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Never Give Up

Notes from an emergency room doctor: This was her first pregnancy, her first success at conceiving after several years of desperately trying. But she had been "spotting" for a week, and tonight, with cramping and heavier bleeding, I confirmed what she already feared. She had "miscarried." Her husband comforted her at the bedside. But even he couldn't assuage her grief. And that reminded me of my wife's and my own similar trials nearly twenty years earlier.

Those many years ago, when my wife and I decided to start our family, all our best efforts at having a child were fruitless. So, my wife went through painful diagnostic procedures to assess her fertility. And I went through embarrassing diagnostic procedures to assess mine. After all the testing, her gynecologist finally summed up our problem by telling my wife, "you're just not making eggs," and he added, "Why don't you adopt." Without belittling the wonderful love that can come to adoptive parents and their children, at that time in our young lives, my wife and I were set on having our own child. And so we ignored our first doctor's advice and sought out a "fertility specialist."

About 15% of all couples will experience infertility at some time during their reproductive lives. Female infertility is most often a complication of prior pelvic inflammatory disease or some hormonal dysfunction, with the delay in the age that women are choosing to child bear now becoming more of a factor. While twenty years ago, infertility was almost always blamed on the woman, today it is recognized that about half the time it is the male who is the limiting factor. If not due to hormonal, genetic, or anatomic problems, male infertility is a matter of sperm count and sperm quality. Average sperm counts are known to be decreasing. And the accepted world standard for "normal" human sperm is a semen specimen with up to 70% abnormals. No other mammal would be considered "potent" for breeding using that standard. So what is affecting male fertility? Well, we know very little about the effects of commonly used drugs. In most countries drug testing does not include toxicity studies on the reproductive organs of animals. It has only been by chance that the toxic effects of some routine drugs on semen quality have been detected. For example, sulfasalazine, used to treat inflammatory bowel disease, can markedly reduce semen quality. Some antihypertensive drugs, like beta blockers can cause impotence. And anabolic steroids, often used by body builders, have severe side effects on a male's "potential." Toxins in our workplaces, including solvents, pesticides, and heavy metals, can also impair reproductive function.

But nowadays infertile couples also have a lot to be optimistic about. Besides several potent fertility drugs, there are treatments like in-vitro fertilization (developing the early embryo in a test tube) and microinsemination (microscopically injecting sperm directly into the egg). Couples can also consider the option of using donor semen or eggs.

Twenty years ago, my wife was given the fertility drug, clomid. She quickly became pregnant but unfortunately miscarried a few months later. To forget our sadness, we took a holiday to Israel. We weren't very religious but nevertheless, according to Jewish tradition, we placed a written prayer in a crevice of the Wailing Wall. We prayed for a child. A week later, we visited a Jerusalem gynecologist who gave us the happy news. We were once again "expecting."

We are very proud of our daughter who is now eighteen. She starts college in the fall. We also have two boys. And for infertile couples anywhere, you should know that though your success at having a child may be achieved by adoption, with drugs, with surgery, or in collaboration with a donor, it is always a miracle of God.