of ICSI, to gain the benefit of some natural selection. Therefore, a better understanding of the epididymis may lead to new therapies for infertility as well as new methods for contraception.

Each segment of the epididymis appears to have distinct gene profiles, producing a highly regulated cellular micro-environment, capable of responding to signalling pathways in a highly orchestrated way. Each segment is physiologically separated from the adjacent segment by connective tissue, permitting compartmentalization of the organ and segment-specific regulation . Not surprisingly, the various cells of the epididymis respond to androgens, the male hormone. Studies suggest that sperm and the cells lining the epididymis also exchange cell to cell  signals as part of the in transit maturation process and probably further regulate that process. The epididymis may have the most complex fluid composition of any exocrine gland and this composition varies with each region of  epididymis. The caput produces 70-80% of the proteins secreted into the epididymal lumen. By the time the sperm get to the cauda end, most of the fluid has been reabsorbed, fundamentally increasing the concentration of proteins bathing the sperm in the tubes.

Take good care of your epididymis and it will take good care of you.  Check your epididymis (and testicles) every month for changes in size, areas of hardening or changes in sensitivity or pain. Let your physician know about any unusual changes which could indicate epididymal (or testicular) inflammation, infection, presence of cysts or nodules,  or even cancer, all of which can impair your fertility and overall health. Here’s a link to more information on how to do a self-exam.

Carole Wegner is currently the VP of Grants Administration at the V Foundation for Cancer Research in Cary, NC. Prior to that, Carole was Lab Director of a Fertility clinic for more than a decade.  Her book: Fertility Lab Insider can be purchased on Amazon. https://www.amazon.com//dp/B004QOB7Z8

 

Hi there. This is Lori, the smartass. Looking to have laughs at infertility's expense? Sign up for my newsletter / check out my little eBook:

Laughing IS Conceivable: One Woman's Extremely Funny Peek into the Extremely Unfunny World of Infertility. It's my infertility story that's been downloaded by 1000s of infertility sufferers & professionals looking to de-stress from infertility with laughs. (comments by top infertility experts in "look inside".)

http://laughingisconceivable.com (newsletter sign up at top of page)

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Let's Hear it for the Boys... & Philip Cottraux

Yes-- This month-- Let's Hear it for the Boys.... and this week- Philip Cottraux. (I'll tell you who he is in a minute. Everyone's so impatient nowadays.) Women dealing with infertility publicly torment themselves and each other with the torture that is mother's day. But what about the men and father's day? Do you think like I think that just because they're not publicly announcing their anguish doesn't mean they don't feel it? Or is this just a woman's view of what a man is feeling? Are they all like my husband whom I begged and pleaded to "let out all of his bottled up emotions" to which he replied following my ten minute-long tirade: "What are you even talking about"?

So for the next couple of weeks, this here Laughing IS Conceivable blog is going to be all about the boys... and their "boys". From first-hand accounts from a man with fertility issues who is also the support person for his wife with fertility issues, to a man and adoption, to a therapist talking about the emotional and psychological aspects for a guy dealing with this, to a fertility lab director giving some great technical male fertility info, to an essay where I compare my relationship to my husband to my relationship with my Dad. How could that go wrong? So let me shut up for once, and get you right over to my new cyber friend, Philip Cottraux. So let's hear it for the boys! I love his story-- and this is it:

Philip Cottraux

The Horror-Comedy of Infertility

By Philip Cottraux

I met Lori on Twitter when her book on infertility randomly showed up in my feed.  She’s asked me to contribute some thoughts for her Father’s Day blog.  Because as you may know, women talk all about this stuff but we men are notorious for staying hush-hush about it.  Or as she said in her blog dedicated to me, acting like it doesn’t bother us.

So trying to break my usual act, here’s our story, such as it is.

My wife (Beth) and I met online.  She was a young widow.  Well, sort of.  Her fiancé had died tragically a few months before their wedding.  It was four years before she was ready to date again.  I’m originally from Atlanta, and she is a North Carolina native.

We were both 26 when we got married.  We were so excited about having kids, we already had four baby names picked out!  Two boys, two girls.  I’m an only child, so I couldn’t wait to have a big family to make up for my lonely childhood.  I’m also the last Cottraux.  So if I never have kids, my family name is going extinct forever.  Maybe I should be placed on the endangered species list?

Beth is the youngest of four, but she was still as enthusiastic as I was!  We didn’t wait too long, maybe less than a year.  People had already started asking if we were trying.  Back then, we would answer by looking at each other and giggling like idiots.

When talking about infertility, I usually start by asking “You know what the worst part is?”  Then after explaining the worst part, I’ll follow up with “But you know what the worst worst part is?”  Before long, I’ve described everything we’ve gone through for the past six years, and all of it is the “worst part.”

I had a common condition among men called a varicocele, an enlarged vein in my…nether-regions…that can cause low sperm count.  The doctor told us to keep trying for a year, and if we still hadn’t conceived, I might need to think about surgery.

The following year got very awkward as people started asking why we didn’t have kids yet.  We were still trying to keep hush-hush about my condition, so we would just give a generic shrug and say “Who knows?  Maybe soon!”

A funny thing I observed was that people automatically assume that the husband doesn’t want kids.  As time kept passing, my mom would tell me that women from our church gossip circle were wondering “I wonder why Philip doesn’t want any kids?  Poor Beth.  She’s probably begging!”  As if I’m Daffy Duck trying to shoot the approaching stork out of the sky with a shotgun and rigging the house with booby traps.

Despicable!

The doctor determined I needed surgery.  I found out that my grandfather had had the same condition and had the operation before my mother was born.  Over the phone, he told me to prepare for my balls to swell up as big as golf balls.  I thought, nah.  He had his surgery back in the olden days, when they bopped people on the head with a mallet for anesthetic and used rusty bone saws.  Turns out he was right.

I tend to be curious by nature, which did me no favors.  The night before the operation, I was glued to YouTube watching videos of “varicole-ectomies” that involved a “laparoscopic ligations along the spermatic chord.”  Or something.  Not exactly what I needed to see, since I’m a bit squeamish.

“They’re going to do that to me?  No!  Don’t cut it!  Don’t…ack, he cut it!  I can feel it already!”

Early the following afternoon, I was wheeled into the OR.  They put the mask on me, I looked up at the anesthetic dripping through the IV bag…and then next thing I know, I was waking up in an upright position, feeling like I’d been hit by a truck.  Beth was worried to death since I hadn’t eaten all day.  As I opened my eyes, groaning “Wha…happened…?” the first thing I saw was an apple being shoved into my face to my wife’s voice saying “Eat this apple!  Hurry!”  I thought I’d died during surgery and gone to apple heaven.  It didn’t matter, because they had forgotten to administer the proper amount of anti-nausea medication, so as soon as my mangled body was wheeled to the car I barfed it all back up.

But, at least it was over.  A week-long recovery, and a follow-up sperm count, and I was good.  Ready for action.  Locked and loaded.  Look out, Beth, cause I’m about to put a baby in you!  After about two years of trying, we’re going to make it now!  The first time we tried was like playing with a loaded gun.

And…it still didn’t happen.  Weeks passed.  They turned into months, which turned into more years.

About 3-4 years into our marriage, the people (most of whom still didn’t know about my surgery) asking about when we were having kids reached a fever pitch.  Then it sort of waned.  Obviously, my parents know.  But all the family/friends/coworkers/church members started asking less and less.  Now, they act weird around us, like walking on eggshells.  Do we have an incurable disease now, or something?

Doctors have determined that since my surgery, Beth must be the reason we can’t get pregnant.  But unfortunately, that’s as far as we’ve gotten.  We were very fortunate that the insurance covered my operation; but they refuse to touch testing, artificial insemination, or IVF.  These things can cost a fortune (and I’ve contacted my company’s benefits department begging on bended knee for help), so we’re stuck for now

As a result, Beth has sought natural treatments.  Over the years, this has gotten ridiculous.  Everything from slathering castor oil on her stomach, to acupuncture and getting her tailbone cracked by the chiropractor, to doing weird nightly belly massage rituals, to a medicine cabinet filled with dandelion extract and whatever else miracle cure for infertility she can find on the internet.  You can’t make this stuff up.  And as of yet, none of it has worked.

The only people who ask anymore are random acquaintances.  For example, the dental hygienist when I’m getting my teeth cleaned.  Or a fired coworker I run into that I haven’t seen since the wedding.  I call it the “dreaded question” now.  It’s almost like they’re flirting with you.  Their eyes get big, they bat their eyelashes, then give you a sneaky smile.  It’s like they’re prodding for some kind of major secret.  Then, in a low voice so no one will hear, they whisper, “So?  Have you guys…talked about…maybe…just maybe…starting a family???”

Instead of beating around the bush, now I just croak “Infertile.”  It’s amazing how fast their demeanor changes to wide-eyed horror.  “Oh!  I’m so sorry!  I shouldn’t have asked!  Oh, I’m such a horrible person!  Please forgive me!”  I have to reassure them that it’s okay while they beat themselves up.  Then it’s time for an awkward subject-change!

Anyway, as you can imagine, it’s difficult to pinpoint what exactly is the “worst part” of all this.  It could be how I feel like we’ve let so many people down that were excited about us having kids.  It could be the horrible combination of guilt-jealousy-trying-to-be-happy-for other couples that announce they’re expecting.  It could be how fast time is flying by, and how hopeless it makes you feel as the years sift through your fingers, like grains of sand.  Or how you picture what your kids are going to look like, and fantasize about pushing them in backyard tire swings and holding their hands while they ride a bike for the first time or take them to their first day of school and read them bedtime stories. The fantasies that are ripped away from you every day by cold hard reality.

Or the fear that you might be slowly turning into your crazy aunt who never had kids.  You know the who I’m talking about; we all have one.  The one who sends out Christmas cards every year with pictures of her bichon-frises sitting in Santa’s lap.

But instead of focusing on what hurts the most, let me describe what helps the most; meeting other people such as Lori who have been through this and knows exactly how we feel.  Especially if they can put a humorous spin on what has otherwise been life’s most crushing disappointment.  I can’t wait to read her book!

Philip Cottraux is a Pentecostal Christian Blogger, Bible Teacher, Writer for Jesus and Husband. http://www.depthsofpentecost.com/

And I swear I didn't tell him to plug my eBook but, well, what can I do now that the damage has been done but give you the link?: https://www.amazon.com//dp/B007G9X19A/ available on all Amazons, Nook, & Kindle

 

Mother's Day Post from an Infertile Dad

Hi everybody! In honor of Mother's Day,  please help me welcome Guest Blogger, James Doherty. He has a great blog called: Scantily Dad. (Just use the link below if you'd like to check it out. I tried googling "scantily" & unspeakable things came up. My home might be raided any minute.) He and his wife have been through IVF and here's his unique & quite humorous take on it, & Mother's Day.... Enjoy! (Alert: children mentioned)

Mother’s Day - An acronym for my infertility journey

To celebrate my wife and I beating the crap out of infertility, I have kindly been given the honour of guest posting for Laughing IS Conceivable. Humour is important for me and I had to try and find humour in the least funny of situations, infertility. The easiest way for me to do this was by creating an acronym that represents my journey through the IVF mill. This is no reflection on my mother or my wife, I swear, so if you read this Oli or Barb, please don’t beat me up.

The acronym for "Mother’s" describes our horrific journey through infertility and IVF. Those nerve-wracking times are thankfully behind us.

The acronym for "Day" is a little more on the positive side and reflects how we got through IVF treatment

MOTHER'S

M stands for Mortified. I was mortified at the fact that my sperm move about as graciously as a Walrus on land.

O stands for Ossified. Being a proud Irish man getting ossified (plastered drunk) was the only way to numb the pain of stopping my wife from being a Mother on Mother’s day. In hindsight, drinking could have been the cause of, and the solution to my infertility problem. Whoops!

T stands for Testicular Ineptitude. It is a sad state of affairs; my testicles are inept. My sperm is about as abnormal as an immigrant on Donald Trump’s board of advisers.

H is for Handjob. How romantic is it that for us to have babies all that I had to do was have a quick handjob.

E is for Ejaculatory dilapidation. Over a decade of eating crap, drinking like a fish and smoking like a chimney has left my sperm in a state of ejaculatory dilapidation.

R is for Ravaged Relationship. Our relationship had been ravaged by the rancorousness of assisted reproductive therapy. Thankfully, we made it through and came out the other side unscathed.

S is for the Shit times. Oh those shitty shit times. Two failed IVF treatments were the shittiest times of our lives. Anyone who has been through it knows just how shit it actually is. When you think you are having a bad day, compare it to failed IVF, and rarely will your day be worse.

DAY- OH HAPPY DAY

D is for Dedication. That’s what it takes to get through the shit times of IVF. You have to keep your eye on the prize. Seeing the bigger picture and being dedicated to the end goal is key to getting through infertility.

A is Appreciation. When everything is so hard and there seems to be no end in sight, it makes the good times feel even better. If you live each day in appreciation of what you have got, then you will be happy for the rest of your life.

Y is for Yes we fucking can. In the words of Barack Obama, with fucking thrown in as intensifying adjective, “YES WE FUCKING CAN” is the only attitude that will get you through infertility and IVF treatment. That attitude is the reason we did not give up and now have twins.

http://scantilydad.com/

https://twitter.com/scantilydad

https://www.facebook.com/scantilydad/

https://www.instagram.com/scantilydad/?hl=de Proud survivor of three IVF treatments, James was born and bred in Dublin Ireland and lives in Berlin, Germany with his twins Max and Mathilda. He is a dad blogger and an influencer that writes about infertility, twins and all things parenthood. The scantily dad blog is the ultimate parenting resource on the internet.

"Thanks, James!"-- This is Lori speaking now. If you'd like more laughs at infertility's expense:

Check out my own new bonus Mother's Day post:                   "Mother's Day in the Land of What Ifs"@ http://laughingisconceivable.com/mothersdaywhatifs/

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Peruse my eBook: (Isn't "peruse" an abbreviation for "purchase"):

Laughing IS Conceivable: One Woman's Extremely Funny Peek into the Extremely Unfunny World of Infertility.

https://www.amazon.com//dp/B007G9X19A/

https://www.amazon.co.uk//dp/B007G9X19A/ (Amazon UK)

https://www.amazon.ca//dp/B007G9X19A (Amazon Canada)

Available on Amazon, Kobo, & Nook

 

In 2011 I'll Quit Cursing, Watching Football, And Eating Ice Cream (Wednesday)

Then I'll be totally unrecognizable even to myself. (Start with "Tuesday" if you can. That should be your first New Year's Resolution. #1: Read entire Laughing IS Conceivable blog post every week from beginning to end and then begin again over and over from Monday thru Friday over and over from start to finish and then begin at the beginning (geez, someone stop me. I'm getting dizzy.)

So, what were we talking about? Oh right. The possible value of New Year's Resolutions for infertility sufferers. And how we must avoid the absurd resolutions that most of us make. I think we all know the kind I'm referring to:  

"I'm going to lose weight by eating only grapefruit for two months."  Yeah let's all do it. From now until March we'll all join together and be on the diarrea diet. Instead of cycle buddies we'll all have bathroom buddies. We'll all dehydrate ourselves down to 100 pounds and pick a centrally located emergency room, perhaps in the midwest, where we can all gather to celebrate in the Spring. 

Diet is a fantastic idea, I think, for people going through infertility. No, not dieting. Eating well. You know those people who never diet and don't believe in diets? I'm one of them.

So, maybe I'm just one of those lucky bitches who never gains weight. Not even close. And to add insult to injury, I'm short and have a small frame so it's got nowhere to hide and it ain't pretty. If you're familiar with the SpongeBob show, think of Patrick. If you're not familiar, let me tell you that Patrick is a flabby starfish. There's a visual for ya.

The reason why I think "eating well" is a good New Year's Resolution is because it's one of the few things along this crappy infertility-laden path that we can actually control. I know a lot of women whose infertility-related issues are directly related to their being overweight issues.

On the one hand it sounds so easy: "Lose fifty pounds and you'll probably have no trouble getting pregnant'. On the other hand, that sounds like enormous pressure. 

Even if weight isn't your fertility issue, I think it's important to keep our minds and bodies working their best and feeling their best especially in times of stress. Infertility? Stress? Never heard those two words together in the same sentence have you? "This infertility is stressing me out!!" "I hate these damn infertility treatments! I'm soooo stressed!" Nope. Doesn't sound familiar. 

Dr. Oz has his list of diet commandments. I've got some too. Mine mean less than his. Okay, mine mean nothing. But I think they're valid anyway so I'll be discussing a few this week. See if you agree with 'em.

1) Start very small. 

Let's not do the: "I'm going to lose eighty pounds by the summer" routine. I've done it. Trust me, it's dumb. 

This is how that kind of nonsense usually plays out for me. I lose ten pounds by February, then do the double cram. First I'd cram as much crap into my mouth as possible in the Spring culminating in Memorial Day weekend barbecue hopping, then do the second half of my Pillsbury Cram-off: Diet my ass off (or any other part that's willing to be shed) in the mad dash to achieve my goal of losing those eighty pounds by summer.

Of course, I'd pretend it would be mathematically possible to achieve by the unofficial start of summer, July 4th, then re-read my resolution notes from January and realize that I never actually specified "unofficial or official start of summer", so it would be well within my resolution rights to extend my goal date to the official start of summer which, I don't need to consult a calendar, I'm pretty sure is in October. 

So instead of killing ourselves with all that rigmarole how about:

"I'll drink eight glasses of water a day. "?

Listen, I gotta go: I'm on my "may as well start my good eating habits fresh in the new year binge." Only a few days left to consume all of that half-price after Christmas, Christmas candy. Ding ding. I do believe I hear a chocolate bell calling me now.

I'll talk with ya again tomorrow.

The Great Thanksgiving Roast (Thursday)

(Start with "Monday" if you can. Read a day at a time. It's a good way to get a break from the relatives. Every half hour or so,  tell them you have a stomach cramp and slip out of the living room and into their computer chair. You'll send a wave of panic through your family as they realize the implications of someone hogging the toilet on this day of all days.) So, what were we talking about? Oh right. Keeping your spouse close by for the entire Thanksgiving hellfest. There is strength in numbers. And if someone asks you an embarrassing question, you can just shove him in front of you to deflect it.

"Helen, you're not doing any of those fertility treatment thingys are you?..."Dave? Where did Helen just go? I could swear she was just standing right there, where you are now."

I also think, there are still in 2010 some things people won't say in mixed company. This can definitely work in your favor. Women probably won't mention your menstrual while your husband's around.

Just like, when you're in the vicinity, men probably won't bring up their highly scientific theory on the culprit behind your husband's fatherhood issues: That time in 1989 when they all went to the beach during spring break and your husband sat on the scorching hot sand with a way too short speedo.

So, if you're a man and a woman together at this function, you've got it covered as long as you hang together. If you're a same sex couple... hopefully just showing up together still freaks out the most annoying of your relatives enough that they'll never even get around to bothering you about the trying to conceive part. Hold hands a lot and gaze into each other's eyes lovingly if you have to.     

For everybody: When you sit down to dinner, choose your seat wisely. Don't be the first to sit down at the table. You'll be stuck with whomever sits down next to you.

What happens if it's your aunt who whips out a newspaper clipping on endometriosis she's been carrying around in her purse since July 4th when you dodged her at the family barbecue? 

If somehow this does happen, however, don't despair. Simply get up, go do something (get a spoon, read more of my blog...whichever), then return to the table and "absent-mindedly" sit in the wrong seat.

You don't have to sit next to your spouse, but you should definitely be within deflection distance of each other. And both of you need to keep your ears perked up for key danger words. For example:

Aunt with the article in the purse sits next to you, and in between stuffing stuffing into her teeth and unwedging it with the back of a matchbook, she tilts in your direction. You're not sure what she's about to do. She could either be internally rearranging the four glasses of club soda she chugged, or worse: She's about to talk to you. You hold your breath waiting to see out of which end the noise will emerge.

Your husband appears to be immersed in his slab of cranberry sauce, trying to decide what is proper Thanksgiving dinner etiquette: To turn it can imprint side down before tackling it or leave it as served. But his ears are wide open and zoning in on your aunt like he's the Bionic Woman.

And she speaks to you:

"Oh (okay, the word "oh" seems fine.)

"did I mention" (no objection so far)

"that my neighbor's daughter" (Warning: Lights begin to flash. I know my aunt. She wouldn't be telling me about this girl I never met unless she's  either having a baby or is a prostitute.)

"is" (Husband reaches for nearest bowl.)

"pregnant?"

"Peas?! Aunt Yenta, do you want peas? Does anyone at this table want peas? How about down there? How about you? How about you? How about you?"

Deflection. That's the name of the game. It's not really a family dinner. It's fricken air hockey.    

Listen, I gotta go before the  tryptophan kicks in and I fall asleep on my keyboard. 

I'll talk with ya again tomorrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr

Men,Men,Men,Men,Manly Men, Men,Men (Friday)

(Start with "Monday" if you can.  Yes, all this week is about men: Specifically, our men and their roles in our infertility journey: From us getting them prepared for their IVF husbandly duties specimen to the history behind the nightly "jab her in the butt cheek" ritual.)   I have to say these guys deserve all of our gratitude. If you're lucky enough to have someone amazing, they're indispensible across the board.  But anyone who's ready, willing, and able to give you tush injections is golden. 

There are a lot of people who volunteer for great causes: Donating blood with the Red Cross. Building homes with Habitats for Humanities. Building schools in developing countries with the Peace Corps. Maybe you're luckier than I, but trust me: There's no waiting list for volunteers to hold ice on my butt every night. Most people would just as soon risk malaria.

Even my husband asked: "Are you positive you can't find somebody else? Have you tried Craig's list... or Match.com?" 

Besides the emotional support of someone who takes on that task, there's the actual physical support.  

I've read online instructions for injecting yourself with progesterone. Has anyone ever tried taking this 1 and 1 /2 inch needle and injecting their own tuchas? I don't know about you, but I'm not nearly that coordinated. Twice in my life I tried to curl my own eyelashes. I ended up in the emergency room both times.

I just can't picture it: "Okay so I think this the upper outer quadrant of my buttock. Yeah, now I've got it. Right...about... here! Oh crap. There goes my spleen."

The husband may have seemingly only a few responsiblilities on this journey with us. But it is an unpleasant little list.

You know when people have a loved one who's sick or suffering and they say: "I wish it was me. I would trade with them in a second." I'm sure our guys really mean it. Sure, some of it is love... But consider the scenario:

"Mr. Jones, your wife will take several drugs, undergo a battery of tests, have doctors' appointments several times a week perhaps for several months during which she will be wearing nothing but a giant paper napkin and socks, lying on a table in a position developed by cirque du soleil...    and for you we have this cup."

"That's okay. I'd rather do the drugs and paper napkin."

"Oh, and by the way. The stress of the whole infertility thing piled on top of the hormones your wife's being given isn't always a pretty concoction. You may find living with her for the next several weeks, months, or years to be difficult if not intolerable. She may be moody, anxious, depressed or just hate being around you for apparently no reason."

"No, I'm serious. I want the drugs and the napkin. Where are they? Give them to me now!"     

Whether it's female infertility or male infertility, or both, or nobody's sure which: If you can really bond together against the odds, and the relatives, and the bills, and the relationship actually manages to survive infertility, the next sixty years should be a piece of cake.

Listen, I gotta go. I have to submit my timesheet at work to payroll. I may goof off, go to lunch and not return until the next morning, chat online all day, and call in sick every Monday and Friday... but I'm always very prompt for the good people in payroll.

If you haven't already, don't forget to check out this week's excellent Health Experts article: "Ways to Boost Male Fertility" by Natural Fertility Specialist Ian Claxton.  http://laughingisconceivable.com/?page_id=642

I'll talk with ya again on Monday.

Men,Men,Men,Men,Manly Men,Men,Men (Thursday)

(Start with "Monday" if you can. You've got plenty of time. Either you're off from work today because the office is closed or you just called in sick because you thought it was a gyp that the office was open.... And if you can put up with me for a few extra minutes a week, consider becoming a subscriber. It's simple and quick (and free did I mention it's free?) and you get some fascinating insider info.) 

So what were we talking about? Oh right. How our husbands, partners, boyfriends, naked acquaintances, kissing neighbors, hot papas, really are quite literally, our "right hand men" in this infertility project. Have no fear. I will stop the puns there.

There's another important role that the man plays in our infertility madness. One, which in my opinion, is a humongous scam.I'm speaking of the nightly progesterone butt cheek injection. Scam!

I'm thinking that way back,way, way, back at the beginning of IVF, like in the 1800's (I think Laura Ingalls was conceived through IVF), there was this husband. And this husband went to his friendly corner fertility clinic/candy store/barber shop and took aside his friendly, neighborhood Reproductive Endocrinologist/store clerk/barber and said:

"Look, I can't take it anymore. My wife is angry and depressed. She's irritable and has mood swings. Yesterday, to make her feel better, I offered to whittle her something and she tried to bite me. I know she's going through a lot with these treatments but sometimes I just wish I could take a sharp, pointy, 1 1/2 inch object and jab her in the ass!"

And the wise old Reproductive Endocrinologist/store clerk/barber, took off his latex gloves, covered his Raisinets, put down his razor, and summoned the young man into the back room.

"Come with me son. I think I may have just the thing."   

And the scam has been carried on between husbands and RE's ever since. The husband has that desperate, basset hound, pleading look in his eyes: "Please, please, she's becoming impossible. I can't take it anymore." And the knowing doctor winks and slips him a prescription in a reassuring handshake.

And then to sell the scam convincingly a whole production is staged in the bathroom (originally outhouse) that night.

My husband put on scrubs with face mask, a lab coat, a stethoscope around his neck. We couldn't find surgical gloves so he just put on the yellow rubber dishwashing gloves from the kitchen sink.

So there we were in our teeny bathroom, with the ten pound bag of ice he bought for our own private "tail-gate" party, needle, vial, alcohol, and Costco box of 70,000 cotton balls.

All the while, I'm picturing him taunting me in his head, like a nasty kid at the playground: "I'm going to jab you in the aaaass. I'm going to jab you in the aaaass... and you can't stop me. Na Na Na Na Na."  

I'm wearing a beautiful long-sleeve turquoise cashmere sweater with lovely detail around the neckline, diamond earrings with matching pendant, and nothing else- leaning against the sink on my elbows, butt-side facing out.

And there's my husband, 1 1/2 inch needle in one hand, instructions from the Internet in the other: "Okay, so I think the upper outer quadrant of your butt is right about... or I don't know... maybe it's more to the left... could you look for a minute and tell me which is right... I mean correct."

And I'm mumbling: "Great, the guy who gets lost with GPS is searching for my upper outer quadrant like I'm on Star Trek Deep Space...Very Deep Space OW!"    

Listen, I gotta go. I have to run outside and capture the glorious symphony of bursting fall foliage before it turns into an unsightly unraked mess.   

Check out natural fertility specialist Ian Claxton's article: "Ways to Boost Male Fertility" in Health Experts this week. You may as well. I mean, you blew off work, so it's not like you don't have the time. http://laughingisconceivable.com/?page_id=642

I'll talk with ya again tomorrow.

Men,Men,Men,Men,Manly Men,Men,Men (Wednesday)

(Start with "Monday" if you can. Tomorrow's Veteran's Day and I'm an IVF veteran. Have some respect. Do I get a free meal at Applebee's?) So, what were we talking about? Oh right. How impressed everyone at the fertility clinic was with my husband's Olympic swimmer sperm and how underwhelmed they were with his old lady- who, in fertility terms was well--- an old lady. 

We also discussed how you sometimes feel jealous when you're the one diagnosed with the infertility problems. And it's okay to lament (momentarily) that you're the one who has to go through all of this, not him. 

In preparing for this post, I came across an article on FertilityPlus' site. It made some mention of the man's role. The seedier side of his responsibilities. Yes, I think you know to what I'm referring. Oh grow up. You do too. 

I stumbled upon this bit of advice:

"Don't talk to your partner too much about his role. This may cause him extra anxiety during an already stressful time and the extra stress can aggravate the performance anxiety that men suffer on the day of retrieval." 

Now you tell me. So which of these things should I have not said to my husband on that day? Or should I ask: "How many of these things should I have not said?"

1) "Honey, I'll leave you alone now. Do you want me to leave The 'Golden Girls' on? It's the one when Sophia wakes up on the couch naked."

2) "Honey, is this like playing golf for you? When you're aiming, does that cup seem extremely small?"

3) "Don't worry about that picture of your mom next to the bed. I'm sure she's not really watching you."

4) "You'll be thinking of me the whole time, right?"

5) "Don't worry if you can't do it. $15,000 down the drain. It's only money."

6) "I'll be in the car. Come on, come on."

7) "Please focus. You know you never finish anything you start. Remember the deck?"

8) a)"Your sister's on the phone. Should I tell her to hold on?"

      b)"This is such an exciting moment for us. I have to tell somebody. I'll talk to her until you're done."

10) "Try to make extra in case we spill some on the way."

10) "So then, if you're doing this now, I'm off the hook for tonight, right?" 

11) "This is kind of a special occasion. Should I iron your dress pants?"

12) "Let me know the second you're done so I can catch you before you fall asleep."

13) "Don't make yourself too comfortable. We have an appointment to get to you know."

14) "Do you need an extra hand to hold the container lid?"

15) "I hope you're not planning to take a shower afterwards. We don't have that kind of time."    

I can't believe he threw me out of the house and then wasted precious time changing all the locks before he commenced.  

Listen I gotta go. Do you think I'll have to dress in uniform like other vets when I go to Applebee's for my free meal tomorrow? I can wear my paper examination gown. I could use a bib when I eat anyway. 

If you have the chance, take a look at Ian Claxton's article: "Ways to Boost Male Fertility" (naturally)...quite informative I think. http://laughingisconceivable.com/?page_id=642

I'll talk with ya again tomorrow.

Men,Men,Men,Men,Manly,Men,Men,Men (Tuesday)

(Start with "Monday" if you can.  This whole week is dedicated to the "Y" chromosome, all grown-up, married to us and keeping us company during the entire infertility debacle.) So, what were we talking about? Oh right. Men and how they fit into the whole female infertility journey.   

As I'm sure most of you are aware, infertility can be attributed to the female partner about 1/3 of the time, the male partner 1/3 of the time and a combination of the two 1/3 of the time... and of course there's also the endlessly frustrating "anybody's guess" column somewhere in the mix.

No matter who gets diagnosed with what: Forget "fault". Neither of you is at fault. Somebody's body' is not working properly.  No fault. You didn't cause a car accident. If you became infertile because you were texting during sex, then forget what I said: Screw you, you are at fault. Otherwise, let blame,guilt, fault, all of that crap go.   

And let's say right here: If you're the one who's deemed to be the "infertile one" in the relationship... you have the absolute right to be a little jealous of your husband/wife, spouse, lover, best-you-could-do-under-the-circumstances, better-than-being-alone-or-so-I- thought-at-the-time, significant or insignificant other.

I know that 's not a nice thing to say. We're all supposed to support our partners unconditionally. Thick, thin; Sickness, health; Richer, poorer. Death, part. (Our marriage vows were in Hebrew. Gd only knows what we promised. The rabbi could show up anytime and take our car. "Look, during the ceremony, you said I could have it.")

But I think feeling a twinge of jealousy is normal.

When my husband and I first walked into a fertility clinic, as I've mentioned about a million times before, I was a month away from turning forty-one. They may have sent both of us for preliminary tests to be polite but let's face it: They had their suspicions.

I'm sure all the medical professionals saw was this handsome man graying at the temples with his deteriorated wife who had a flashing red light, red neon flags and a siren over her head. I guarantee more than one staff member gazed down the hallway to see who kept opening the emergency exit.  

So they looked in my husband's direction for about a minute and a half and then came up with this determination: "Mr. Fox, your sperm is the best we've seen in 20 years of practicing medicine. May we replace the tropical fish in our waiting room aquarium with your specimen?... As for the elderly lady with the shriveled ovaries you shlepped in here..."   

So why would I be a little jealous?

Okay, so let's make sure I have this straight: I'll be instructed to insert suppositories, take pills and inject nightly hormones into my person for several weeks, months or years and you'll be instructed to watch "The Real House Whores of Bootyville" and take liquid notes.

Wait wait, let me make sure I have this straight once more...

I'll be enduring hormone shots (nothing, I imagine, like Jello shots) and anesthesia, and egg retrievals, and pregnancy tests over the next several weeks, months, or years and you'll be cozying up to a Hooters' calendar on your lunch break.

Listen, I gotta go. I have to brush up on my Hebrew and replay our wedding video. I really need my car.

If you can, take a glance over at this week's Health Experts article by Ian Claxton: "Ways to Boost Male Fertility". It's a real page-turner, I assure you. http://laughingisconceivable.com/?page_id=642

I'll talk with ya again tomorrow.

Men Men Men Men Manly Men Men Men (Monday)

Okay so if you're not familiar with the theme song from the show "Two and a Half Men" you're now thinking I have either a speech impediment or a severe short-term memory disorder. ("Did I just type the word 'men'? I can't remember. I'd better do it again to be safe." Then half a second later: "Did I just type the word 'men'? I can't remember. I'd better do it again to be safe."  It's a time-consuming affliction. I could spend all week writing and never make it out of the title.) And that's what this week's posts are going to be about- No, not me developing Turrets syndrome late in life: The manly men in our lives who are joined at the hip with us during our infertility stresses and messes.

And for all of you guys who are kind enough to log on, stop rolling your eyes and don't worry... I don't anticipate doing any male bashing.**

**Writer not responsible on Monday for what she might say later in the week or even in the next paragraph. But she'll try her best.

I also think there's sometimes a lot of female bonding going on here but it's not really female bonding. It's more those-of-us-dealing-with,-or-who-have dealt-with-infertility bonding. Whether we are male, female. partner or patient, good friend or relative of an infertile or empathizing health professional.

If you are a regular reader of Laughing IS Conceivable, you know that I don't often let the fact that I know nothing about a subject stand in the way of me writing about it passionately and extensively.    

I don't know a whole lot about male infertility (but give me a sec and I'll introduce you to someone who does.) So I'll mostly be talking about the guys as they relate to their infertile wives, girlfriends, and hot mamas. 

This week in "The Health Experts" we're lucky enough to have a great article by Ireland's Ian Claxton, a natural fertility specialist. (I don't think "natural" implies that it came easy to him as in "You wouldn't know she just started taking piano lessons, she's a natural", but maybe it did. Anyway... ) Ian will be discussing, in this article, male infertility and offering some very specific professional advice on boosting male fertility naturally.

I thought you'd prefer to hear from him than to hear me say something dumb and obviously completely made up like: "Take swimming lessons. Studies have shown if you swim better so will your sperm."

Listen I gotta go. My sister-in-law  just quit her job and I have to find her a new one before she gets any bright ideas and comes to live with us for an indefinite period of time. Finding a job for another adult, - a  forty-seven year old in another state where the unemployment rate is ten percent. How hard could it be? 

If you have a moment, take a look at Ian's article, "Ways to Boost Male Fertility" at   http://laughingisconceivable.com/?page_id=642 or visit Ian at http://laughingisconceivable.com/?page_id=1230

I'll talk with ya again tomorrow.