I’m going to walk you through the part of the IVF process we’ve already done: GP appointments and tests.
The first GP’s appointment is a bit like admitting you’re an alcoholic, and realising that you’ve actually got to do something about it. You need support from each other. You’ve been trying for a couple of years, and it’s got to the point where sex is a chore done at very specific times of the month rather than that fun thing you used to do because boobs. You’re finally admitting there’s a problem, and it’s quite a relief to do so. It’s a bit odd sitting down as a pair, and the GP asking what’s wrong – instead of describing your ailments, there’s just a bit of an awkward silence as both of you pluck up the courage to go first. The GP was very reassuring, setting out the long process – referral, tests, appointments, decisions, undergoing the process before (if successful) being handed off to the NHS for antenatal care. The NHS has fairly stringent guidelines for receiving the first free round of IVF, but they’re not insurmountable, although they do vary from area to area. The first thing on the agenda is the nurse appointment at the clinic; you go together, and a lovely nurse sits you down and talks you through the tests.
For blokes, it’s pretty simple. The blood tests you have to go through are for hepatitis (all makes, all models) and AIDs, and a piss test for chlamydia. Don’t pretend you don’t know about that one. Like most people, providing that you’ve been sensible, they’ll come up negative. I’m most people, and they came up negative, so that’s a relief. If they come up positive, I’d recommend seeking advice from someone other than a blogger with a B in GCSE biology, because they’re bad’uns. But this is done in your traditional GP surgery environment, and if you’ve ever had to have a blood test before it is utterly unremarkable. Most pressing though – semen samples. Gentlemen, let us get one thing out of the way before we go any further:
Wanking on demand is difficult.
I mean, most of us can manage it on a regular basis without any undue pressure, beyond the whole “loved one accidently walking in the room whilst you’re on the vinegar strokes” thing. Lock the door, it’s not difficult. However, taking time off work to go to the fertility clinic to sit in a little room and wank yourself silly for the benefit of an anonymous fertility specialist is surreal, to say the least. A small room with a leather armchair which you do not want to sit on, with a ringbinder full of porn that doesn’t look like it’s been updated since the nineties. It’s very hard to concentrate on thinking about Emma Watson when you’re also thinking about not touching any of the surfaces.
(Protip: take a coat, and sit on that – you do not want your bare arsecheeks touching that armchair).
First off, if handed a blank beaker, write your details on beforehand, not after. Common sense. Secondly, whoever designed that little beaker they just gave you was obviously female, with a knowledge of the mechanics of the business but no practical understanding of the process. They googled “average penis girth” and decided to make the pot exactly that wide. Sensible, but stupid. When you’re trying to hold the damn thing upside down with your left hand over something that’s being vigorously stroked back and forth with your right you just know that you’re not going to get it all in and trying not to spill any on your trousers because oh god I need to go back to work in an hour and they think I’m at the GP’s. You try angling to one side so that gravity isn’t as much of a problem but now you can’t keep it in the beaker, think oh Christ what’s that stain and in your mind’s eye, Miss Watson is giving you a very peculiar look because you’re clearly not focussing on the task with her, and small wonder.
If you’re an extremely lucky man, you might get it all in.
Then you seal it up, clean yourself up (Christ, I haven’t got any on my trousers, have I? I mean… better double check) and pop it in the little hatch where some quite clever people do a rather odd census check on the previous contents of your balls, whilst you go back to work for the rest of the day, trying to suppress a smile every time you shake someone’s hand whilst you settle down to wait for the test results. This is actually quite stressful, as it takes a little while for the results to come back. Obviously, when you’re together you’re publicly sad in front of her that you’re both unable to reproduce, but below it all is the mental subtext of please God don’t let all this be my fault. You don’t know how you’re going to face her if it is your little swimmers doing slow, lazy laps instead of determinedly cracking on with the job like tiny wriggly Royal Marine Commandos. And what’s worse is it will be an undeniable, black and white, here is your scientific proof that you are toting an unloaded peashooter whilst every other bloke has naval artillery shoved down their pants. Nothing wrong with her tubes, it’s all you. You both go back to the clinic to get the results; she’s had all hers done: Blood tests, FSH, LH, Estadiol, progesterone and a couple of ultrasounds; don’t worry you do not need to know what any of these are, but she’ll appreciate it if you do – trust me, she has it far worse than you. You sit down with the nurse. Deep breath. She begins.
And it comes back average.
Slightly above average, actually. You’re fine. Yup. It’s all fine down there. You weren’t worried. What did you expect? Only about 20% of men have a low sperm count (Mackney R, Bray R, Nicopoullos J, Get a Life: His and Hers survival guide to IVF, Orion Publishing 2015). As you walk down the street, one in five of the young men you see have low quality sperm, so if you are in that camp, don’t worry, you have bags of company. If you’re watching a game of rugby, combine the two teams and about 6 of the players on the pitch would have difficulty conceiving (Sigh… all right, 6 ±√6, which falls between 3.55 and 8.45 of the men on the pitch, not including the ref or linesman for all the statistics pedants out there). Low sperm count as the cause of a couple’s infertility only occurs about 25% of the time (Mackney et al, 2015), so it’s probable that she’s the cause of it all and you’re not, so help yourself to another beer. The female reproductive system is a tremendously complex chemical factory, with far more things to go wrong; odds are that you are fine. If you are worried, avoid smoking, alcohol (whoops, better put that beer back in the fridge), eat well and get fit, but frankly you should be doing all that anyway because you’re an adult and I’m not going to give you much sympathy for your lazy swimmers if you’re not. If you want to improve your general fitness and mental wellbeing, get a dog – they’re lovely companionship and their walks do you good too. If you’re not up to the responsibility of keeping a dog, I’m not going to sugar-coat this but you really should be asking yourself if kids are for you.
Beyond that? As I said, you’re in good company if you’re in that 20%. It’s not just you. If you’re fit and healthy then you’ve already done everything you can. Trust the process.