Opening up about male fertility problems
After dealing with male infertility, Newfoundland couple’s dream comes true
“Don’t let your infertility define you as a person. It’s easy to let it consume you, your marriage, and your relationships with others. If you are struggling mentally, find someone to talk to.” Stephen Ryan
Stephen Ryan always prided himself on his work ethic and his ability to provide for his family. He firmly believed anything was possible if you were willing to put in the work.
“I considered being able to successfully reproduce as one of the simplest things between a couple. But it was the single most thing I couldn’t provide,” says the Conception Bay South man.
Ryan and his wife, Stephanie, were high school sweethearts and spent their younger years having fun, travelling, focusing on post-secondary education and their careers, and using contraception.
Once they decided to start a family, they expected the stars would align and they would be holding a bundle of joy within a year.
This was not the case, and it started a seven-year journey full of physical, emotional, and financial costs … and heartbreak.
After 18 months of trying to conceive with no success, they were finally referred to a fertility clinic for testing. The diagnosis: male factor infertility — low sperm count and poor sperm motility.
The first recommendations were about lifestyle change, says Ryan.
Eat healthier, lose a few pounds, avoid alcohol and caffeine consumption, wear loose-fitting boxers, take cool showers, avoid heated seats, saunas, and hot tubs, which they had just purchased a few months before.
He took vitamins and any “magic” fertility pill he found online, had multiple rounds of laser acupuncture to increase blood flow and hopefully semen quality.
“The change in lifestyle was supposed to be the answer to all our problems,” he says, Unfortunately, it was not. “After six months of living a very limited lifestyle, being hyper-aware of everything I put into my body, unsuccessfully buying into alternative medicines with still no pregnancy, I was ready to give up.”
HEART-WRENCHING JOURNEY
After two unsuccessful rounds of IUI (artificial insemination) in Newfoundland, the couple was referred to a clinic in Calgary for IVF (In-vitro Fertilization).
Although Ryan knew this was the best option, he realized his wife would bear the brunt of the treatments. She endured what seemed like endless tests and needle sticks and had every part of her reproductive system poked and prodded to prepare for the procedure.
Her ovulation cycles were held hostage and controlled with hormones and medications to stimulate egg production, says Ryan.
“The guilt that I felt was unimaginable,” he says. “I was the one with a reproductive issue, but she was the one who had to endure the surgical procedures and interventions so we could have a chance at having a family.”
Although Stephanie kept reassuring him they were a team, he says it did little to ease his guilt.
The first two rounds of IVF resulted in two miscarriages, implantation failures, and a whole lot of heartache.
“This left me spiralling out of control,” says Ryan. “I felt defeated and like a failure, became depressed and angry with everyone around me.”
He began avoiding family gatherings where he knew infertility would be a topic of conversation and all things and people associated with babies. It was just too difficult to share their joy, he says.
“We were obviously struggling in our marriage, so divorce was suggested on multiple occasions, and suicide was on my mind more than I like to admit,” says Ryan.
On top of that, Stephanie developed ovarian hyperstimulation syndrome, putting her at risk of developing serious medical issues. When they arrived in Calgary for ta third attempt in February 2020, they were denied the procedure; the risk was simply too great.
“Panic ensued, as our biological clocks were ticking and we were both edging closer to 35-year-olds, which is considered geriatric in the fertility world,” says Ryan.
They eventually travelled again to Calgary for the third round of IVF.
Two weeks later, they got a positive home pregnancy test.
“We were skeptical and cautiously optimistic since we had been here twice before to only have our hearts broken a few days or weeks later,” he says.
It wasn’t until they were at 24-week gestation, the timeframe for fetal viability in the event of complications, that they started to accept this was looking like a successful pregnancy.
And it was. Baby Dominic is now over two months old.
“It’s hard to describe finally getting to hold our son,” says Ryan, who says he has never felt the sense of happiness and relief he did when Dominic finally arrived.
“I’m not much of a crier, but I thought I was going to fill the room with tears. Even now, almost three months later, I find myself just staring at him in admiration,” says Ryan.
CAUSES OF INFERTILITY?
Dr. John Grantmyre is a male fertility specialist in the department of urology at Dalhousie University who also works out of the Atlantic Assisted Reproductive Therapies Clinic in Halifax.
When it comes to reasons for male factor infertility, he says there can be many factors involved. These may include smoking, marijuana use, alcohol, and medications.
Steroid use, however, is one that’s often overlooked by young males.
Many take steroids at a young age, not realizing it may have fertility consequences in the future, he says.
Athletes don’t think twice about taking steroids, but are then surprised they don’t have any sperm.
“Patients and doctors both need to be aware of this,” cautions Grantmyre.
TOLL ON MENTAL HEALTH
Carolynn Dubé is executive director for the national organization Fertility Matters, based in Moncton, N.B.
She says one-third of all fertility cases are related to the male partner. Another onethird are female-related, while the cause of the remaining third is unknown.
Studies show that an infertility diagnosis has a negative impact on men’s well-being and self-esteem.
“They experience increased feelings of loneliness, depression, and anxiety, including increased thoughts of suicide. They can feel shame and guilt for being unable to provide their partner with a child,” says Dubé.
Ryan knows all this firsthand.
“I’ve questioned my masculinity, often thinking, ‘I’m not manly enough to get my wife pregnant,” he says.
The Ryans recognized these issues and, after five years of infertility, they sought professional counselling from a clinical psychologist.
“It is important for men to feel a safe space to connect with other men who are going through fertility struggles. Connecting to a support network outside of the relationship with their spouse or partner can be incredibly helpful,” adds Dubé.
FINANCIAL TOLL
Ryan believes they invested between $60,000 to $70,000 in trying to conceive, including the cost of treatments, medication, travel and associated expenses.
In Newfoundland, most of the IUI procedure is covered by healthcare, but medications and IVF are not.
Prince Edward Island and New Brunswick both have public funding to offset the out-of-pocket expenses patients experience, for both men and women, says Dubé. And in Nova Scotia, Grantmyre says assisted treatments are not covered.
“Treatments cost money and should be covered by universal health care,” says Grantmyre.
SUFFERING IN SILENCE
Male infertility is not a topic widely talked about, often because of a perceived stigma, says Dubé. More women openly speak about their fertility journeys, which can make it difficult for men to know what to say to open the conversation with friends or family.
Grantmyre believes it might be because of this lack of open conversation on the topic that there is less political lobbying to have associated healthcare costs covered.
Ryan thinks the conversations are slowly evolving, though, and it’s becoming more acceptable to discuss.
“How could it not when one out of six Canadian couples struggle with infertility? People like us are waiting until later in life to conceive, so infertility is becoming more prevalent,” he says.
Ryan gives the following advice to other men in a similar situation:
“Don’t let your infertility define you as a person. It’s easy to let it consume you, your marriage, and your relationships with others. If you are struggling mentally, find someone to talk to,” he says.
“Always do what makes you happy. Don’t let other people’s opinions change your mind.”