news item: The flip side of infertility

Last weekend an ALI friend texted me a link to an article entitled The flip side of infertility, and when I first clicked on it, I wasn’t quite sure what to expect. From the cozy warmth of my bed, I started reading a post that was somehow instigated by a comment from a woman who had requested the author write a column on infertility and its challenges. I’ll let you pop over and read that post now before you read on here, but suffice it to say, I was blown away by how the post morphed into writing that included gems like:

I am fertile. I come from a family of women who are this way. My mother bore 10 children, her mother had six, and I have a sister who began with twins, following quickly with two more in the space of three years. Then there’s me. I have five children in the space of five years and four months. We are expecting our sixth child in about a month.

and:

For me, however, the biggest challenge I have faced is knowing when it is time to be done having children. Being raised in a home that loved and welcomed so many children, as well as a religion that encourages having children and growing families, it is difficult to know when to call it quits.

and:

Being fertile does have its challenges. Struggling with infertility has its challenges … merely being a mother and a woman has its challenges, and not one greater than the other.

It left me speechless (and to be honest, pretty rage-y), as it made it incredibly evident how clueless the general public can be (and usually is) when it comes to infertility. I’m sorry, but your Mom being extremely fertile doesn’t mean squat about what your fertility will be, and saying that deciding when to stop have kids is just as big of a problem as the challenges an infertile faces… um, are you &#%$^ kidding me?!

The basic difference is this: ONE of those “challenges” includes a CHOICE that one can make. The other does not. One guess for whose “problem” is a choice?

I’m not saying that having an unintended pregnancy isn’t a financial strain for many people, but you really cannot compare choosing to have sex and accidentally getting pregnant and being stressed about it to spending your life savings and then some just trying to get/stay pregnant in the first place or to adopt. You just can’t – or at least you shouldn’t.

I respect that this woman started writing and then realized she had no way to empathetically write an article about infertility since “[she] is fertile,” but to swing 180 degrees the other way to use the article to then claim that the challenge of infertility is no greater that being a fertile and having to face the decision of when to stop  having children… GAH.

If you haven’t figured it out, I don’t really have a point to this post, but it truly is the first thing I’ve read in a while that caused me to stop in my tracks by the outright ridiculousness of the statments and assumptions. Boo hoo on the pain olympics and all that, but really? I’m not feeling badly that it’s so hard for you to decide when to call it quits with having children.

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Do you think this woman should have written the article at all once she realized she was so far out of her knowledge base?

How do we educate the general population about ALI without sounding “woe is me” and hypercritical?

Do you ever get rage-y about articles you read online? Do you comment to try to educate or stay far, far away?

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Josey is mommy to Stella (born Dec.2011) after a two year TTC journey and a tentative Dx of lean PCOS and anovulation. Blessed to get a BFP with a Clomid + Menopur protocol IUI done at CCRM. Currently naturally pregnant with #2! Loves to travel and speak French, drink beer in the sun with her husband and friends, and enjoy all of the outdoor activities that life in Colorado has to offer.

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news item: Latest IVF Scare: ICSI and Intellectual Disabilities

The news was full of dramatic headlines about the results of the latest IVF study last week. This study, the first to compare IVF treatments and the risk of neurodevelopmental disorders in children, found that ICSI was associated with an increased risk of intellectual disability and autism in children.

Researchers analyzed over 2.5 million Swedish birth records and compared those born via IVF with those conceived naturally. Here’s the data:

  • 1.2% or 30,959 children were born via IVF
  • Of the 6959 children diagnosed with autism, 103 were born via IVF
  • Of the 15,830 with intellectual disability, 180 were born via IVF

The Good News

While there does not appear to be an increased risk for autism for children born from IVF, there is a small increased risk of intellectual disability for children born from IVF: about 47 in 100,000 infants born from IVF compared to 40 in 100,000 for those conceived naturally. Unsurprisingly, this increase disappeared when researchers factored in multiple births.

The Bad News

More concerning, however, was what the researchers found when they compared outcomes by IVF procedures: fresh embryos, frozen embryos, ICSI, and if ICSI was used, how the sperm was obtained (surgically or ejaculated).  The researchers found that children born from IVF utilizing ICSI (regardless of fresh or frozen embryos) were at a 51% increased risk of intellectual disability (62 to 93 births out of 100,000). Even when the researchers adjusted for pre-term and multiple births, IVF using ICSI and fresh embryos was still associated with an increased risk of intellectual disability.

The news outlets are interpreting these findings as a much-needed reminder that male-factor infertility exists and could have ramifications for couples to consider since ICSI began as a treatment for male infertility.  What many of the articles ignore is that clinical usage of ICSI has expanded beyond male-factor infertility to be used for many patients undergoing IVF. My husband does not have male-factor infertility, but our eggs were fertilized using ICSI during both of our fresh IVF cycles because, as this article notes, ICSI works.

The problem is that injecting the sperm into the egg bypasses the “survival of the fittest” process most sperm have to go through to fertilize an egg. I’m speculating here, but it’s likely that the line of though most embryologists and clinics take is that if the sperm is bad, the egg won’t develop or the embryo will arrest before transfer or freezing or will result in an early miscarriage. Nature’s safeguards will still prevail.

I’m concerned that this study and the emphasis it places on male-factor infertility will confirm the general public’s tendency to believe that ART is playing God and that interventions such as IVF and ICSI allow couples who possibly should not be able to reproduce to do so.  I also worry about the despair it could cause couples suffering from male-factor infertility and/or relying on ICSI as part of their treatment arsenal: they really are genetically inferior.

It’s important to remember that the outcome of intellectual disability after ICSI is still very rare and that ICSI remains a safe option for the overwhelming majority of couples using it.  These types of articles frustrate me because they tend to overstate the results of these studies almost gleefully: of course IVF is unsafe. We told you so!  The bottom line is that having children, having healthy children, is a crap shoot that every couple faces regardless of whether they use ART or conceive naturally. And reproductive science continues to advance all the time. On the heels of the sensational IVF/intellectual disability headlines came the news about Connor Levy, a baby born after his parents had cells from their IVF embryos sent to Oxford for scientists to analyze for genetic abnormalities. The results of the analysis enabled the Levys’ doctors to transfer the best embryo; the screening process is being hailed as revolutionizing IVF and potentially reducing the number of multiple births.  Maybe in a few years, we’ll regard the study’s findings about ICSI as a quaint example of IVF’s earlier days.

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What do you think of the results of the survey? Did you use ICSI? Would it change your usage of ICSI?

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Keanne of Family Building With a Twist in her own words: I’m KeAnne (like LeeAnne w/ a “K”). Mommy to 1. Wife to someone who knows how my mind works. Scary (you should see what goes on in my mind). Owned by 3 cats. I work full time and don’t craft or DIY (you’re welcome). I like books, conspiracy theories, Downton Abbey and cooking. I dislike chocolate, zinfandel, carpet beetles and experts. Expect over-thinking, the occasional rant, strong opinions and the occasional (OK, often) piece of useless knowledge.

It takes balls…

This is part two of our two-part feature on male factor infertility issues. Yesterday I shared an article about what it’s like for men dealing with infertility. (Click here to catch up.) Today, my husband is guest posting to give us his personal take on it. We hope you’ll enjoy and share your thoughts with us.

They are THE symbol of virility. And, for the man who really wants to make a “statement” about his manhood, he can even hang a pair from his truck bumper. Regardless of what that statement might be (that’s a blog post for another board/time), as a man who has struggled with male-factor infertility (MFI), I find the truck nut statement, regardless of what it might be, confusing. Do the balls really make the man? If so, what does that mean for a man who may be struggling to “do his part” in conceiving a child? What I’ve learned on my journey with MFI is that it’s not the circumference of one’s testicles that makes the man, but the size of his… I’m getting ahead of myself.

First, a little about my story.

It was December of 2010, Chandra and I had been married for two and a half years when we miscarried. Yes, “we.” We miscarried after months of preparations, procedures and counseling with a fertility specialist. We. Nothing can prepare you to “be a man” in the midst of a miscarriage. I’ll never forget that night: running to Walgreen’s and buying multiple pregnancy tests to “make sure” that it wasn’t a misreading; sitting in the hall as Chandra took the tests; barging in when she started bawling; and, holding her as we cried in each other’s arms on the bathroom floor.

I wish I could wax eloquently about the emotions that led to my decision to get tested. The fact of the matter is that I couldn’t bear to see my wife so heartbroken again. I had to do something. And, that something was making sure I was “doing my part.” After several “complete” examinations (and I mean complete—in 21 years when I turn 50, I’ll know exactly what to expect), it was determined that I had varicoceles that were overheating “the boys.” Surgery was the only option: a same-day surgery with a small incision just below the belt line. February of 2011 I had the surgery. I had to be horizontal for a week and no “heavy-lifting” for a week after that. Since I work in a very public setting, and I was out for two weeks, news quickly spread about me being “laid up.” And, though this was a private matter, the rumors became very public. People were spreading unflattering rumors about my balls. Seriously, I’m a pastor not a porn star. It was strange that otherwise great people felt it their responsibility to provide commentary on something they knew nothing about. The rumors were embarrassing and spread quickly. Nevertheless, I stayed quiet and let the rumors circulate and run their course without saying much of anything. But, I shouldn’t have. I should have said something then, but I didn’t. So, I’m going to say it now…

Male factor infertility doesn’t make you less of a man.

Manhood is not defined by the circumference (or the productivity) of the testicles hanging between your legs (or from the bumper of your truck!). The true measure of a man is his ability to see the truth of a situation and do something about it.

Male factor infertility is a real issue that we (especially men) can’t ignore. According to the American Society of Reproductive Medicine:

“about one-third of infertility can be attributed to male alone factors.”[i]

It’s a common issue. By saying and doing nothing, we are diminishing our manhood. Denying the truth of a situation doesn’t help anyone. Let me be clear: being open about and dealing with male factor infertility will “take a lot of balls.” It takes courage to talk about, find answers to, and go through treatments (if there are any) for MFI; but, in the end, it’ll make us all better men.

Male factor infertility isn’t easy to talk about. I know that. This is really the first time in three years that I’ve written or spoken so openly about it. I know, statistically, I’m not alone on this journey, but there aren’t many other men who are willing to talk about male factor infertility. “It takes balls” to tell your story. I’ve found and shared mine. Will you?

What’s your story?


Has male-factor infertility affected or influenced the way you understand manhood?

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daddy unicornChandra is a Mom and Foster Mom. She holds a Master’s degree in Theology and is particularly interested in the theology of infertility. Chandra’s husband has *balls* and she is so crazy in love with him it’s not even funny. She occasionally attempts to make sense of all those things, and more, over at her blog, MetholicBlog. She also shares embarrassing stories about her husband and unicorns, because yeah, he’s so manly he plays toy unicorns with his daughter, Stella, and they have magical adventures together.


[i] “Men’s Health: Male Factor Infertility” at OSU.edu <http://medicalcenter.osu.edu/patientcare/healthcare_services/mens_health/male_factor_infertility/Pages/index.aspx> Accessed June 19, 2013.

news item: for men, infertility often becomes a private heartache

Welcome, this is a special 2-part series featuring posts from myself and my husband. Today I’m going to review a news article that looks at the male perspective of infertility, and share with you about our own personal journey. Tomorrow my husband is going to respond to the same news article with his perspective – what it’s like to be the guy half of a couple facing infertility. So stay tuned!

What is it like to go through infertility? We could all write pages about that one question. But ask it slightly differently and I bet most of us would struggle to find an answer: What is it like to go through infertility as a man? And even harder to answer: What is it like to go through infertility as a man, with indications that male factor infertility issues are at play?

A recent Washington Post article attempts to look at these two questions. What is it like for a man to watch your wife go through injections, invasive procedures, only to not get pregnant month after month? The unspoken rule of silence that pervades men when going through infertility issues, how does a guy bring that up to his buddies? At best it’s just a general comment of “were having trouble getting pregnant” and then averting of eyes and changing the topic.

Why? Because society tells us that infertility is a) ALWAYS the woman’s fault, and b) men are always super fertile. When a couple announces they are pregnant, what happens? The husband gets slapped on the back and comments of ‘good job’, ‘way to go’ and other inane and inappropriate comments are made. The author of the article relates a real life example:

When she considers what men go through, she thinks about rapper Jay-Z. At an awards show soon after wife Beyoncé announced her pregnancy, cameras panned to the expectant mother proudly rubbing her growing belly. Men sitting near the couple jumped up to slap Jay-Z on the back and offer high-fives for a job well done.

And when you do come out of the ‘infertility –closet’, Stephen Yunis, one of the men interviewed in the article says:

Friends would joke he must be doing it wrong. “It’s always a guy thing, like a sexual guy thing. And they think it’s hilarious. Most of them are just kidding. But it’s like, ‘You don’t have any idea.’

Yeah. We got that comment, multiple times, from friends and family. And when you come fully out, when you tell close family and friends your infertility is related to male factor infertility (MFI) issues – wowza – the comments, I was not prepared for the comments we got. Most given in general support, people grasping to say anything. That support is appreciated, the comments, not so much. My husband was actually questioned about whether he was really a “man.”

This is why we, both my husband and I, talk about this. And I will talk about it here as well. My husband had varicoceles. That’s a fancy word for extra veins in his groin. Now, if you remember your sex-ed class correctly you’re thinking ‘but good blood flow down there is a good thing, isn’t it?’ It is, varicoceles don’t impact function, if you get my drift. But extra blood flow heats the ‘boys’ up, so it was like my husband was sitting in a hot tub 24-7. And we all know too much heat causes all sorts of problems. We had poor morphology, poor motility, and DNA fragmentation.

There are many types of MFI, from genetic factors present at birth that render a man sterile, to a missing vas deferens, to lifestyle factors. For the most part MFI is never about whether a man can ‘perform.’ But in some cases, say a man who was abused as a child, or a man on certain medications that, as a side effect, cause impotence, it does come down to function. Now imagine those comments again, and how damaging they can be.

I can’t say our decision to talk about our infertility issues has always been rosy; people for some reason are uncomfortable talking about MFI issues yet are more than willing ask a woman personal questions about her body. But I can say this; my husband’s willingness to address this issue head on has proven to me more about his ‘manliness’ than anything else in our relationship. When we first started having trouble he was there to support me, and volunteered himself to get checked out, saying he would do whatever needed to be done to figure out our fertility issues. That, my friends, is a M-A-N. Confronting the unknown, the uncomfortable, and facing it head on. That is the face of a true man dealing with infertility issues. That is what helped me get through our infertility issues, both mine and his, knowing his was 110% with me and willing to put in the same effort I was.

I hope you’ll read For Men, Infertility Often Becomes a Private Heartache, tell us what you think and come back tomorrow to get the male perspective from my very own husband.

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PAIL headshotChandra is a Mom and Foster Mom. She holds a Master’s degree in Theology and is particularly interested in the theology of infertility. Chandra grew up in the Northeast but she and her husband are raising their daughter in the middle-of-nowhere Indiana. She has 3 chickens that drive her crazy, a huge garden, and a penchant for bacon. She occasionally attempts to make sense of all those things, and more, over at her blog, MetholicBlog. She also shares embarrassing stories about her husband and unicorns.

Reminder! april 2013 – monthly theme: NIAW

Just a friendly reminder from everyone here at PAIL – don’t forget to “JOIN THE MOVEMENT” and write a post to submit to Resolve for National Infertility Awareness Week!

While we are not officially working with RESOLVE, we highly encourage you to participate in this very important blog challenge. One of our core messages at PAIL, and the cornerstone of our mission statement is to “keep talking” through this part of the ALI journey. Your story, your journey, and your path to healing matters. Writing on the suggested prompts above from your current place on the journey lends an important perspective and new avenues on how to Join the Movement.

For full details on how to participate in the Bloggers Unite Challenge (including how to submit your posts and formatting) please click here.

Your post must be submitted directly to RESOLVE by tomorrow, April 27, to enter the challenge. If you would like to link your post up to us as well, please fill out the form at the bottom of this post, but remember, you must submit your post to RESOLVE first if you want them to also include your entry. We will post links to the full list from RESOLVE as well as your posts for all to read and get inspired!

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