Published in the Sunday Times on 16th July 2006 ~ Nigel Dawson talked to Paul Johnson of the "Infertility Network UK"
People think that, as a man, infertility doesn’t affect you. Wrong. As Nigel Dawson explains, it can be an emotionally debilitating experience
I’ve always wanted a family, but, like most men, I’d never really given it much thought. I assumed that I’d meet the right woman and we’d have kids when we were ready. But life didn’t work out like that. My wife, Nic, and I met in 2000 — I was 33 and Nic was 26 — and we married in September 2002. We both wanted children and started trying for a family straightaway.
It seems ironic now, but we assumed we could plan a baby, saying things like: “We won’t try this month, because we don’t want a baby at Christmas.” We thought it might take a month or two to conceive. We went to bed, didn’t take precautions and thought we’d make a child.
When Nic didn’t get pregnant, we put it down to timing and bad luck. About seven months in, we thought we should start looking into what was going wrong. I remember hoping it wasn’t me, but looking back, I did suspect that I might have a problem, even though I had no real cause to be worried — I have a twin brother and he fathered a child easily enough, so there was no genetic issue or reason to think I was different to my twin.
Tests revealed that my sperm count was low: it came in at about 1.5m per millilitre. A healthy amount is about 60m, and anything under 20m is considered infertile. There is no clear explanation of why there’s an issue with my sperm. One theory is that mumps, which I had when I was six, damaged the blood supply to my testicles, but this may not be the reason.
Some people expect you to feel less of a man, but I don’t. I know it’s not my fault, nor is it down to my lifestyle. I haven’t done anything to cause it, it’s just the way it is.
I don’t really have many outlets to talk about my experiences. With my male friends, I’m quick to make a joke about it. I say to the guys down the pub: “I told you I’d never change a nappy.” It’s my way of dealing with it. Like most men, I don’t want to talk about these things on an emotional level. But I don’t hide the fact that I can’t have children. I’ll actually bring it into conversation when I can. I think it’s important not to deny infertility or be ashamed of it. I can’t change things: all I can do is make the best of it, even if it’s difficult to come to terms with. But that’s life.
I don’t break down in tears because I can’t make a baby. The pain tends to manifest itself in other ways. I have found I get more and more wound up, and I react in ways that are out of character. When we went to a friend’s funeral, I was really emotional. I knew it wasn’t only the funeral — everything that I’d kept bottled up came flooding out.
We researched how I could improve my sperm count: avoiding caffeine, hot baths and alcohol, and taking herbal supplements. But nothing worked, and the doctors said IVF would be the only way to get Nic pregnant. We chose the John Radcliffe Hospital’s fertility unit in Oxford, which seemed to have good results, and started our first IVF treatment cycle in October 2004. We didn’t get funding from the NHS, so we had to pay for it ourselves.
Once the eggs had been collected from Nic in the clinic, I had to do my bit by providing the sperm. It seemed like an unromantic way to make a baby: they gave me a pot and sent me off. It’s not the easiest thing to do. I went into a room with a box in the corner containing porn magazines. There were people walking along the corridor outside, and all the while I was thinking: “I’d better get on with it or they’ll come and get me.”
Once the sperm had been used to fertilise the eggs, the next hurdle was to implant two fertilised embryos into Nic, then wait a fortnight to see if the pregnancy was successful. We stuck a picture of these embryos on the fridge, hoping they’d be our children. We even gave them names. Those two weeks were terrible. We knew there was a one in three chance of success, and we could talk of nothing else. We were devastated when it was unsuccessful. I just lost it and broke down sobbing.
People think that, as a man, infertility doesn’t affect you. When the IVF failed, people would say to me: “How’s Nic — is she okay?” They didn’t ask how I was feeling. But I felt the pain acutely. We grieved for a failed IVF cycle the way we would have grieved with a bereavement — we’d become emotionally attached and made plans for the future with our possible children.
We had two more IVF cycles, each one bringing a similar pattern of hope, then a two-week wait spent on tenterhooks, only to have our dreams dashed when the treatment didn’t work. I can’t express the devastation and disappointment I felt. After the third cycle, the doctor told us that we were unlikely to conceive. Surprisingly, the first thing I felt was relief, knowing that it was the end of the journey. Nic felt the same — we no longer had the burden of trying.
Every time we had the IVF treatment, it was as if someone was dangling something in front of me that I wanted desperately; I had striven for it to the point where it had become all-consuming. We’d had nearly two years of this rollercoaster and we felt it had to stop.
Nic still walks down the nappy aisle in the supermarket and cries. It’s amazing how many television adverts have babies in them, too. It doesn’t affect me in the same way, but for Nic it brings home what we don’t have.
Our sex life inevitably suffered while we were going through treatment, because sex becomes so strongly linked with having a baby. But we’re fortunate that we can talk easily and openly with each other, so we’ve been able to work through any problems.
We gave it our best shot — and spent £15,000 on IVF — but now there’s nothing else we can do, which has helped us to move on. There is a positive side to it, in that it has brought Nic and me much closer together — it’s a huge shared emotional experience. But the key has always been communicating.
All through this, adoption was an option, and we have now decided that it’s the right way for us. I’d love to be a father, and feel that Nic and I have a huge amount to offer. The children won’t be biologically ours, but the further we progress down the adoption route, the less the genetics matter. We’re really excited about the future.
We realise that infertility is something that will always be with us — you don’t “get over it” — but we have come to terms with it and it seems as if a huge weight has been lifted. We’re not talking any more about if we have a family, but when we have a family.
About 1.5m men in the UK have fertility problems, although many don’t know there’s anything wrong until they start trying for a baby. An estimated 1% of men are completely infertile, with no sperm at all, and about 5% have a low sperm count or other fertility issues. Dr Allan Pacey, a specialist in male fertility at Sheffield University and honorary secretary of the British Fertility Society, says: “Poor fertility doesn’t necessarily mean a man can’t have children, but conception can take far longer than normal or need assistance, such as IVF. Couples shouldn’t wait too long before trying for children, as IVF doesn’t always work.”
Sperm health
Most male infertility is down to sperm problems — usually a combination of low sperm count and poor motility, which is the speed and direction of sperm. One ejaculation may produce 100m-600m sperm, but only a few hundred will make it to the fallopian tubes, where the egg is fertilised. The more sperm there are, and the greater the concentration of strong “swimmers”, the better the chance of conception.
Boosting fertility
A healthy lifestyle — good diet, exercise and no smoking or drugs — can help. Avoiding hot baths, tight underpants and extended periods sitting or driving will help keep the testes cool and sperm production up. “It takes three months to produce a sperm, so plan ahead,” says Pacey.
If nothing works
Couples who have tried for a baby unsuccessfully for a year or more should see their GP, who can arrange further tests and treatment options. Even if a man has sperm problems, a type of IVF called intracytoplasmic sperm injection (ICSI) can be used.
What about artificial sperm?
There was hope recently after scientists announced they had used artificially grown sperm, made from stem cells, to fertilise mouse eggs. It could be decades before the technique is used in humans, but experts say the research greatly adds to scientific understanding of sperm.