Maybe This Was a Mistake

“Maybe this was a mistake."

No, I didn’t say that to Melissa about IVF. I was talking about the blog. After a few posts, especially the most honest and vulnerable ones, people began reaching out to me with genuine concern.

“Are you depressed?” “Are you ok?” “Do you need anything?”

I felt bad. I don’t want people to worry about me. I kept scolding myself with a line from the pilot episode of The Sopranos: “Nowadays, everybody’s gotta go to shrinks, and counselors, and go on Sally Jessy Raphael and talk about their problems. What happened to Gary Cooper? The strong, silent type. That was an American. He wasn’t in touch with his feelings. He just did what he had to do. See, what they didn’t know was once they got Gary Cooper in touch with his feelings that they wouldn’t be able to shut him up! And then it’s dysfunction this, and dysfunction that, and dysfunction vaffancul!”

First I was struggling with infertility. Now I’m bucking masculine convention by talking about my feelings. Oh god, I’m a corny millennial convention. But the great irony of the Tony Soprano quote is the fact that Tony admires Gary Cooper for something that Tony can’t be. Tony spends the next 86 episodes of the show trying to get in touch with and better understand his feelings, and his failures as a character, and as a human, are often based on his failure to do exactly that.

Melissa and I didn’t start this blog to become victims. It was never about sympathy. We wanted to document a moment in time. We didn’t want this experience to define us, but suddenly it felt like it was. I opened up in my writing and I worried that people were now thinking of me as devastated and damaged, characterized by a single struggle. Without a doubt, when you’re dealing with infertility, it can feel all-consuming, but it is still just one element in a multifaceted life. Through our writing, we were looking to, quite literally, define this experience. I don’t mean that in an empowering “grab the bull by the horns,” “you got this” way. I mean that we wanted to define it intellectually. It was a challenge to ourselves. We wanted to see how deep we could go as creators and writers to put into words what we were going through; to go to those places that we avoid articulating. We were seeking words for the pain, anger, and frustration that people in our shoes feel but do not talk about.

The bottom line is, this is like a lot in life - a struggle. Struggle isn’t just hard to go through, it’s hard to talk about. Joy is easy to define. Joy is what everyone shares. It floods our social media feeds. But pain is the most human of emotions. Pain is what makes us human. Later in that Sopranos scene, Tony finds his own nugget of truth: “Could I be happier? Yeah, who couldn’t.” Is there a better expression of what it is to be human? We could always be happier. Everyone has that anxiety and stress that keeps them from being present and keeps them up at night. For us, if it wasn’t infertility, it would be something else. Melissa and I aren’t more or less happy than everyone else, we’re just seeking to put our experience out there.

The bottom line is, like Gary Cooper, however we all feel, we all have shit to do. And the world, as a whole, is indifferent to our struggles. Bills need to be paid, work needs to be done, the dog ain’t going to walk itself. Life doesn’t stop for our feelings, so despite our struggles, we get out of bed in the morning and get to work. Speaking to emotion, understanding our oh-so-unmasculine feelings will not change our ability to do what we have to do, so why are we all so hesitant to be open? No matter what happens, Melissa and I are going to keep going forward in life. It would be one of life's great devastations to not have children. But don’t we all end up with great devastations? As Melissa likes to tell me, “We all have our cross to bear.” What can you do but move forward? And in the moment, what can you do but grin and bear it?

This doesn’t mean we have to sit around complaining all the time, but what’s wrong with genuine deepness and honesty? We’re conditioned to avoid and hide our pain. Pain is awkward. We don't know what to say. But pain is as much a part of life as everything else. We don’t need to hide how we feel to be strong silent types. It’s surface-level bullshit. Tony storms out of Dr. Melfi’s office and of course, proceeds to have another panic attack that will drive him back to her. Hiding the struggle does nothing. Vocalizing my pain and frustration hasn't made it more real; instead, it's made me feel free.

Back to School

My previous two posts have been so damn heavy…

So I thought it would be nice to change gears and talk about… school. IVF school.

Preparing for the IVF process is overwhelming. Before ever entering a fertility clinic, months (or years) of trying to have a child to no avail leaves couples juggling the existential question of whether or not they will ever have a child. Then there’s the financial hurdle to confront: are they even in a position to pay for IVF? Then, once they decide to move forward, a couple is hit with an incredible amount of information. They’ve got multiple appointments a week (eventually every day), blood samples to give, medications to take, an egg retrieval, and the big one: shots (and in all fairness, almost all of the blood sample, medication, and shots burden falls on the woman). An IFV newbie knows only that there are a lot of shots, administered at home.

Fortunately for me and Melissa, our fertility clinic offered a class to help prepare us for this daunting process. What we didn’t realize, however, is that while a class is great for preparation, it’s sort of like peeking over a giant cliff before you dive into a huge lake below. You want to know what’s ahead to ease your stress, but looking ahead ends up doing the opposite; something that up to that point was theoretical is now laid out for you in material form.

As we’ve written before, the IVF process is one of isolation. A couple goes through it with only themselves, their doctor, and some nurses. But when we walked into IVF class we walked into the fertility clinic’s conference room with two other couples. One would think that finally sharing a room with fellow couples who know exactly what the others are going through would lead to a sort of kumbaya, coming-together moment, but nothing like that happens (at least, it didn’t for us). Every couple keeps to themselves. There is no handshake, no icebreakers, no “nice to meet you.” We all came in with our heads down, ready for business, avoiding eye contact.

It was as if we were each wary of invading what is a very private process for every couple involved. We all came into the class with baggage, and we knew every other person in the room had their own baggage but in a different way. Their story is unknown and known to us at the same time, and we avoided each other out of a sensitivity to the delicateness of everyone’s situation. Each infertility scenario is completely different. Statistics don’t mean anything, what happened to someone else doesn’t mean anything. To meet and bond with another couple means taking the risk of seeing their positive result when you could be stuck with a negative one. It’s as if we’re wary of sharing the luck, good or bad, we may be headed for.

The nurse handed out sample schedules, providing a sense of what the weeks of the IVF cycle would look like in terms of daily doctor's visits, medications, and injections. We were given what resembled an epipen and some hypodermic needles to look at and handle. Immediately, we were a little bugged out. The nurse explained that Melissa would need to give herself nightly shots and, eventually, I would have to get involved, administering a big fat needle, right to the ass cheek, every night for two weeks straight.

As the nurse explained things, I tuned in to my heartbeat. I could feel it gradually increase, both in speed and pressure, as the session went on. I caught myself sighing every few minutes, taking deeper and deeper breaths, and I realized I was simply trying to catch my breath, normalize my breathing, which had grown erratic from the stress. At moments in this infertility process I’ve had to stop and wonder, “Geez, we have a blog, I’m so stressed out, I’m irritable. I mean, it can’t really be this bad. We’re going through a thing. It’s months of our lives. It will be over at some point and life will go on. Am I just being over the top with this?” But as I sat there in the IVF class, and took stock about how, literally, each sentence the nurse spoke ratcheted up my stress level just a little bit, I realized that this is exactly what had been going on, day by day, since I got my first diagnosis from my urologist in September, and in actuality, even before that, as month after month went by with disappointing pregnancy test results for me and Melissa. I finally saw that this is what infertility is. It’s bad news, frustrations, questions; each drop is tiny, but tiny drop by tiny drop these stresses fill the well of your subconscious.

One poor guy in the class had a lot of questions, and each time he asked a question he was visibly more stressed out. His hands would go through his hair, he would take deep breaths, and his eyes would open wide in shock at each answer he got and each needle he saw. When the nurse got to the big needle he looked like he was going to puke. As I reflected on his visible stress, coupled with the stress I sensed in myself each time I sighed, I realized us guys were taking it, at least on the exterior, way worse than the women. The women are forced to carry the weight of the process in terms of shots, hormone changes, and bodily impact, but it seemed it was the guys who were visibly exuding fear.

The class ended much how it began: no goodbyes, no parting gestures of any kind. We all walked out of there slightly more prepared but even more nervous than before. In that moment I realized: we wouldn’t meet these people, we wouldn’t share our stories, and we wouldn’t leave on the same road. But the roads we set out on would be very similar, fraught with many of the same hurdles, the same fears, the same anxieties, and, we hoped, the same happy ending.

The Last Man on Earth

“Maybe to be powerful is to be fragile.” - Ai Wei Wei

Infertility is isolation. You hesitate to talk to people about it because a) you don’t want to unload your shit on people, b) they likely won’t get it, c) you don’t want to upset or worry those who care about you, or d) you’re like me and you shut down and don’t want to talk to anyone about anything. What we didn’t expect, however, is that the isolation would creep into our relationship. Infertility wouldn’t leave us alone, but we were leaving each other alone.

I’d had two semen analyses and they persisted with the same issue: low morphology. That big fat “0” would not budge. I was suffering in silence and saying everything was fine. One night Melissa asked me to watch a pregnancy announcement video on Facebook. As we watched, I looked away from the video and saw the tears in her eyes, but instead of wanting to comfort her, I found myself frustrated, thinking, I’m not going there. There’s nothing to be upset about. We’re going through a process and it will work itself out, whatever happens. Being upset or emotional is just a waste of time.

I refused to acknowledge externally what was going on inside of me because it was too scary. There was an overwhelming fear that if we hit the end of this road, and we can’t have a kid, it’s all my fault. Based on everything her doctors have told her, Melissa is completely capable of having a child, but because of my problem, I’ve denied her a natural motherhood. Physically, she is not barren, but because of loving me, she is. And there is no way, for the rest of my life, that I don’t look at this beautiful, loving woman, with so much to give, this “human piece of sunlight” (to quote Philip Roth), who would make an incredible mother, and not feel the weight of her childlessness on me. Like everyone, I’ve had my share of envy, self loathing, difficulties, humiliations, and disappointments, but through all of the things that life, and especially adolescence, threw at me, I never wanted to not be me, or not be in my own skin. Suddenly I found myself feeling fundamentally flawed in a way I couldn’t comprehend. There was a piece of me that was wrong and I wanted to find and exorcise it from myself, but I knew that was impossible.

I felt the only way to deal with it was to keep trucking along, granite-faced. I found ways to pretend everything was okay. I would make jokes to Melissa about how I was “broken.” “Oh, you want to buy that thing? Don’t ask me, do what you want, I’m broken.” “You pick what movie to watch tonight, I’m broken.” “Oh, of course I spilled something, I’m broken.” It was an easy way to make my feelings a joke. See? It’s fine, I can laugh about it. But it was also pathetic. I got a laugh from Melissa the first time I did it, and that felt good, but then it started to bother her.

Melissa kept telling me we should talk about how I was feeling, that I should open up and say whatever crazy things were going on inside my head. I held back. I felt I couldn’t talk to her about it because I knew that everything she would say would be perfect, and that would be too much to bear. I didn’t want her to say anything to try to make me feel better. I felt undeserving of any comfort she could offer. So instead I grew short with her, angry, and at times, rage-filled, but nevertheless convinced that I was dealing with it.

One day I went crazy with research about infertility. I was reading about chemicals, endocrine disruptors, toxins, and suddenly I was convinced that I would not have a kid. Later that day I went on Facebook (big mistake) and I saw a picture of an old friend I hadn’t seen in nearly fifteen years. After high school he went one way and I went another. While he was busy living the single life, I met Melissa and settled down. But right there on Facebook is a picture of him in the hospital with his wife and their new baby, and I thought, that guy had a kid? Suddenly it was like the world was slipping away from me. It was like an anvil of frustration landing on my head.

The next morning I woke up still thinking about that guy. I was annoyed with myself. I don’t compare myself to other people. I should be happy for him. And now, on top of being annoyed about seeing that picture of him, I was angry at myself for being annoyed about it. I was pissed off and zoned out. So of course Melissa and I had what should have been a trivial disagreement, but instead I completely bugged out. We were running late, I was worried I would miss the train, and as she dropped me off at the station, I broke one of her cardinal rules. I flew out of the car - no goodbye, no kiss, and most importantly, no “I love you.”

That night, Melissa picked me up, but she made clear that we were not getting out of that car until we hashed everything out. She explained how much I had been isolating both of us, and how alone we both felt in the process. And I mentioned, again trying to be tongue-in-cheek and failing, that I felt broken and Melissa said, “Stop feeling bad for yourself.” And it was exactly what I needed to hear. I opened up and told her about the fear, the frustration, and the self loathing that I was feeling. What I feared most, that she would give me a pat “Don’t feel that way, you’re wonderful,” she didn’t do. Instead, Melissa told me that she knew the self hatred I had felt, that she had been there in other ways, at other times in her own life. She also told me that she knew from experience that the place I was going was a dark place and “there is nothing good in that place.” It was the simplest, most concrete advice she’d ever given me, and I heard her words, and I decided I needed to stay far away from that dark place. And suddenly, after telling her how sad I was, I wasn’t as sad.

The next day I interviewed someone for my documentary. I was at his house with his young son and his pregnant wife. My own interest in kids came up, and I was honest with them about what I was going through. And the wife said, “I had a bunch of friends who had a hard time, and I’ll tell you, they all have kids now.” I’m almost afraid to write those words. I know it means nothing to my situation, but it’s a reminder that all you can do is move forward.

A Dream I Had

I left my first urologist appointment feeling good. Pyospermia. That’s what the sheet of paper he gave me said. Simple issue, easy to solve. He handed me the paper and said, “You’re going to get home and your wife will have questions. You’ll try to explain it to her and you will fail. It’s a lot easier just to hand her this piece of paper.”

The paper started: “Pyospermia refers to the presence of significant numbers of white blood cells in the semen.” Basically, pyospermia is associated with poorer sperm parameters including low motility and morphology, as well as diminished fertility. White blood cells are supposed to attack bad cells, but in the process, they can end up attacking and harming sperm as well. The great thing was, I had an issue and he had a protocol to deal with it. I would take a lot of vitamin E, an antibiotic for ten days, and anti-inflammatory for ten days, and in six weeks I would be back to see him and all of this would be a distant memory. Even if I came back in six weeks and it wasn’t better, he had another follow-up protocol, so things were looking good. Then I got home.

I did what the doctor said and I handed the paper to Melissa. She read it. But then she looked at the second paper. My semen analysis. Melissa looked a my semen analysis and keyed in on the big fat 0% on my morphology score.

“You’ve got this zero on morphology.”

“Yea, but pyospermia.”

Statistics show that patients retain about 40% of what a doctor says in a single visit. Once he handed me that sheet, all I remembered about that appointment was that my numbers weren’t ideal, but they were fixable. I had completely forgotten about the fact that where one number should have been four percent or better, I had a big fat zero.

Somewhere in my mind I could hear the sounds of a plane flying, no, a plane falling, no, a plane exploding as it crashed into the ground. Instinctually, I knew why she was keying in on that. It’s one thing to turn a low number into a higher number. It sounds quite possible to try to turn a 1% into a 2%, and then a 2% into a 4%, but nothing happens when you double 0%. That zero gives you nothing to work with. In that moment, everything changed. All positivity seeped out of me. The doctor had mentioned the morphology, but he focused on pyospermia for a reason: it was something he could deal with.

I tried to adopt his methodology. I put the semen analysis numbers behind me and focused on the white blood cells. This protocol would lower my white blood cell count, and maybe that would make everything better. Nothing to stress about. All I could do was wait and see what happened in six weeks. I felt like I was putting one foot in front other the other, moving on, and doing fine, but something started to happen to me as I slept.

I'm lucky to be a very good sleeper. I rarely have trouble sleeping and I typically sleep through the night. Even through most of this process, I mostly sleep through the night, but not always. After that first urologist appointment I started to have a series of incredibly vivid dreams. My eyes would shoot wide open in the middle of the night and I would find myself fully awake, my heart pounding so hard in my chest that I could feel each beat tremor throughout my body, down to my toes.

One night I dreamt that I Melissa and I were alone in a nondescript, unknown room. She was sleeping and I sat there watching her. I got up and left the room and entered a large, square space. It was filled with people. Some were standing around, some were chatting. Everyone turned to look at me. My mom was there. She was sitting on a square ottoman in the center of the room, and she was holding a baby. She looked up at me, beckoning me to come to her. As I approached, I knew instinctively that she was holding my baby. I bent down, picked up the baby, and looked at his beautiful eyes. But as I held him I realized he was horribly, horribly deformed. As my eyes moved from his seemingly normal face down to the rest of his body I saw that, emerging from his back, where his rear end should have been, was another head, but this head was scrunched, disproportionate, and in excruciating agony. The baby was an afflicted, tortured creature. But despite all of these deformities I welled up wit this deep sense of love. And I knew, I just knew, that I had to greet this baby’s pain with a sense of calm and love. I had to push aside the heart wrenching sadness of what I was witnessing and exude nothing but joy, resolve, and tenderness. That baby was a mess, and it needed me. And I held that baby, and when that baby started to cry, I comforted it.

I didn’t know what the hell that dream meant. But as I sit here recounting it, I realize that while the baby clearly represented my own desires for a child and uncertainties about whether it would happen, the deeper meaning lay in my overwhelming sense of duty to remain calm and composed, despite the fact that, in my dream, as in my life, my heart was being torn into a thousand pieces.

The Great Fertility Hand-Off

I received a package today. Normally, mail time is a highlight of my day (#realtalk #oldandsad). Aside from all the bills (SO MANY BILLS), it usually brings with it all kinds of fun stuff. Paychecks! Birthday cards! That thing I ordered from Amazon! Today was no exception. FedEx appeared, dropped off the goods, and I tore it open. I was excited. I knew exactly what it was and I was ready for it. But when I opened it, all that excitement quickly turned into something else.

Something heavy.

Something messy.

And the worst: something totally out of my control. 

This package contained the torch of the IVF Olympics, the first symbol of The Great Fertility Hand-Off: my first cycle of IVF medications.

My kitchen island looks more like a torture chamber these days.

And just like that, all the pressure of this whole making-a-baby escapade transferred from Bobby (where I liked it just fine, thankyouverymuch) to me.

You see, in theory, all of this medical intervention we're using to get pregnant is an effort to bypass Bobby's fertility issue: his low morphology. 

[Before we move on, I need to take a moment to say congratulations to Bobby's little swimmers. His most recent semen analysis showed that he has 2% - not 0% - morphology. Go, Bobby tadpoles, go!]

As I was saying, until now, the reason we weren't having any success was because of an issue with Bobby. I felt safe in my cocoon of fertility, a cozy spot from which I played the role of supportive wife as Bobby grappled with what I know was an incredibly emotional process for both of us, but especially him. And Bobby handled the stress like a pro, probably way better than I would have. Ok, definitely way better than I would have. There was a brief moment early on in this process where I was mistakenly told I might have premature ovarian failure and I didn't handle it with nearly as much maturity as Bobby handled his diagnosis (think tears and all the emotions and lots of self-pity). Yes, this has been so hard on Bobby, but for the most part, he handled the immense weight of his infertility diagnosis with grace, sensitivity, and humor, and I've watched in awe with an ever-deepening love and overwhelming appreciation for this man every step of the way.

But now, with IVF and ICSI (pronounced ick-see), we're sidestepping the problem that has been holding us back. From here on out, if we don't conceive, IT'S ALL MY FAULT. Yes, yes, I know that's totally irrational, but irrational fears are still fears nonetheless. And this fear is real.

WARNING: I'm about to say all kinds of words about the female anatomy and menstrual cycles. If you find that kind of stuff offensive, this probably isn't the blog for you (also, grow up).

For all you natural conceivers out there who are fortunate enough to not have to know a thing about this, there are many steps in the IVF treatment cycle, and thus many places where my body can fail me (and us) in making a baby. Here's a brief rundown:

PHASE 1: STIMULATION

It all starts with day 2 of my cycle. That's when I officially begin treatment - and by treatment I mean up to 3 self-administered injections daily, oral medications, and a few 1.5" needles straight into the coolie (in addition to about 10 check-ups over the course of 2 weeks to do blood work and barrel-of-laughs transvaginal ultrasounds. Did I mention how fun this is going to be?). The aim here is to stimulate my ovaries just enough to make a whole bunch of eggs (the body normally makes about 1 on its own each month) so they can be harvested later.

How I can fail: Mix the medications incorrectly; inject myself incorrectly; accidentally hit a major artery and bleed out (kidding); OHSS, or ovarian hyperstimulation syndrome, in which my ovaries go bonkers from all the hormones and I end up in the hospital or, you know, dead (not kidding, but this is very, very rare).

PHASE 2: RETRIEVAL

After about two weeks of medications - and assuming I don't screw them up - it's time for the docs to put me under anesthesia, poke holes in my uterus, and retrieve the follicles growing on my ovaries (which hopefully contain some eggs) with a little sucky tubey thing. Meanwhile, Bobby is in another room providing a sample so his sperm can be whisked away, injected into my eggs (that's the ICSI part), and then cultured in a petrie dish for a few days. Isn't it romantic? Upside: I get drugged up. Downside: Did you read the poking holes in my uterus part?

How I can fail: Not produce enough eggs; not produce healthy eggs; not produce any eggs at all. No pressure.

THE WAIT

At this point, many people would begin gearing up for transfer day (more on that below). However, Bobby and I have opted to put all of our eggs in one basket (see what I did there?) and get genetic testing done on our embryos (assuming we come away with any). Because we're footing this procedure 100% out of pocket, we want to do everything and anything that will give us the best chances for a healthy pregnancy in one cycle (again, no pressure!). Genetic testing will help us eliminate any embryos that likely wouldn't have made it very far once transferred back into my uterus anyway. This takes about two weeks, so the embryos are frozen and then transferred during my next cycle about one month later.

How I can fail: Oh, there are many ways, but for this month, none have to do with fertility.

PHASE 3: LUTEAL PHASE

A mostly meds-free month will have elapsed by this point, and then, right about halfway through my cycle, Bobby will give me progesterone shots (those 1.5" needles in the booty again, oof) for 5 consecutive nights leading up to transfer day. This is to hopefully thicken my endometrial lining and create a cozy, welcoming environment for our embryo.

How I can fail: Not produce an endometrial lining that's thick enough; produce an endometrial lining that is too thick. Essentially, tell my poor little embryo that there's no room at the inn.

PHASE 4: TRANSFER & THE TWW

This is the biggie, guys. On day 5 of my luteal phase, I'll head back to the clinic to have our 5-day-old embryo transferred into my uterus with what is, as I understand, the spitball method. No anesthesia here, unfortunately. Just a quick wham, bam, hope you implant, mam. We go home and then begin what all of us on the TTC (trying to conceive) journey refer to as the dreaded TWW - the two week wait. And there's not much more to it than that: for two weeks, we wait, and hope, and pray (even though we're not the praying type) that our embryo implants and I'm officially pregnant.

How I can fail: Oh, just like, not implanting or getting pregnant, essentially flushing about $20,000 (give or take) right down the drain along with our hopes and dreams of becoming parents and being left with nothing but the painful choice of giving up or starting the whole process again.

So here we go. If all goes according to plan, this time next week I'll be injecting myself for the very first time and the weight of it all will officially be on my shoulders.

Body, don't fail me now.

Thank You Leslie Nielsen

Dealing with infertility is filled with so much mind-crushing doubt and anxiety that it will be nice, for this post, to think back to the start of this process, before all of the stress crept in.

Eight months after we started trying to have kids, I went to see a urologist. My GP told me to try for six months, then make an appointment, but I spent two months in denial: “Let’s see what happens this month… I’m fine… it will happen this time.”

So there I was, with my pants around my knees, as Dr. Seaman checked out my junk.

“Does anyone ever point out to you how funny it is that you’re a urologist named Dr. Seaman?” I asked.

“Only about once or twice a day.”

“Well, glad I could help you reach your quota.”

“Yup. Things look good. The next step is to provide a sample. Now, you can do it here, right now, and we can discuss it in twenty minutes, or you can provide one at home and bring it in.”

Provide a sample. What a lovely euphemism.

“Let’s do it now, I want to know what’s going on.”

“Ok. A nurse will come in to explain everything and I’ll see you shortly.”

The nurse entered the exam room, and there I was with a giant smile on my face. She looked at me like I was a creep, when, in reality, I just couldn’t stop thinking about Leslie Nielsen in Naked Gun 33 ⅓.

I have a habit of laughing at the most inopportune times. It can be both a blessing and a curse. Sometimes my laughter helps: friends are in an argument, I start laughing, and it breaks the tension. Sometimes it’s wildly inappropriate: a buddy of mine rear-ended another car on one of New Jersey’s infamous traffic circles and all I could do was laugh hysterically. I don’t think he appreciated it.

And so, with scenes from Naked Gun running through my head, I looked like either a complete pervert or a thirtysomething with the maturity of a ten-year-old. Neither option is good.

The nurse handed me a plastic collection cup, pointed to a portable DVD player in the corner of the room, and said, “Have fun.” Yes, she really told me to have fun, but all I wanted to ask as I tried to control my laughter was, Do you have Spartacus?

For the sake of propriety and my dignity, I will limit further details about what happened in the sample room, but I will say that, after you provide a sample there is a special couch, just for guys who have provided a sample to sit and wait for their results. One couch, just for us sample providers. That couch is a tome of awkward male silence, where I sat with my eyes fixed on my phone until my name was called.

Finally a nurse came to get me. “Want to see your sperm?” he asked.

See my sperm? This is a thing? He wouldn’t invite me to look at the sperm if there was something wrong with them. This is a good thing.

“Sure, why not.”

The nurse led me into a small room with a microscope. I peaked in and there they were: SPERM. Just swimming around with nowhere to go. It was interesting, yes, but there was no possible information I could gather from looking at them.

“How do they look?”

“Good for the most part. Doc will talk to you.”

Good for the most part? What the hell does that mean? He probably says that to everyone.

I took a seat in the doctor’s office and waited. I was surrounded by pictures of the doc and his wife. Doc and his kids. Doc and his glamorous doctor-y vacations…

“Miiiister Andersen,” he said, like Agent Smith from The Matrix. “Do you get that a lot?”

“Only about once a day,” I replied.

The question remained, would my sperm make me THE ONE or not?

The doc handed me my semen analysis results. My eyes immediately scanned the top of the page: “Sperm Count: > Normal.” Above normal. Above normal! That’s it. Victory! Fuck Keanu Reeves, I am THE ONE!

“Sperm count is above normal, that’s great. Motility, above normal, also great.”

I was riding high.

“But your morphology is zero.”

“Zero? Like zero percent?”

“Yes.”

“What’s morphology?”

“Morphology refers to the shape of your sperm.”

“So my sperm is deformed.”

“Don’t say that. There is something about the sperms’ chemical makeup and shape that is keeping it from binding with the egg.”

“So, my sperm is deformed.”

“The good thing is, just because there’s an issue with the chemical makeup and shape, doesn’t mean they create a baby with a problem. The DNA information inside the sperm is just fine.”

“But my sperm is deformed.”

“You’ll also notice here on the sheet that you have excessive round cells in your sperm.”

“What are round cells?”

“White blood cells.”

“Oh, they’re good right?”

“They are good in that they fight infections and kill bad cells in the body, but because there are excessive amounts in your semen, they’re also attacking your sperm. The good thing is, this could be causing your zero percent morphology.”

I left the doctor’s office with a prescription, a piece of paper explaining what pyospermia was (turns out there’s a name for having white blood cells in your semen), and an appointment to retest my semen six weeks later. I had a plan of action but, for the moment, all I could think about was Leslie Nielsen.

I Hate This Blog

I saw Melissa’s chat message blinking on my computer:

“I’m going to make the blog public after my work call.”

I wanted to vomit. All forms of anxiety ran through my body. I had the kind that starts at the front of your brain and shoots down your shoulders, the kind that begins in your chest and settles in the pit of your stomach, and the kind that numbs the bottom of your feet. Or maybe it was just that I swam 2,400 yards that morning and it was time for lunch.

I messaged Melissa back: “I’m going to puke.”

“Don’t worry about it. It will feel good when it’s out there.”

Nope. It still feels like garbage.

I don’t want to be one of those people who puts his whole life on the internet. I don’t have romantic notions of privacy, but I don’t like the idea of falling into the current millennial crazed world of oversharing.

You’re lying to yourself Robert. This might be true, but is it the only issue? Settle down and get off the soapbox...

I don’t mind telling people we’re having a hard time having kids. I didn’t hesitate to tell my family, my friends, hell, the random coworker I talk to maybe once a month who asked if my wife and I want kids. “We’re working on it, but it’s taking much longer than expected.”

Random coworker: “Your wife might have to go to her doctor and get some tests.”

Without hesitation I replied, “It’s not her, it’s me.” I was fine with telling people.

You’re still lying to yourself...

So what is it about the blog?

When I found out I had low morphology (what I really want to say here is “deformed sperm” but my doctor got mad at me for saying that) my first instinct was, “I should make a documentary about this.” I was ready to take a long look at what some people see as an epidemic impacting men throughout the world. So again, it’s not as if there’s an inherent fear in me that people know about this. With a documentary, however, I have the privilege of distance. The final film would be years down the road and I can share it removed from the experience. On top of that, I can craft the story, control the message.

The same goes with talking to people about it. I can control my delivery, laugh, and frame everything with positivity.

It’s not that these things aren’t true, but you’re still skating around a deeper truth...

It’s incredible how skilled we are at lying to ourselves. I can pretend I’m not bothered by being infertile, but I can feel how full of shit I am every time I tell someone, “...and so I got my test results from my urologist and MY SPERM COUNT IS GREAT, but…” There it is, right there. It’s like I’m dealing from the bottom of the deck, pulling out the ace every time. I have to get that in there. Give myself and my listener the assurance that my balls might not work perfectly, but they’re working. Ok? Got it?

And that’s how I knew that I had to do this blog. I want to make that clear. This desire to vomit when we published was not because my wife dragged me into this thing kicking and screaming. We both knew this is something we wanted to do. In a case of classic marriage-mind-meld we vocalized our desire to do it at the same time. In my case, I knew I wanted to do it because I caught myself falling into stereotypical traps of toxic masculinity. I could see that no matter what I did, and no matter what I told myself, that my identity was very much tied into my inability to have a kid. Lying to oneself does nothing. The answer is to dig deep, to sift through the layers of lies we tell ourselves on a daily basis. As Thomas Jefferson said, "Honesty is the first chapter in the book of wisdom."

Between A and B

Early in our relationship, Melissa and I were on a road trip, probably up to Boston where I attended film school, and we hit traffic. The likelihood of hitting traffic on a trip from New Jersey to Boston hovers somewhere in the area of 50 percent, increasing to 100 percent if you’re foolish enough to take I-95 the whole way. I hated traffic so much that I became obsessive about avoiding it. I researched and tried out various routes until I was sure I had the best way. I would leave only at a certain time of day, even if it meant dragging Melissa out of bed at 5:00 AM after a night out behaving like twenty-two year olds. And so we would depart, customized “I’ll outsmart not only other travelers but also the computer” MapQuest printout in-hand (this was in the days before Google maps and traffic alerts, of course).

Nevertheless, despite my best efforts and strategies, one day we hit an awful jam. I was enraged. It was a blow to my ego. I don’t hit traffic. I’m smarter than everyone else and figured this thing out. This does not happen to me. And there I was fuming, probably cursing, maybe yelling. It’s a miracle Melissa married me after seeing my traffic behavior. Watching me fly off the handle, she did probably the worst thing you can do to an irrational lunatic: she reasoned with me. “It’s just traffic. Why don’t you make the best of it?”

“Best of what? This is the worst possible thing that could be happening right now.”

“There’s probably an accident up ahead. Someone might be dead. We could be dead in an accident. Or hurt, or a lot of other more horrible places than traffic.”

“That’s just stupid.”

“You can’t spend your life being pissed off at things you can’t help.”

“Well I wanted to be there at 10:00 AM and now who knows when we’ll get there.”

“Life doesn’t stop when you leave Point A and start again when you get to Point B. All that space in between is still life. And you’d be a hell of a lot happier if you filled that space with something besides freaking out about when you’re going to get to Point B.”

Boom. Melissa, as she so often does, dropped knowledge. Sad to say, but I lived my life so obsessively by the clock, by an agenda, by what comes next, that I had never in twenty-two years looked at life like that. I was enlightened. I calmed down.

Do I still obsess about traffic? You’re goddamn right I do. I’m not going to sit here and pretend that I don’t still act, as Melissa so affectionately tells me, like “a whiny little bitch” in the heat of a traffic catastrophe (sometimes in Melissa’s battle between passionate feminism and North Jersey attitude, North Jersey wins). In the over ten years I’ve known her, however, I try to take her words to heart. If we’re stuck waiting for a table at a restaurant, or in a crazy long line at the store (who am I kidding, does anyone go to stores anymore? Amazon!), or counting down the days before an exciting vacation: Life exists between Point A and Point B. Embrace the journey.

We’ve been saying that to each other quite a bit over the past year.

Melissa and I are both planners. As our 30s approached, we watched friends having kids and we thought, “We’ll know when we’re ready.” As “ready” approached, we told people, “Oh, we won’t be like those crazy people who track ovulation and all that weird stuff. We’ll just stop not trying and when it happens, it happens.” But then we decided we were ready, Melissa went off of her birth control, and a month later we looked at each other and said, “All right baby, get here already.” Once we want something, we want it. But as it continued to not happen, we took a deep breath and remembered the mantra. Hell, when you’re first trying to have kids there’s a hell of a lot to embrace, but along the way, after three months, six months, OBGYN checks, urology appointments, and multiple semen analyses, it became more and more difficult.

Now it’s harder than ever. We’ve reached a new, major phase: the fertility clinic. The past few months have been a struggle of stress and frustration. We’ve been searching for an outlet, searching for meaning, searching for a way to embrace a part of the journey that leaves little to embrace (and little in your savings account). We came to realize that people don’t talk about infertility. People get pregnant, they make an announcement to the world, and they celebrate it. Guys are happy to point out if it only took a month or two of trying, but stories of pregnancies that took years and visits to the fertility clinic rarely leave peoples’ inner circles. This code of silence is even more prominent around male-factor infertility.

Why aren’t we talking? What can be gleaned, or gained, around a broader topic of infertility?

It’s time to find out.

A Dream Deferred

It was the dream I mourned the most when I heard the news. I'd taken the dream for granted, assumed it was a given. It was part of the master plan, the script I'd read and revised a thousand times, the movie emblazoned on the backs of my eyelids. We won't be part of the statistics, I'd tell myself. We live healthy lives. We eat right, exercise regularly, get our eight hours on most nights, use organic and all-natural products... and, of course, there was the dream. The one that doubt had not yet tainted.

The dream went a little like this: There'd be a twinge. A feeling. I can just tell. A stomach full of butterflies as I wait for the test results. The uncontainable excitement when I see the second line. Running to Bobby to shove the stick in his face so he can see for himself. We're going to be parents. We did it. Jumping on the bed, dancing, crying, plotting how we'll share the news with our family and friends. A boy or girl? What will we name it? A nursery to decorate! 

The first few months were fun in all the ways you'd expect trying for a baby to be fun: the planning, the daydreaming, the trying. The first negative test was upsetting, but only fleetingly. It's only the first month. Most people don't get pregnant that quickly. Onto the next! Two, three, four months went by and the excitement built, the hope never waned. At five months though, what was once a brief sadness of another negative test, another period, became a gut punch. It was around this time that I got the feeling that something wasn't right. Not quite wrong... but off. Despite all the studies that show many healthy couples take up to a year to conceive, I just knew. Something isn't right. The thought worried at the back of my brain with each failed cycle, but I forced myself to ignore it. Not us. It won't happen to us.

It was somewhere around the sixth or seventh month that we decided it was time to investigate. With the exception of a brief scare on my side that was the result of a doctor misinterpreting my hormone test results, all signs pointed to things working well in my reproductive system. I had even undergone an ultrasound months earlier, for unrelated reasons, the results of which led my OBGYN to assure me that I was "very fertile."

Relief.

Briefly.

The next step was for Bobby to see a urologist. His first semen analysis showed that all of his numbers (count, motility, volume, etc.) were at or above normal, except for one: morphology. Morphology has to do with the shape of sperm and, therefore, its ability to penetrate the egg. A normal morphology range is 4-14%, meaning that's the percentage of "normal" shaped sperm a man has to have to be considered fertile. Bobby's was 0%. He also had white blood cells present in his sample, which the doctor thought could be the cause of the morphology issue. He was put on a round of antibiotics and an anti-inflammatory to try to kick any underlying problems. We left with a plan, a follow-up appointment for six weeks later, and - outwardly, at least - hope. Recently, we admitted to each other that we both had a terrible, gnawing feeling from that point on. Some things you just know. And we knew, although neither of us said so, aloud, just yet. We put on our brave faces - for ourselves, for each other, and for the few people around us who knew what was going on - and followed the doctor's protocol. And we waited. Lots of waiting.

The next appointment with the urologist showed that nearly every single one of Bobby's numbers improved, except his morphology. Still 0%. But the doctor felt hopeful that, because the treatment had improved every other aspect of Bobby's sample, another round could move the needle on his morphology. More prescriptions. More brave faces. More waiting.

In December, right before a holiday trip Italy, we went back to the urologist to see if the second round of treatment worked. I had a pit in my stomach the whole night before and the morning leading up to the appointment. We had tried everything - medications, supplements, vitamins, dietary changes - and, despite my gut telling me otherwise, I found myself hopeful. We had even joked about how we could make our "miracle Christmas baby" on our trip. Bobby produced his sample, and we waited... and waited. Infertility, which no one tells you, ever, anywhere, requires more patience than you ever thought you could muster. Finally we sat down with the doctor.

Every single number improved.

Except morphology.

0%.

We were given the diagnosis of male-factor infertility that left us with no option but IVF with ICSI (an additional procedure in which the sperm is injected directly into the egg before being transferred back into the uterus). We were, officially, a statistic. We were infertile. And so, off to the fertility specialists we go.

Hearing the i-word is devastating for so many reasons. There's the fear that you may never have a child of your own, made with your DNA. I wonder if I'll ever get to see what our child would look like, sound like, be like. I fear that I'll never get to experience pregnancy and delivery. I worried then, and still do now, about how Bobby was taking the news; seeing the person you love most in the world in pain, especially when there's nothing you can do about it, is excruciating (but more on that another time). And then there was the dream. It seems trivial to someone who hasn't experienced it, but knowing my pregnancy journey wouldn't be anything like I envisioned is gut-wrenching. Even if I do get pregnant with IVF, all the fun and romance has been zapped from the entire experience. It's now going to be so clinical, involving doctors, nurses, technicians, anesthesiologists, coordinators, insurance companies, pharmacies, and a million other people who don't belong in our bed. And there is no guarantee that, even after all that, we'll end up with a baby. That was the day I lost the dream. And I cried for so many reasons, but also for the dream.

The thing that no one tells you about infertility is how incredibly isolating it can be. There's a certain stigma with infertility, even now, that keeps those who experience it always on the outside. No matter how many listening ears you have, unless those people have experienced it themselves, they simply can't understand how it feels. At some point, you begin to feel like your infertility is a burden to everyone around you, no matter how wonderful, supportive, and good-intentioned they are or what they say to the contrary. You don't want to upset your parents, who will be upset simply because a child's pain is the parent's pain, too. You don't want your friends to feel awkward or unsure of how to respond. If your partner is the one with the infertility diagnosis, you don't want them to feel responsible. This deeply emotional experience devolves into a series of strictly medical and progress updates devoid of any emotion at all. And once you begin to have trouble, it feels like everyone around you is suddenly getting pregnant. You don't want to diminish their joy with your pain, so you smile, and tell them how happy you are - and you are happy for them. You're just also devastated for yourself.

And you feel so very isolated.

That's where we are today. Alone, but together in our loneliness, which you come to find is something incredibly special, in a way. The only silver lining in this process so far has been that it has, in so many weird and unexpected ways, brought Bobby and me closer. It's proven to me that infertility sucks (like, big time), but there's no other man in the entire universe that I could go through something like this with. So there's that. And the sadness and loneliness, too, but love has a way of outshining them both just when you need it most. Love will get us through this, whatever the outcome.