Testosterone, Estrogen, & Sperm: What Every Man Needs to Know about His Hormones… Serena H. Chen, MD, IRMS at Saint Barnabas, NJ
Sara: Getting into male fertility and learning about it, I was very fascinated with how much your hormones actually have to do with your reproductive health. I don’t know if we all know that but I was totally floored by that.
Dr. Chen, you’re an endocrinologist, which is the study of hormones, so maybe we could just start with some basics. What are our reproductive hormones, and particularly what are men’s reproductive hormones? We all have heard of testosterone, but there are other ones. What are they and what do they do?
Dr. Chen: Hormones are very interesting because they affect every single cell in the body. Your brain is actually involved in your hormones. Both men and women have these hormones in their brain called GNRH (gonadotropin-releasing hormone). They have FSH (follicle-stimulating hormone) and LH (luteinizing hormone), which then act upon the gonads. In men that’s the testicles and in women that’s the ovaries. The FSH and LH travel through the body and stimulate egg production in women and stimulate sperm and testosterone production in males.
The testes have two jobs. They make testosterone and they make sperm. Sperm of course are for making babies, and testosterone is for maintaining men’s health. Men actually also need estrogen, as well. A lot of people don’t realize that the growth spurt that boys experience during puberty is actually mediated by estrogen. Estrogen actually helps the bones to grow.
Testosterone of course does things like help with sexual function, erections, ejaculations, muscle tone, muscle building, and affects your metabolism, as well. There’s a whole complex interplay between the brain and the testes that makes sure everything is working well.
Sara: So for guys, it really is true that their head and their balls are connected.
Dr. Chen: Yes. That’s very, very true.
Sara: They’re not making it up. They really do have a biological link between their head and their balls. I think that’s a good take home.
Dr. Chen: That is interesting. For men, a lot of couples that I work with are struggling with infertility. We see that stress of course affects women but it can affect men, as well. A lot of our infertile guys may experience things like erectile dysfunction and ejaculatory dysfunction.
We send them for check-ups, and it’s not necessarily a mechanical or physical issue. But they can experience tremendous amounts of stress and stress can affect your sexual function. That’s always one important thing to consider when we’re thinking about those kinds of issues.
Kristen: The stress of this all, of course, is the emotional component. At the end of the week on Thursday and Friday, we’re addressing the stress on men’s health, too. That’s the emotional component and how men and women choose to deal with that emotional trauma of this.
To be honest with you, that’s why Sara and I started this conversation last year. It was exactly what you talked about, doctor. A client of mine, this amazing, big, huge, burly man was diagnosed with male infertility and he just broke. The shame of it was so overwhelming for him.
That’s why I so appreciate you bringing that right out in front because that was the inception of this whole conversation. Of course, I called Sara and I was like, “I’m not doing enough for the male clients about the stress.”
Dr. Chen: It’s hard because guys don’t really like to talk about it. When we talk about stuff like that, we have to be sensitive to that. I think this is wonderful that you guys are having this whole Making Dads Summit because getting it out in the open and making it part of the conversation will hopefully normalize it and people will realize that they’re not alone. They’re not struggling with this by themselves. They don’t have to just tough it out.
There are resources like you guys in your website, our website, of all kinds of experts out there to help them with not just the medical but also the emotional. I think knowledge and understanding definitely are one of the first steps to helping with the stress of it all.
Varicocele – Treat or Not Treat: How to Make a Decision… Dr. Michael Eisenberg
Sara: Let’s start off with varicoceles. What are they?
Dr. Eisenberg: Good question. Basically, they’re dilated veins in the scrotum. The testicles are outside the body because they need to be a little cooler. Anything that warms them up could potentially be a problem. In some men, there are dilated veins in the scrotum. That’s thought to impair normal temperature regulation.
There are some other theories as to why potentially they can cause issues: increased pressures in the testicle, not being as efficient in carrying away byproducts of metabolism. Those are all some possibilities.
They’re actually fairly common. About 15% of all men have them. They cause issues maybe about 20-25% of the time. The issues they cause are three-fold. There are three main reasons we would deal with them.
- Sometimes they cause pain. As blood distends the veins, sometimes there can be an ache associated with that and so some men feel that.
- Sometimes they can cause shrinkage of the testicle. That suggests some problems with the health of the testicle, so that’s another reason that we fix them sometimes.
- The other thing that’s obviously very relevant to our conversation today is they can impair testicular function. The testicle does two things. It makes testosterone, but it also makes sperm. Sometimes if there are lower sperm counts, it can be associated with the varicocele.
To that end, while 15% of all men have varicoceles, if you look at men who are trying to have children and are unsuccessful, it’s probably about 40%, so it’s a little more prevalent in the infertile population. Because of that, there is this association that has been identified, and that’s potentially an actionable item that can be corrected and hopefully improve the chances for men to conceive.
Kristen: Doctor, I have a question and I don’t really know how to articulate this in a way. Everybody has a sense of normal about their body, right? Part of what I’ve heard from clients is they didn’t realize this was an issue. They thought that was normal for them, the amount of heat that might be generated.
Is that true? Heat is generated by having this excess pool of blood, if that’s how you say it? I just want to address this. How do you know that you have this if what you feel is your normal?
Dr. Eisenberg: That’s a great question. Usually, they come about puberty, and that’s probably about the time that most boys or men start to become familiar with themselves, especially down there.
I think that some people, probably if they are struggling with fertility, may have a little bit more appreciation doing some research online or in textbooks and things like that. Or if they see a provider, they may have a sense.
But I think you point out a very relevant point that a lot of times it’s not something you can easily diagnose. Usually, it doesn’t cause any symptoms, things that you would obviously feel. If you have an ache down there, maybe you would be more likely to be concerned about something and do a little research about it.
But you’re not going to feel if your sperm count is a little bit lower. That’s not something you would notice. You wouldn’t necessarily notice if one testicle is a tiny bit smaller than the other. A lot of times, it is asymptomatic and if it’s something that you’ve had for a long time, you may not know that it’s an issue.
I think in this country it’s usually brought to the attention because it’s either found in a screening physical either by a pediatrician or a primary care provider for adults or at the time of an evaluation for fertility as well it’s commonly seen.
Drive for Men’s Health: What Fertility Can Tell You About a Man’s Overall Health… Sijo Parekattil, MD and Jamin Brahmbhatt, MD
Kristen: If you circle back to the topic that we’re so excited to be sharing, how does one’s overall health affect it, or the other way around?
Dr. Brahmbhatt: There are a lot of things that can affect infertility. First and foremost, you have to eat healthy. Think about if everything for the sperm gets out, you have to think about your overall body. If your health is healthy and your lungs are healthy, then you’re going to better have a better sex life, which then will lead to more activity sexually to be able to have the process where the sperm goes and you get the pattern of reproduction and sexual activity, etc. So you have to be healthy.
But if you’re 30 years old and morbidly obese, and even walking up a flight of stairs is difficult, then having sex is going to be very difficult, too. You’re going to have infertility issues that way. Speaking of obesity as well, when you have obesity, you’re likely to have higher levels of estrogen which can affect your fertility as well.
It’s overall health. Your sperm have your genetics in them, so if you overall are in an unhealthy state of mind, then your sperm are also going to be in an unhealthy state of mind.
Kristen: Right. That makes sense. It’s just common sense that if you’re healthy, then your insides will be healthy also. What do you think it is that keeps men from having that mindset or desire or need to go?
Women, from the time you’re an adolescent, you go to an OB/GYN, then you have your annual mammogram. Is it the whole systemic problem for men that there’s not a process for them?
Dr. Brahmbhatt: I think it’s just lack of awareness. Women still have more opportunities when they’re younger to be engaged with health care professionals. You mentioned it. When they’re of child-bearing age, they’re going to go see their doctor. When they go see them for that, they’re going to get their other screenings done.
Men really don’t have a reason every year to go see a doctor. But if you look at the guidelines, it doesn’t matter how old you are (20, 30, 50, 60, 70), you should be going and seeing a health care professional at least once a year. Based on those guidelines, there are certain things that you should be getting done. At a minimum, you should be going to see your physician. You should be getting your blood pressure checked. Then based on your various risk factors, getting some basic lab work done as well. As you get older, that lab work and the amount of things they examine in the office is going to get larger. That’s because you’re more prone to having other diseases down the road.
At the same time, you can’t just go by a guideline. If you have certain risk factors, let’s say for prostate cancer, then we would want you to get screened earlier for prostate cancer because you do have that family risk, which does elevate your risk of having prostate cancer down the road.
It’s a very dynamic process. You can’t just go by what you see in a graph or what’s in a guideline. What you need done is more of a conversation with you and your physician or your health care provider.
The reason I keep it so vague is it’s not just doctors. We have many practitioners, PAs (physician assistants). There are so many opportunities to get in with a primary health care professional.
We had a guy yesterday complain, “I have to wait four months to go see my doctor.” Well, you probably do have the option of going to a clinic in one of the pharmacies. You can always call the doctor’s office and talk to a nurse to see if they can get you in sooner. See if there’s a nurse practitioner or a PA that can see you.
From a primary care standpoint, all of those specialists are qualified to be doing the basic screening that is needed. I don’t think it’s an access issue anymore. I think it’s more of a motivation issue.
The Truth About Testosterone: Understanding Low Testosterone… Philip Werthman, MD
Kristen: Welcome, everyone! It’s the Making Dads Summit. Sara and I are so excited to be talking about “The Truth About Testosterone.” Welcome, Sara; and welcome, Doctor. Here’s Sara to tell us everything that we’re going to speak about today.
Sara: Awesome! Thanks for starting us off, Kristen. I’m so happy to introduce Dr. Werthman. He’s becoming a really close friend. He’s a wonderful guy. He’s a surgeon to the stars down in Hollywood. His clinic is the Center for Male Reproductive Medicine and Vasectomy Reversal. Did I get that right?
Dr. Werthman: You got it right!
Sara: Awesome! It’s a long name. He has an incredible practice down there helping lots of men in their journey to fatherhood. He’s an approachable, wonderful guy. He’s so easygoing to talk to and learn stuff from. I always love the opportunity to interview him on these really important subjects. Welcome, Dr. Werthman!
Dr. Werthman: Thank you for that very nice introduction, and may I say ditto. I always learn something from talking to you. I love talking to you. We don’t talk enough, unfortunately. We both have babies and that takes up so much time.
Sara: It really does. Today, we’re supporting men on their journey to fatherhood. It’s so hard for some men. We’re getting towards Father’s Day and thinking about trying to become a dad, and thinking their own health and their own bodies and starting to learn things about their bodies.
I wanted to talk about testosterone because this is a big thing that comes up for a lot of guys. “How’s my testosterone?” There are commercials that are on and you have these things about being tired or having a low sex drive. Maybe it’s testosterone related.
I want to start with: what is Low T and how common is it? Is it really as the TV says? Just talk about that a little bit.
Dr. Werthman: Sure. The body makes testosterone, specifically the testicles. It makes it in a rhythmic fashion, meaning that testicles secrete testosterone. Not constantly, but the level of protection goes up and down with circadian rhythms over the course of a day. Testosterone production hits into high gear around age 12 or 13 in puberty, and that gives boys the hormone boost in order to get the secondary sex characteristics. Testosterone levels are high, and we know from studies that as men get older, the testosterone levels drop. Probably in their late 20s or early 30s is when they start dropping. They drop in some men very, very slowly; in other men, more significantly, depending on what conditions are going on with their body.
We know that we expect to see a decrease in testosterone as men get older. The term for that has been affectionately coined andropause. Just as women go into menopause, there’s a belief that men after they hit a certain a midlife age (and there’s no specific age) that testosterone becomes so low that it causes symptoms.
The issue really isn’t Low T as measured as a number, because it’s just a number. I think the issue is somebody having symptoms of hypogonadism. In my profession, we call men with low testosterone and the symptoms of low testosterone as hypogonadism, or those men as hypogodadim, meaning that their testicle isn’t secreting as much testosterone to support their normal function.
I believe it’s a reasonably common problem. Let me outline what these symptoms are. I think it will resonate with a lot of men in middle ages. It’s the feeling of tiredness at the end of the day or in the late afternoon when testosterone levels are at their lowest. Testosterone levels are highest in the early morning and lowest in the mid to late afternoon. You have a big lunch, you go back to the office, and then by 4:00 or 5:00 you’re ready to take a nap. Part of it is diet, but part of it also might be low testosterone. So, lack of energy, lack of sex drive, sometimes erectile dysfunction goes along with this, lack of mental acuity, memory loss. In some men, it’s significant enough to cause depression. I’ve actually seen men who were treated for years with antidepressants, and they came to see me and we found out it was actually their testosterone was very low and that’s why they had the symptoms of depression and we replace the testosterone. The depression goes away and they can go off Wellbutrin or Prozac.
Those are really the main symptoms. The other physical symptoms or signs are the love handles around, the spare tire, the belly, a decrease in upper-body muscle mass and an increase in waist size. Those are also related to low testosterone. Of course it could also be related to poor diet and exercise. At the end of the day, everything is interrelated because exercise actually raises testosterone levels, and there are certain foods that are better or worse for men as they get older and their metabolism changes.
I do think that it’s a fairly common thing as men get into their 40s, 50s, and 60s. It’s not something that, like for women, it’s a for-sure thing. I know men in their 70s and 80s who are very vigorous and have never had any issue. You measure their testosterone levels and they’re actually pretty good in the mid-range.
But for a lot of men, their testosterone levels are going to drop significantly as they progress through midlife. I don’t have a specific statistic as to how many or what percentage of men will go through this, but it’s clearly a big enough business that, as you mentioned early on, there are commercials on TV targeting men with these symptoms. It’s certainly a multi-billion dollar business. That means it’s affecting a lot of people. A lot of men are symptomatic.
Sara: You said this is primarily in guys that are getting a little bit older. If you’re thinking about becoming a dad when you’re older, is this something you need to worry about? It’s made in the testicles. Does that impact your body’s ability to be fertile?
Dr. Werthman: That’s a great question for two reasons. The first reason is, as you said, it’s made in the testicle and the testicle only has two jobs. It makes sperm and it makes testosterone. Certainly it would be logical to assume that if the testicle is not making enough testosterone, it might also be not making a whole heck of a lot of sperm.
We know also that sperm counts drop as men get older. They probably drop correspondent to the testosterone to some degree. But there’s so much redundancy and excess capacity in terms of sperm production that an 18-, 19-, or 20-year-old might have a sperm count of 100 or 200 million, whereas maybe a 40- or 50-year-old may have a sperm count of 15 or 20 million which might be a fifth or a tenth of what it was when they were younger, but it still might be perfectly fine to get the job done in terms of fertility.
The bigger thing about low testosterone, aging, and fertility is – and I think this is what you were alluding to – the treatment of low testosterone can make men infertile. Very few doctors and very few potential patients are aware of this. When a man goes in and he complains to his internist or he goes to one of these anti-aging clinics and he complains and says, “I’m having all these symptoms,” they measure his testosterone. It might not even be low. It might be just on the low end of normal, and they start him on testosterone whether it’s a gel, a cream, a patch, or a shot.
They don’t typically tell men that once they start on the testosterone two things happen. Number one is that it actually stops sperm production. It shuts down the testicle. When somebody starts on exogenous testosterone taken from the outside, their body senses that they have lots of testosterone; and therefore their testicle doesn’t get the signal to make testosterone. It also doesn’t get the signal to make sperm. It’s very, very common that when a man starts taking testosterone, he becomes sterile.
Kristen: That’s some big news if you’re trying to start a family. You could get that big blow of “I have Low T” and you go in and you try to get some T, and now you get back from your semen analysis and you’re shooting blanks.
Dr. Werthman: Exactly.
Fertility Hacks: Optimizing Your Fertility Naturally… Marc B. Sklar, Lac (CA), DA (RI), MSTOM, FABORM
Kristen: What I love about the time now is that this is so, I want to say, mainstream. Way back when I was trying to create my family, I was seeking out the herbal complements and the Chinse medicine. It was almost like the “back streets.” “Do you know where to get this, or do you know where to go?” I’m so thrilled for the advancements that we have as a group about what you do because it was so needed way back when in my day. Thank you so much.
Marc: My pleasure. I agree. The fertility world has come a long way since I’ve been involved in it in the last 15 years or so. I’m excited to see the progression and where it goes. You’re right. The way we’ve been able to accept and build in and bring all these different treatments, if you will, and modalities and medical services together to start to better treat our patients and those who need our services, I think has made such a big difference and big impact. It’s unfortunate that it didn’t happen sooner, but at least we have it now and we can take that and take it to the next step.
Kristen: Thank you. Sara, what did you have on your mind? I can see you have all those questions buzzing around.
Sara: There are so many. I’m listening to you guys talk and thinking about the wellness and the wholeness approach and thinking about the whole man. In the fertility journey, we’re not often thinking about the whole man. This is a really good chance. It’s Men’s Health month, so there are a lot of people out there talking about men’s health.
I think men’s health has a big impact on a man’s fertility, so maybe we can start there. For you, Marc, where do you start with the whole man?
Marc: You mentioned that this is Men’s Health month and men’s health has such a big impact on male fertility. There is something that I have been talking about with my patients for quite some time, and so I feel like this would be a great place to mention it.
For me, male fertility issues are really a microcosm of a greater issue going on in the body. This perception that we are individual components in our body and that one part of our body does not communicate or talk to the other I think really needs to be thrown out the window at this point.
I think we can all agree that we were created as a whole being. Our cells communicate and talk to one another regardless of what area of the body they’re in, and this is no different. When our body as a man starts to break down a bit, one of the first things I find is going to happen is that our reproductive function is going to decrease.
This is a really natural, very normal response in the human body as we prioritize our function and what’s important. Reproduction is not as important as staying alive. In terms of prioritizing our body’s ability to stay alive and do what it needs to do first and foremost, reproductive issues are going to go by the wayside first.
When we start to see that a man is having reproductive issues, I think it’s important to take a step back and ask, “What else is going on that’s causing this or potentially causing this?” and ask these questions of why.
Often, that doesn’t get addressed. It’s, “We’ve got low sperm count. How can we fix that?” It’s about patching that little break, if you will, and putting that patch on. For me, when I approach my patients, I go into this sort of detail a lot when I start to work with patients one-on-one. It’s about asking that question “Why?” and investigating more.
When you asked that question, Sara, as to what sort of things come up for men and what do we do about it, I think it’s important to first ask that question as to why they’re standing in this office and what we can do about it. Then it’s about finding out what the main issues are.
I usually break those down into three groups. The first one is about the sperm. Sperm count: how much sperm there are and does that fit or meet our needs? Motility: do they swim well, fast in a forward direction? Morphology: the way they look, the structure of the sperm – one head, one body, one tail or what variation of that do they have? That’s one aspect of it.
The second aspect that I look at is structural issues. Is there anything going on structurally, whether it’s in the penis or the testicles? It’s usually in the testicles that we have issues, such as a varicocele that can be causing a disturbance.
Then number three is hormonal issues, for instance like low testosterone, and is that causing a repercussion in sperm count?
Kristen: When do you find that men, your patients or clients, what state gets them to come into your office? I love how you explain that because I talk about that with my clients too. You’re mind, body, and soul. There’s a whole bunch of communication going on that we’re not even aware of. The way I think about it when I talk to a client is on the scale of being open, or are they shut to this information?
When you see a male in your office, when they come in for an appointment, what is their motive or how do they get to you? Maybe that’s the question.
Marc: Unfortunately, as men, we ignore things. Let’s put it that way. We have to be beaten on the head with loud pain or discomfort for us to take effort to make change in our health and seek help.
DIY Babymaking: Assisted Reproduction at Home… Stephen Bollinger
Sara: Hello, everyone. Today we’ve been talking about fertility hacking and things that you can do to maximize your fertility naturally. We just got done with a conversation with Marc Sklar about all the different wonderful aspects of acupuncture. I’m happy to introduce Steve Bollinger who is the founder and CEO of Rinovum and inventor of The Stork.
In my journeys looking at and exploring what products are out there for couples that are dealing with male factor issues, The Stork is one of the most profound innovations and one of the best products that I’ve seen. I love everything about what they’re doing at Rinovum and how much they are working to keep intimacy in the home. I will just let Steve introduce The Stork and introduce himself on any amazing work that they’re doing over at Rinovum.
Stephen: Thank you, both. It’s an honor to be here. The Rinovum company was built on the premises of trying to give women greater tools for their life in their life’s path. Our first technology, The Stork, is really a couple’s technology to support bridging that gap between natural intercourse and the more aggressive treatments that are out there, like intrauterine insemination and in vitro fertilization.
My wife and I having gone through the process, we really were trying to figure out a way to come up with a solution that made sense and you could keep it private and intimate. We took a medically-approved approach to fertility which is called cervical cap insemination. We said that if a man can use a condom and a female can use a tampon, we can take our technology and bridge that gap in the privacy of a couple’s home and give them that same kind of success rate that they were receiving under a physician’s care.
Kristen: That’s exciting. Part of it is that emotional hurdle to take this very private act of procreation, this loving act, and then the next thing you know you’re in a high sterile light-over-your-head insemination. I’m so grateful that you’re here sharing this as an option.
Stephen: What couples often forget is the fact that they’re not alone. Infertility has grown substantially over the last – oh, my goodness – 40 to 50 years. In the ‘60s it was one in 20 couples, in the ‘70s it was one in 15, in the ‘80s it was one in 10, in the ‘90s to 2000 it was one in eight. Today, the Centers for Disease Control is saying that one out of every six couples are deemed infertile. In the United States, that’s over 8 million couples having a difficult time conceiving.
You could imagine that under a physician’s care, there are a little less than 2 million women going to a doctor’s office and beginning some form of assisted reproduction, and really there just aren’t many options other than, “Hang in there, kiddo. Keep practicing for a year.” And they’re really not interacting a lot with the male.
This huge change in infertility from one in 20 couples to now one in six, there have been two major issues that we are trying to address. The one we can’t address is on the female side. As the female gets older, her chance of conception obviously dwindles. A healthy 25-year-old has a 25% chance per month of conception. In four months of natural intercourse, they’re likely to conceive. But as the female hits 30, she goes down to 15%, 35 to 10%, and by the time she hits 40, she has a 5% chance per month of conception. So any way we can nudge the factors together will obviously benefit the female, as well.
But on the male side, we are such a different demographic. The European Tissue Regenerative Bodies study published this last year showed that the male sperm count has dropped between 30% and 45% over the last 20 years. Lower sperm count has had a major impact I think on this infertility issue we’re seeing to now giving couples this one in six that are having a problem conceiving.
What we said was, “Wow. If we could get more sperm next to the egg, wouldn’t that be an amazing opportunity?” What doctors have done for years in a doctor’s office can now do it privately. Because really, that’s all what cervical cap insemination, intrauterine insemination, and in vitro fertilization all physicians and patients are trying to get the egg and the sperm closer together.
Kristen: Can you explain the first one?
Stephen: Cervical cap insemination?
Kristen: Yes. Can you explain that?
Stephen: Sure. It’s an amazing approach. Historically, what doctors would do is the male and female would go into a doctor’s office. The male, just like in intrauterine insemination, would leave a specimen. That specimen would then be placed into a delivery modality which, for visualization for most people, they could think of it as half of a racket ball. They take the semen (it’s in half of a racket ball) and then the female would be speculum. Their cervix which looks like a half of a golf ball.
What the physicians were doing was putting the half of a racket ball filled with semen next to the half of a golf ball and leaving it in there for six hours. So the patient normally would stay in the doctor’s office and hang out for six hours. Then six hours later, they re-speculum the patient, remove the container or the half of a racket ball. That was cervical cap insemination. It gave you about 10% to 20% success rate which is very similar to the success rates of intrauterine insemination done in the physician’s office today.
Don’t Cook Your Balls & Other Commandments for Making Healthy Sperm… Sara Naab
Kristen: Hi, everyone! It’s Tuesday of our amazing week Making Dads Summit. I’m so excited that I have my Sara all to myself for a little while. We’re going to share within our conversation, bringing some of the pieces that we’ve been talking about already together into practical applications.
It’s my pleasure and honor to introduce and have this special time with Sara Naab who is my partner in crime and co-host. I am so grateful we came together a year ago to band together to talk about the men in our lives and to bring focus to our husbands, brothers, and uncles.
Thank you, Sara, for joining in this conversation two years in a row and, hopefully, many more. Why don’t you fill us in about what you’re up to? I know that you’re deep in your study and all the amazing offerings that you have through the website, Don’t Cook Your Balls. Hi, my friend!
Sara: Hi! This has been an awesome week. I love being a yin-and-yang pair with you. You really cover emotional and mind, holistic kind of approach to things. I really focused on empowering control over health and wellness and looking at both the medical side and the self-lifestyle improvement aspects to your health. I think the two of us together really bring a great pair to talk about this big problem that no one really talks about. I’m honored to do this with you and I love doing it with you. You’re so fun.
Kristen: I so appreciate you. Within your divine feminine way of being in the world you also have this amazing, intuitive way of just targeting and getting into the heart of an issue for the divine masculine. I’m so grateful we’re on opposite ends of the country because I think if we were together physically, we would be in a lot of trouble. This whole buffer zone between both coasts, that’s a good thing.
Sara: Yes, I think you’re right. We get into enough trouble being on opposite ends of the country in different time zones. Who knows what we would do if we were actually in the same place.
Kristen: What I love about your story and what brought you to be so active within the men’s health community is that you walk your talk. You are using your wisdom that you’ve gained through your own personal experience and that of living with so many brothers about coming from that heart-centered place of really caring for not only your immediate family but also our global family for men. That’s why I’m excited for you to share about the website, www.DontCookYourBalls.com, and what you have done to – I don’t know the acronym for sparkling it up for men – but you manned it up.
Sara: Yes. We started Don’t Cook Your Balls two years ago now. When I got into this space and started looking at male side, I realized that the information was not very good. There were a few articles on WebMD and they weren’t very detailed. They didn’t really give any guidance. I was imagining if this was my brother and he had this condition and he was out looking for information trying to understand what to do, there just wasn’t good information online.
As I dug deeper, I realized that most men are not getting treated either and they’re not getting seen by doctors. This is what we were talking about Dr. Turek, men don’t get the care. There’s a problem with fertility, and let’s just figure out what kind of assisted reproduction we need to do to get the sperm into the egg to make a pregnancy happen because that is the outcome that we’re medically looking for.
But there’s a reason. There’s something going on. That guy is at a place of vulnerability, wondering what’s happening with his body and he’s not getting answers and he’s frustrated. But he’s not going to say a thing because that’s not what guys do. They don’t push out and try to go, “I don’t understand this. What’s going on?”
I just felt so upset for the guys who are going through this that they’re not getting the care, they’re not getting the answers, and as I read blogs I just got even more fired up. I felt like my own testosterone was going through the roof. I was getting mad for these guys.
Kristen: You were cooking your balls, man! You had to get on that!
Sara: I started thinking, we talked in the past that guys don’t get care unless they’re bleeding. But there’s this desire in men to become fathers. It’s just, “I’m going to be a dad someday!” If that’s taken away, it’s one thing to talk about my future health. Maybe in some 50,000 years I’m going to die of whatever. I don’t care about stopping smoking for that because I’m going to die anyway, so I might as well live my life. But you can’t be a dad, that’s a chance. That’s a moment where a guy really connects with himself and his body and what’s going on. I feel like it’s such an opportunity that we really need to be there for these men.
Kristen: I love how you language. We come together, the yin and the yang. I language very softly and you’re like, “Roar!” I love that about us and we have come together about it.
What is so amazing, before we talked, I actually read a little clip. We’re in June and it’s Men’s Health Week, but they’re also talking about being outside and how drowning is a quiet act. Drowning is a silent act. I thought to myself, “Oh, my gosh!” The analogy about men’s fertility, the way some men approach the diagnosis of infertility is a silent act. In a way, they’re drowning with this burden that there’s so much help out there.
I love how you made those awesome little videos and how you address this through your blogging. Not only that, how you’re on the leading edge of meeting the need through the technology of what you’re doing for in-home testing because of that, because of their silence and also because of the stigma that has to be erased for this and still is a work in progress.
Maybe if you could just talk about in your expertise, in your especially unique niche, what are the three things that you find drive men to click on Don’t Cook Your Balls? What is the reason that you’re seeing the traffic come to your amazing site?
Sara: It’s interesting. I think it’s amazing what men Google. These have to be men because the searches are things like “shrinking balls” or “icy hot and my balls.” Just things that you can tell that something is going on with him and he’s not sure what that means, so he’s just putting in stuff to try to understand his body a little bit. I don’t know if a woman would search that way. Maybe she would. Maybe she would notice it and then start looking. But I think a woman might put “lumps in testicle” or something.
IVF Aspects of Treating Male Factor… Michael A. Feinman, MD, FACOG
Sara: Dr. Feinman is a fertility doctor at HRC, which is actually one of the biggest clinics. There are nine locations in Southern California. He’s a Board Certified Reproductive Endocrinologist as well as in obstetrics and gynecology, and he’s been in the field since 1986, not to date you at all.
Dr. Feinman: It’s alright. There are some benefits with experience.
Sara: Exactly. He’s been doing incredible groundbreaking work on assisted reproductive technology and performed one of the first transvaginal ultrasound-guided egg retrievals. He also developed an anonymous egg donor program at the Albert Einstein College of Medicine in New York.
Thank you for joining us and talking about the various ways of assisted reproduction and particularly IVF and how that works when we are dealing with a male factor.
Dr. Feinman: Thank you for inviting me. First of all, as you were talking about through these many fascinating and fantastic sessions, our urology colleagues have made incredible strides in helping men who were previously thought to be sterile – I hate that term – to actually have children. Once sperm is miraculously obtained from these men, the female partner needs to go through in vitro fertilization. The sperm is not adequate for simple insemination procedures.
Of course, most men don’t fall into this unusual category. However, many couples with male factor issues will also need IVF with intracytoplasmic sperm injection (ICSI). Some couples with mild to moderate male factor can undergo intrauterine insemination (IUI) before they go onto IVF. In some cases, the male factor can be improved with procedures like varicocele repairs – I’m sure that’s been discussed – and, when appropriate, hormonal therapy.
Once all of that is investigated and possibly done, IUI can give reasonable chances of success if it’s possible to concentrate around 10 million motile or swimming sperm for the insemination procedures. Some people actually consider 5 million to be adequate. Other factors such as the female age should be considered when proceeding with IUI below 10 million sperm to make sure that precious time is not being lost. Most of us feel that attempting IUI with less than 5 million motile sperm in the final processed specimen is probably not worth it.
There is a family of tests known as DNA fragmentation assays that might help couples decide if IUI is appropriate. These tests evaluate the stability or quality of the DNA in sperm. Some papers have actually shown that when the DNA quality is poor, as done by these types of tests, the pregnancy rates with IUI are not better than nature. Once there is a decision to possibly go on to IVF, I’d like to discuss briefly the process, including the screening along with of course some of the possible complications.
Obviously, at this point the male part has been taken care of. So the female partner needs a few things to be looked at first. One very important aspect is what we call ovarian reserve or her ability to respond to the so-called fertility drives and make multiple eggs. This is done usually through a combination of ultrasound and blood test done on any of the first three days of her period to assess the amount of follicles that her ovaries contain and the blood tests are indirect measures, as well.
An important and sometimes ignored test is the hysterosalpingogram (HSG), also known as an X-ray dye test. This is the only test that can both evaluate the uterus and the fallopian tubes at the same time. It’s obviously important to make sure the uterus is shaped normally.
In addition, people need to know that when there’s a type of blockage at the end of the tubes known as a hydrosalpinx, the presence of those tubes will lower the IVF success rates by 50%. It’s important to do these old-fashioned tests before going onto IVF. Some women have had these all evaluated previously with a laparoscopy, which is fine, but more invasive and surgical.
In addition, most states including California require that the partners be tested for a variety of infectious diseases, including HIV, hepatitis, and syphilis. We’re very proactive at HRC. We encourage couples to undergo appropriate genetic screening.
Genetic screening used to be rather costly and we would only do a few genes, but now there are a number of commercially available and readily available genetic panels at very affordable prices that take the guesswork out or the worry about the cost of genetic screening. These tests will screen for things like cystic fibrosis, Tay-Sachs, sickle cell anemia, and Fragile X in the female.
The reason this is so important is that, while it’s unusual for a couple to walk in together with both of them carrying a recessive trait like this, if they are going through IVF we will have the golden opportunity to prevent the transmission of these diseases to a child through the process of pre-implantation genetic diagnosis. I think it’s incumbent upon our colleagues to look out for these genetic diseases.
The process of IVF starts with the injections of one of the various brands of fertility drugs to induce the production of multiple eggs. That process will require monitoring visits for ultrasound and blood. In our program, it’s on average three times over a ten-day period. When the follicles are considered ready, the eggs are considered ready, a final injection called HCG is given to so-called trigger the process and get the eggs ready for collection.
The egg retrieval is done, as you mentioned a few minutes ago, transvaginally using ultrasound probe to guide the needle into the ovaries with light anesthesia usually given to the female. However, the sperm are going to be produced either through the traditional method or through the more modern methods for men without sperms by taking the sperm directly from the scrotum. Later that day through the process of ICSI, individual sperm or injected into the eggs.
The next day we find out how many of those eggs fertilized normally and three or five days after the egg retrieval, a small number of embryos are transferred gently through the cervix into the females uterus in a process called embryo transfer. Most programs will supplement the women with progesterone after this and then, actually, within two weeks they find out if they’re pregnant.
The IVF process is considered safe, but like any medical procedure there is potential for complications. These complications come from the two obvious sources – the drugs and the procedure. The use of the fertility drugs on rare occasion can cause the production of a huge number of eggs (over 20 usually). On occasion after that, the women can experience a complication called hyperstimulation syndrome where their ovaries get quite enlarged and even weep literally gallons of water to their abdomen.
The good news is that this is preventable. At HRC, we use an alternative to the HCG injection which is actually the hormone that causes this complication. We use something called Lupron trigger, which causes the women to have their own LH surge. Natural LH is far less likely to cause hyperstimulation than HCG injections.
Putting a needle into the ovaries of course can cause some bleeding afterwards and infection. Fortunately, infection has proved to be very rare, and we give antibiotics to make this complication even less likely.
The bleeding, once in a blue moon, a woman will report a few hours after an egg retrieval that she’s in pain and we discover that there is a small bleeder in the ovary. The majority of these patients can be managed with a night in the hospital, an IV, and bed rest.
I mentioned PGD before (preimplantation genetic diagnosis) in the area of testing embryos for genetic disease when the parents are carriers. PGD or PGS (preimplantation genetic screening) can also be used to look at the chromosomes in embryos. This is becoming more and more of a popular alternative for couples.
While not perfect because no test is that perfect to completely wipe out the chance of having a Down syndrome or similarly affected child, PGD is useful to help couples consider single embryo transfer and reduce the complication of multiple pregnancies.
In the area of male infertility, particularly with ICSI, there has been some concern about the safety of this procedure. There are papers alluding to higher rates of certain complications or congenital anomalies in the children. Of course, we’re always vigilant and worry about this, particularly in the more severe male infertility patients because these men in previous generations would not have had children and now we are helping them have children.
It would be comforting to people to know that in Belgium where ICSI was first described and performed, a very interesting study was done a few years ago. They have a huge number of patients coming there from all over Europe.
They found a group of patients who happen to have their first child naturally and now couldn’t have a second child. These people then went through IVF with ICSI. They then compared with rate of congenital anomalies in the natural pregnancy group to the ICSI pregnancy group and then compared those to the congenital anomaly rate in Belgium as a whole. Lo and behold, the congenital anomaly rate in the first two groups – the couples with male infertility who conceive naturally or with ICSI – were similar and slightly higher than the natural population.
So there is the belief that the actual infertility may contribute to some of these concerns. Unfortunately, while they are statistically elevated, they’re not clinically out of range. In other words, they were slightly higher than the general population, statistically significant, but still the vast majority of children born through these processes are healthy.
I hope I didn’t talk too much, but that’s a brief summary of the comparison of IUI and IVF. People might like to know that we are currently running an FDA trial that allows women 35 to 42 with certain qualifications to undergo IVF at a greatly discounted rate, and we can discuss how to contact me for that at the end of the session.
Kristen: I have a couple of questions. I was taking notes while you were speaking. The process that you just talked about is very similar to what it was a bit ago when I was experiencing it. But I feel – maybe you can confirm if this is accurate – that there are just multiple choices within the process. The part about preimplantation genetic testing and ICSI and all the new innovations, the process is basically the same as it was.
Dr. Feinman: You’re right. It hasn’t changed much in 25 years.
Sara: Right. But the analogy that we maybe can use is the car analogy: it’s the bells and whistles that are on the car now, the options in the system. It’s surprising to me that the hysterosalpingogram is still the way of obtaining that information about the uterus shape, size, positioning, and also the tubal functioning with the expansive options now. Is that done within your clinic, or is that an outpatient?
Dr. Feinman: It’s an outpatient procedure. It can be done by radiologist. We happen to be one of the few programs in California, probably the country. There are few others but we actually have the machinery to do the test in our Encino facility, so that’s an unusual arrangement to be able to have a reproductive endocrinologist perform the test rather than a radiologist. A radiologist will do a fine job – I’m not picking on them – but we do have it.
Kristen: No. It’s a different comfort level for a woman. For me, personally, I can only speak to my personal experience with having that done three times, it’s uncomfortable. Knowing that you have your reproductive endocrinologist – mine did come and do the procedure for me because he was that kind of a gentleman, which seems like your clinic is also doing that – that it brings comfort.
Shooting Blanks: Treating Azoospermia… Michael Eisenberg, MD
Kristen: Hi, everyone. Once again, I’m joined by my co-host Sara Naab from Don’t Cook Your Balls and Dr. Eisenberg. Today we’re talking about “Shooting Blanks.”
Sara, hi, honey!
Sara: Thanks, Kristen!. Luckily and hopefully, many men with azoospermia or shooting blanks do have treatment options. It is an incredible thing of modern medicine that doctors are able to treat this.
I’d love to introduce Dr. Eisenberg, one of the world experts who does this. He, on a regular basis, treats men and helps make miracles. When guys come in and they find that they don’t have any sperm, he’s able to help them identify the causes and find solutions. He is the Director of Male Reproductive Medicine and Surgery at Stanford and a researcher focused on the correlation between fertility and men’s health. He is just an incredible expert and resource to have with us today while we’re talking about shooting blanks.
Welcome, Dr. Eisenberg.
Dr. Eisenberg: Thank you. Thanks for setting this up. Thanks for having me.
Sara: Let’s start with that “deer in the headlights” moment. You’re trying to have a baby, it’s not going so well, you finally get in there, you finally get that semen analysis done, and then that dreaded moment happens when you look at it and there’s nothing there. It’s probably one of the most terrifying moments of a man’s life to just see that paper. What’s going on?
Dr. Eisenberg: It’s very devastating to have to give that news to men. One thing that I always try and let them know is it’s not that uncommon. About 1% of all men in the world and in this country have no sperm. One sounds small, but that’s actually a lot of men. It’s millions of men. I think that’s important to know that they’re not alone.
The other thing that’s important to know is there’s a lot that we can do. Just because there’s no sperm in the ejaculate now doesn’t mean that in the future there won’t be. There are a lot of treatment options that we can offer that hopefully will improve it.
The first thing that we look at when we talk about azoospermia, no sperm in the ejaculate, is why. There are two broad classifications. One is there could be a blockage in the system. Sperm is being produced; it just can’t get out. The other possibility is there’s a production issue. Production is either absent, which occurs unfortunately sometimes. But oftentimes what also happens is there’s just limited production, and it actually takes a threshold amount of production to occur so that sperm can actually get out into the ejaculate. So there may be some production in the testicle but just not enough so that it actually makes it all the way out into the semen.
The first thing we want to do is try and figure out which of those is going on and once we have a handle on that, we can talk about some treatment options. If it’s a blockage, we can hopefully try and correct it so that we can get sperm back in the ejaculate and so then we can use that just to have sex and have a baby.
But other times, if it is a production issue, figure out why production is limited. Maybe there’s an exposure in the past. We just need to give a little more time for things to recover. Maybe there’s some anatomic reason. There’s actually an association between varicoceles, which are dilated veins in the scrotum. They can warm up the testicle.
We talked about that on Monday. Actually, one of the first instances of the link between varicocele and fertility was actually a man who had azoospermia, had no sperm in the ejaculate. This was fixed, and then he developed a sperm count after that. That’s another possibility.
It can also be hormonal influences that can be optimized. Through that sometimes we can improve sperm production.
One of the important things is to find out why, but then once we found out why, we can talk about some of the options. So I think hope does remain. There are actually reasonable chances of conceiving even with no sperm, what we see in the first step, the first semen analysis.
Sara: We’ve talked about throughout the week, men aren’t very used to going in to the doctor. It can be very intimidating. What’s going to happen? What is he going to do? What’s the workup like?
Dr. Eisenberg: Nothing should hurt, basically. That’s the first thing I would say. If we see no sperm in the ejaculate, the first thing we want to do is just check another one. At least 20% of the time, if there’s no sperm in the first one, we can find some in the second one. I think if we find sperm, it really changes the scenario dramatically. Even if there’s just a few, it gives us a lot more options immediately.
The other thing that we want to do is check some hormones. The testicle does two things: it makes the sperm, but it also makes testosterone. We check testosterone and some of the other hormones involved in that pathway and that will help us tease out a little bit whether this is an obstruction problem, a blockage problem, or whether it’s a production problem.
Any time there’s very limited sperm or no sperm, the other thing that we look for is some rare genetic diseases. This is another blood test. This just lets us know likely what’s going on. I think it’s always important to figure out the why and how correctible it’s likely to be.
In addition, depending on some of the different test results, there also could be some implications to any kids. So one thing that we commonly test for or we always should test for is a Y chromosome condition.
If you remember from biology, women have two X chromosomes. Men have an X and a Y. On the Y chromosome, there’s a lot of DNA that’s important for sperm production. Rarely, a little piece of this DNA can be lost. That would be the reason that sperm production is not optimal or completely absent. If a man has this problem with his Y chromosome and he has a son, his son is going to get the same Y chromosome and will have the same problem.
I think that’s important to know. I’ve counseled men with this deletion many times. I think there are two main answers. Some men say, “When my son is ready to have his own family in 30 years, we will have found a solution for this. So I’m not too concerned about it. Let’s proceed with having a baby.” But other men would say, “I know how stressful this has been for me. I don’t want my child to go through this. In that scenario, maybe I’d just rather have daughters.” Both of those are options, but it’s very important to get that information.
When we do get this diagnosis, it’s important that men are thoroughly evaluated by people who are familiar with the workup. I think all these different tests and the implications of all of them are very important. Some of them can be quite complicated, so it’s important to have some familiarity with them.
What Every Guy Should Know About Donor & Surrogacy Family Building… Amy Demma, Esq.
Amelia: It is a mouthful, as you suggested in the intro. It’s the American Academy of Assisted Reproductive Technology Attorneys (AAARTA.org). It’s where folks can feel safe and confident in seeking legal counsel that is experienced in ART within their state. I’ll start there.
Kristen: You know, Amelia, what is so amazing about that? Sara, jump in too because you know I get to be Chatty Patty.
What is so amazing about just that piece of knowledge that there is a such a specialty in the legal arena that only deals with creating healthy families is you need to know that if to get pregnant you need assisted reproductive technology, you need to go to a reproductive endocrinologist. That’s the same arm for the legal hand. You really need to seek out counsel from an attorney who is focused on creating families every day.
Amelia: Let’s start off with a case that was in the media. I think much of the case highlights issues, interests, and concerns for any gentleman considering engaging in assisted family building. We’re starting out with a Kansas case. Again, these are general principles. Whether or not this case and this opinion is applicable in your state is something that you need to speak with an ART attorney in your state about.
Here’s what happened in Kansas, and we’re seeing this a lot particularly coming out of the lesbian community. The scenario is this: two women had hoped to build a family with a friend as their known sperm donor. They approached this gentleman or there was an arrangement that came to be.
As expressed by all parties, by both women and the gentleman, there was never an intention for the gentleman to parent. He simply was engaged in assisted family building in an effort to help his friends build a family. Beautiful. Terrific. I love when clients come in and give me those stories. I love working on those cases.
Here’s where things went terribly wrong. The first thing the parties did was I guess they had some indication that legal counsel was necessary, but they sidestepped reaching actual counsel and downloaded a known sperm donor agreement from the Internet.
The first problem with that was they downloaded an agreement that was written under California law. There’s nothing in this case that connects it to California. This was a case that happened in Kansas, so that agreement was invalid and inappropriate for these parties.
Secondly, they didn’t seek independent counsel. Gentlemen, if you are out there and you’re considering assisting a friend or loved one in becoming a family and you’re intending to act as a known sperm donor, you need your own attorney to protect your interests to be certain that your cannot be held liable for parental obligations.
What happened in this case was in the state of Kansas because legal counsel was not sought, the parties chose to do an at-home insemination. As is the case in many cases, if you are participating as a known sperm donor, at-home insemination is not recognized under the law in establishing you as a donor.
You need to go into a medical practice, and the medical practice needs to assist in the insemination. This is the way you establish yourself as a donor, forever a donor, and only a donor and will not be liable or exposed to parental obligation – child support essentially is what we’re talking about.
In this case, they downloaded a contract from the Internet, never sought legal counsel, relied on a contract written under state law that did not apply to their case. They did an at-home insemination. They never sought the services of a medical professional. Ultimately, after a series of other facts that actually are irrelevant to this discussion, the court held that this gentleman had parental obligations despite all three coming forward to the court and saying, “We intended for him only to be a donor.”
He is now, as of today, liable for child support for the children that resulted from the donation. That means other parental entitlements as well: custody, visitation. That is not what these two women had anticipated.
There are a lot of red flags there and a lot of things that can be generally applied. We are hearing more and more of this, and it’s wonderful that our community is supporting LGBT family building. We’re hearing a lot about lesbian couples relying on their male friends to be donors. Let’s protect the gentlemen so that they stay donors and only donors and don’t have obligations.
Kristen: They created a baby, so the bottom line is that they created this family. How did it get moved into the court system? Did one of them petition?
Amelia: No. None of the three wanted parentage assigned to this gentleman. The couple went in for state assistance and it triggered an inquiry as to the paternity of the child. It was then determined that the intended donation did not happen properly under Kansas law.
All of it could have been avoided. These folks had the best of intentions going in, side-stepped the law, downloaded a contract, relied on inappropriate law, didn’t understand they needed medical services for the embryo creation. Now we have a party who did not wish to or intend to parent parenting, and we have two mothers who did not intend or expect to have a gentleman in their family dynamic as a parent and now they do. It went terribly wrong, and it’s really quite unfortunate.
What’s interesting about this, and this is a case where we are now taking the opinion of that case, and we really are spending a good deal of time counseling men who are coming in as known sperm donation agreements. I write known sperm donation agreements all the time. They’re straightforward documents.
My document is complex. It’s about 25 pages at this point. But they are documents that experienced ART attorneys can quickly and efficiently produce for their clients. We do it all the time, and I encourage anybody who is being asked or is offering to be a known sperm donor to be sure that he is protected with a known sperm donation agreement.
We have another case. It starts out looking similar and then flips a little bit. The Kansas case I just mentioned to you has been decided. In New Jersey we have a pending case. This is also a lesbian couple who built their family with a known sperm donor. They in fact did have a contact drafted, so they didn’t download anything from the Internet.
However, they apparently did not seek the counsel of an experienced ART attorney because also in New Jersey, in order for a donor to be recognized as a donor, in order for you not to be exposed to parental liability if you are helping someone else to build a family, the creation of the embryos must happen within a medical clinic.
These folks did an at-home insemination and now this gentleman, unlike the gentleman in the Kansas case – in the Kansas case all three, the two mothers and the donor, agreed they didn’t want him as a dad but the court says he is a dad. In the New Jersey case, this gentleman would like to now assert parental rights. This means that this family dynamic is going to be disrupted if the court in fact finds that this man did not act as a donor because he participated in at-home insemination.
Folks, if you’re considering at-home insemination, I know Amazon is exploding with all kinds of kits and products that assist in at-home insemination. I understand the interest in creating your baby in a much more intimate setting than a clinic. But if your state requires a medical facility to perform the services that result in the embryo, you cannot do it at home and be protected, gentlemen. Please pay attention. Seek the advice of an ART attorney and find out what your state requires in terms of you as a sperm donor.
It looks like this lesbian couple in New Jersey may end up having a dad in their family dynamic when that wasn’t intended. We’re watching that case, and it will be interesting to see what happens there.
Kristen: It’s powerful. It’s important information that you’re disseminating, the distinguishing between having to have the insemination within a facility.
Building a Family with Donor Sperm… Eric Schwartzman
Kristen: Welcome, everyone. It’s Sara and I and our theme for today is “Hope Beyond Infertility.” We are so excited to begin the conversation about “Building a Family With Donor Sperm.”
Thank you so much, Eric, for being with Sara and me. Hello, Sara. I know you’re on the phone. Hello, Eric. We’re just going to let Sara introduce you to everyone.
Sara: Thanks, Kristen. I think this is a good session to highlight the great work that sperm banks often do in bringing hope to families where the male factor issues are insurmountable and there aren’t very many other options. These sperm banks are there, and they create these incredible miracles for family building. I just want to echo the “thank” as we start this important conversation on donor-conceived children.
I’m really happy to introduce Eric. He is the founder of DI Dads Yahoo Group, which is the biggest community on the Internet for support. It’s a private community that allows men a space to delve into these issues and talk and work through their emotions as they’re considering building their family with donor sperm.
My hat is off to Eric for creating this space because I think it’s a very emotional issue, and men need a safe place to have these discussions. I thank you for your work and for joining us today to have this conversation.
Eric: Thank you for having me. I appreciate joining you guys every year because it is an important topic overall, talking about infertility. Certainly, donor conception with creating and raising children via donor conception is not just about the families who are doing the creation, but it’s also about the children themselves and their relationships to their families as they grow up in light of their creation story. Thank you very much for allowing me to join in and participate.
Sara: Let’s start at the beginning, and we can get a little background on you and what inspired you to create the DI Dads group.
Eric: I grew up knowing that I was born with undescended testes. Then when I was a kid back in the 60s, one was lowered surgically and one via drugs. Many men of my generation who had dealt with these things knew that there was a possibility that their fertility was going to be affected.
It wasn’t until before I was going to be married that I actually learned that I suffered from non-obstructive azoospermia, which basically means there’s nothing physically that was preventing the creation of sperm. It’s just genetically my body doesn’t produce it. I learned a short time before I was to be married that I had this issue. My then wife and I decided to continue on. Luckily for me, we got married. Then we knew we would have to address the infertility down the road during our marriage and how we wanted to create children.
Eventually, after learning about IVF and ICSI and everything that goes along with that, we were lucky enough to understand that donor sperm was also an option. We had two beautiful children using a common donor for both of them, an anonymous donor.
It was during that time, I think after my second child was about two, that I learned of the donor sibling registry and started getting involved with their Yahoo discussion groups that existed at that time. Then I realized there was no venue for men to speak. Primarily, women were the ones on these sites to begin with. There was a fair number of men, but there were very few places if at all that men could talk among themselves about these issues. That’s how the Yahoo Group DI Dads was actually formed.
It was actually created by a British gentleman who was a sperm donor himself. He and I were having discussions on one of the other Yahoo Groups. He actually created it, but then he just turned it over to me immediately after he created it.
I started trying to publicize it for men who were either considering using donor sperm or people who already had families, like myself, created using donor sperm to basically just have a place where men can shoot the breeze, ask the serious questions to feel they weren’t being judged.
As much as men pride themselves on being “the stronger gender” – a lot of people have that issue putting that aside – talking about these issues in public where women are involved, men would clam up. Men would not speak about these issues publicly because of the stigmas attached to it and the fear of not being seen as a man.
They needed a venue, and having this group allowed men a safe place where we can discuss among ourselves issues of concern: how it affects our marriage, how it affects how we see ourselves as men. Just as women who have problems producing eggs and carrying children to term have issues about who they are as women, men have the same issues on our side.
That’s what the group has been. Now the group must be about ten years old I guess already. I didn’t realize without thinking it through because it’s a very self-sustaining group. As more men come on, the men that are on the group step up to the plate and start providing support and answers about how we went through the issues as we decided to grapple with them.
His and Her Coping Strategies… Kristen Darcy
Kristen: Hi, everyone. Today’s theme is coping with infertility or diagnosis of male infertility. I’m so excited for the amazing men who are speaking today and coming out with such bravery to share their story.
One heartfelt thanks as we’re on day four of this week – oh my goodness, it has been such an amazing week – but just a great thank you to the amazing women who are behind the scenes making this Google Hangout happen and the telesummit run smoothly. Thank you so much and I appreciate my team. I love you both so much.
My topic is “His and Hers Coping Strategies – Don’t Go Into His Cave.” It has been such a profound learning experience for me to listen to the gentlemen days prior sharing their journey and talking about how their focus during their trauma, you could call it – receiving a diagnosis of male factor and, unfortunately for some, also a diagnosis of cancer too – was about making sure their partner was okay. Part of their bravery and part of their approach – there’s a Doreen Virtue card, “If you get nervous, focus on service.” – the part that I really want to address is the ability for the male partner or partner within the couple to self-nurture, self-care.
The idea came to me because within a couple of coaching session that I was doing, this amazing couple came to me. You probably heard the story before, but if not, I just want to reference it again. This gentleman was so in love with his wife, so supportive, so heartbroken, and they were mirroring each other’s feelings back and forth. The part that I felt that I needed to focus more and bring more attention is that there was almost a sense of him not allowing himself to feel what he was feeling because he felt he needed to be so strong for his wife.
On this particular day when he came in for his coaching session, they had a failed IVF attempt and previously had lost a pregnancy. But on this day, his best friend had passed away a few days before. He was his caregiver/caretaker. This big, amazing, brave, kind-hearted, gentle soul just broke. It wasn’t until then that his wife was able to see how this was really affecting him because of his ability to compartmentalize his life and cope, and he was doing a brilliant job.
That’s how Sara Naab and I came together to really bring attention to men’s health, men’s infertility, men’s whole way of how the system is maybe not serving them in the way that they need the best. To that, how do we help each other communicate to each other so that one of us is not shut down?
It was so amazing to hear Eric Schwartzman talk about his journey yesterday, about how he took to writing things down and created a way for men who created their family through donors to have a platform to talk without shame.
What needs to happen for this conversation with me is to give you one simple tip about how you communicate with yourself first affects how you communicate with your spouse (of course, you know that) and how you communicate and create a healthy family. What is so amazing, with a few of the strategies, the most powerful one would be to write it down or get it out. Get those emotions, acknowledge them.
What ends up happening is if you’re feeling like that gentleman grieving. He was grieving the fresh wound/trauma of losing his best friend but he was also grieving the fact that fatherhood was being such a challenge – the IVF failed and that they lost a child. When you rattle that off, it’s a tremendous emotional burden if you’re holding that inside. The analogy is bringing it back to the drive for guy’s health.
The doctors talked about that. It’s really great for us to be talking about it this week, bringing attention to men’s health. Men’s health not only physically, but mentally, spiritually, and emotionally. But this needs to be a constant communication, a constant conversation. Dr. Turek said that he felt that men are underserved in the medical community. We are one mind, body, soul, and heart.
It was interesting to me that the men who are coming out and speaking about the journey decided to write it down. At first it was just for them to write down in their journal. You don’t have to create a blog or you don’t have to create a book or start a community, but writing it down. What ended up happening was their spouse read it and it was a form of indirect communication.
How to Support Your Wife, Save Your Marriage, & Conquer Infertility… Marc Sedaka
Kristen: Great. One of the things I loved that you did that, because your voice is so important. The takeaway that I continue to share throughout the blogs when I write anything related to male experience, regardless if it’s your diagnosis or your wife’s, is that quote. I was hoping you could say it. It was something about your analogy to the marriage and then your wedding.
Marc: Oh, that’s right. We did discuss that. That’s something my wife actually said to me. I’m not sure if she thought of it or if she heard it in her fertility group. “The infertility is the wedding; the children are the marriage.”
You spend so much time thinking about the wedding, the wedding, the wedding, when you have all these years ahead of you. It’s kind of like that. When you’re in the throes of infertility, it seems like your entire world until the end of time, but it’s really just the wedding. The marriage is the kids.
We have three kids now. We have twin 12-year-old girls who were born through a gestational surrogate and a 9-year-old boy who was that story – completely naturally after the fact. I’m thankful that we’re beyond it, but I’m still so empathetic to the people going through it because it’s ingrained in my brain how all-encompassing it is at the time.
Kristen: Isn’t it so amazing? I wrote a story about when Mother’s Day was coming up for me. It was 4:00 in the morning, and the house was quiet. I sat down to read a magazine and all notes on the contributing writers; I always look to see if one of my girl pals wrote an article. Underneath, it said, “Son of So-and-So. Daughter of So-and-So,” and I just started crying.
It brought me right back. It’s just ingrained in your life story. It’s part of you. Like my friend Michelle said, “It’s like her eye color.” It’s just part of you every day. It was so amazing that it comes out of nowhere. I don’t know if you’ve ever experienced that too.
Marc: Oh, definitely, when you speak to people who have had that mutual experience. I like that you said it’s part of your identity. I have a friend whom I interviewed for the book who also used a gestational surrogate. He, like I, wanted to bring that out into the open and not make it something you’re ashamed of. The expression he used is, “It’s a badge of honor,” and I really like that. It’s something we can tell our kids. It’s our badge of honor that we went through all this.
Thankfully, it all exists and we can take advantage of it in whatever way we can. The bottom line is becoming a parent. That’s the goal. Something I always like to say, and it’s something I firmly believe, is anyone out there who wants to be a parent will become a parent. It might not be how you thought it would happen but, again, the wedding doesn’t matter; it’s the marriage that matters in the end. Everyone can/should/will become parents out there, one way or another.
Kristen: It’s the process of shifting. You have to go through the grief process of how you thought you were going to be a parent and then be able to surrender. My mantra was “through me or to me,” I was going to be a mom.
Love, Loss, & Infertility: Dealing with the Hard Stuff… Richard Spencer Reimagineit
Here is a link to Richard’s twitter https://twitter.com/remagineit and you must follow! Richard Spencer knows what dealing with the hard stuff means. In addition to being diagnosed with cancer he was told he had no sperm. He and his wife also lost their twins before they were born. They went on to become pregnant and are now raising a beautiful little girl with Down syndrome. In his own words, here is more about Richard Spencer Remagineit:
I’m a 29 year old (as of writing this in January 2014) male from Canada. My passions include hockey, laying video games and creating video games. I come from a large family with 2 older brothers and 2 older sisters. My father passed away when I was only 12 years old and my mother re-married years later.
My passion influenced my education and career and I graduated with a diploma in Video Game Development. I worked in the field for a couple of years, but after losing my first job which I had directly coming out of college, my career slowly evolved into web development which is what I currently do.
We have 2 cats and 2 dogs. The two best dogs you could possibly ask for. We got our boxer in 2010 just before I lost my first job. He’s been with us through everything. We always wanted a play buddy for him but put it on hold when we found out about the twins. After the loss, we still had much love to give, so we eventually got another puppy. Our English Bulldog is super cute, fun and she gets along great with our boxer. She was the perfect thing for us after the losing the boys.
My amazing wife
My wife and I met online in 2007 and we instantly clicked. After a year and a half of dating, I proposed to her at the most magical place on earth, Disney World. We always spoke about having a big family and often joked that we’d have the best looking children. Being a Canadian and coming from a large family, I also joked of having 5 kids or more to create a “hockey team.” We were 25 when we got married and were still young.
Remagine It: The meaning of the title of this site.
When my wife and I were getting serious with our relationship, I had this vision in my head of what our lives would be like. Great career, lots of children, nice house, etc… But with each hurdle we were faced with, I had to “imagine” a new vision of our future together. After getting cancer, I had to “re-imagine” our future. After finding out I was infertile, I had to remagine it once again, and so on for every other life event that has happened to us. What I imagined our future would be like when we were 25 is completely different than it is now, it’s still constantly changing and our struggles aren’t over yet.
Kristen: Hi, everyone. Thank you so much for joining us for the second annual Making Dads Summit. Today is June 18, Thursday, and it’s my privilege again to be here with my partner in crime and co-host, Sara.
We also have a wonderful guest today. Thank you so much for being here also, Richard. I’m just going to throw it over to Sara, and we’re going to start this amazing conversation about creating dads.
Sara: Thanks, Kristen.. This is just a really important conversation for us to be having, and very few people take the time to think about the dad side of the fertility equation.
I want to introduce our guest today, Richard, who is better known as Remagineit, an incredibly brave man who has inspired me since I’ve been involved in this. I’ve been following his blog, sharing his experience.
He’s a 30-year-old web developer who is on his journey to start a family just like every other guy except for he has had a lot of really large roadblocks in his way. He has gone through cancer and infertility, stillborns, and now blessings that he through donor’s sperm has a wonderful daughter who has Down syndrome. She is the shining light in his life, the cutest baby I think I’ve ever seen in the whole world. I just want to eat her up.
Kristen: We’re fighting over that baby.
Sara: She’s so cute. He’s shared so much of this journey with the world through blogging, and it’s really been a way for him to find support and to be an advocate for infertility, child loss. He’s a lone voice in some ways, sharing his experiences.
Welcome, Richard, and thank you. Thank you so much from my heart for joining us and sharing your really unique perspective.
Richard: Thank you so much for having me. I’m glad to be able to be a part of this and speak my voice and hopefully get others to speak up, as well.
Sara: I kind of just rushed through it, but maybe we can share a little bit of your story and how we ended up here today.
Richard: Yes. It’s a bit of a long one. As you said, very many roadblocks to get here, but I’m here and I have my daughter. I have a family now, and I couldn’t be happier. I couldn’t be prouder. It’s through those difficult times that I’m able to find the strength to continue each day and just keep going and keep doing what I’m doing.
I started out building my family or trying to build my family in 2010, about a year after I got married. My wife and I were trying, and nothing was happening for maybe about six months and so we didn’t know what was wrong.
Around that time, I went for just a yearly physical check-up and the doctor found a lump and, sure enough, it ended up being testicular cancer – what I wasn’t ready for. Cancer was a shock enough. You don’t expect to hear that at the age of 26. Nobody does. But apparently it’s fairly common in men between the ages of 15 and 35 to have.
The cancer was a shock, and luckily I had a friend who went through it, as well. He went through the worse of it though. He had chemotherapy and surgeries and other things like that. I had surgery, as well. So talking with him, he discussed fertility preservation. He suggested I do a sperm test because chemotherapy can greatly affect it.
I did a sperm test, and what shocked me even more than the cancer is finding out I had none. I have azoospermia, which is likely as a result of the cancer. I did a bunch of other tests and they all came back negative, such as Y chromosome, microdeletions, and whatnot.
My wife and I decided to focus on one thing at a time. Although we were trying to build our family, cancer was prevalent. I had surgery. We tackled that and afterwards we tackled infertility.
I did everything I could to get my sperm back, reading all sorts of articles on what to do, what not to do, even looking into acupuncture and Chinese herbal medicine. I wanted my sperm to come back so bad. At that point, the doctors were telling me there was maybe a 2% chance it was going to come back or could come back.
It was about a year and over that course of the year I would do semen analyses and still the same result – nothing. My wife and I prepared ourselves for using donor sperm. Then we also decided to do IVF at the same time as having another surgery for me on my one and only remaining testicle, called micro-TESE surgery, where they cut it open and try and find sperm. We did that along with IVF. They didn’t find any sperm, so we used the donor as a backup and then luckily we got two embryos.
We transferred one and froze the other. We liked the idea of twins, but we didn’t want to, I guess, risk more multiples by transferring both. So we transferred one and then a couple of weeks later, we were the happiest people alive when we saw the ultrasound. There were actually two. The embryo had split into two, and we were having identical twins.
We went from the lowest of lows to the highest of highs. We wanted a family and this was it. This was the beginning, and we are ready for whatever challenges. No matter how many times people told us, “Twins are going to be a handful,” I embraced it. I wanted it so bad.
The pregnancy was going fine. Everything was going good. We had frequent ultrasounds because twins are considered high-risk. Then just one day on a weekend, Ellen realized she hadn’t felt the babies kick in a while because usually she can feel one or both kick relatively often. So we decided to go to the hospital, and I didn’t think much of it.
I thought everything was fine, everything was normal, until the nurse was trying to find a heartbeat and couldn’t find any – couldn’t find one of them. It began to sink in that maybe there’s something wrong. They brought in an ultrasound machine, and I pretty much knew as soon as I saw the picture that they were gone.
Kristen: I’m so sorry.
Richard: Thank you. It was surreal. It was like a dream. A really, really bad dream. Seeing so many ultrasounds I knew that they moved a lot, but they didn’t move. I didn’t see them move. Then the doctor came in and he said, “I’m just going to confirm,” and then that was it.
Ellen and I were just in tears, holding each other tightly. Then all sorts of things go through your head, “Why me? Why us?” Not just for that but for everything else that happened prior. We were at the lowest of lows into the highest of highs and then back down even further below. So we had to deliver them. Ellen had to deliver them.
That was a really rough time. We took time off work as much as we could. We were both extremely depressed, and I started writing what I had gone through. I didn’t really have the thoughts of starting a blog, but it eventually turned into that. I started writing and found people who were going through similar situations – either cancer, infertility, or loss.
I was doing that for a while. Then we eventually transferred the other embryo, and we were pregnant with our daughter. Honestly, it was scary. Looking back, I know more now and I think it’s because people are misinformed or have a preconceived notion of what Down syndrome is like.
It was really scary but now that she’s here, there obviously are challenges, but any kid is a challenge. Any child is a challenge, but we embrace it and we love her. She’s just super happy and fills our days with joy all the time. No matter how much of a bad day I might have, I come home, I see her, and I’m immediately better. I’m out of that bad mood.
I’ve just been through a lot only in the span of about four years. By blogging or by writing it, it was therapeutic to help me cope with a lot of things I was going through. It allowed me to look back and reflect upon the feelings that I had. Then I eventually shared it in a blog, and theirs would be inspirational to me, and just connected with people from all over the world.
My daughter is now over a year old. I’m just working and just being with my family and living with all these scars pretty much that still affect me on a daily basis. But a lot of people around me may have forgotten or don’t think about it, so you kind of put on a front and you just live your daily life. That’s pretty much it. Like I said, it was a long one.
Kristen: Powerful. What a warrior both of you were through this. So many other people would’ve been on their knees with just one of those things that you shared. But the fact that you, within you, found the fortitude and grace to move forward and then share that with the world is just for me – and I’m so spiritually-based so I hope you don’t take offense – but you’re doing such an amazing service to the world. It’s so powerful.
Shooting Blanks, Especially DNA, Shooting Blanks, & Coping… Jonathan Boldt & Steve Ruiz
Sara: Hi! I am so excited to be here today and to continue this discussion. This day is just the absolute heartstring day. We’ve been talking with men about their stories and their journeys. I have been so honored by how people have just really opened up and shared their experiences.
This topic for this session is one that’s super close to my heart. It has a lot of resonance with using humor as a coping mechanism and as a way to get through. Don’t Cook Your Balls website, very light-hearted. Shooting Blanks, very light-hearted. But underneath that is a lot of depth and a lot of being real. That’s why I love these guys so much. They have a lot of courage to put themselves out there to share their journeys and to do it with an honest laugh.
Welcome, guys. Maybe you can start off by sharing a little bit about each other and how you met and how this all started.
Jonathan: Steve is currently a physician’s assistant at the doctor’s office where my wife has grown up. It has been her family doctor ever since she was born. Once we got married, I started going there. We’ve kind of known each other a little bit through our interactions there. But what got us going on writing and work was that we, one day, I think my wife had the flu or a cold or something.
Jonathan: As you’ll be able to tell, Steve likes to talk and tell stories. After five minutes of, “This is what we’re going to do for you being sick,” we talked about infertility and how we’ve been trying to have kids and he had similar experiences. We just spent half an hour talking about that.
Steve: Then he approached me and said, “How did you feel about teaming up on a book?” I said, “Sure. Why not?” and here we are.
Jonathan: Pretty much the idea for the book just came about because everything out there, the reading material for guys is “Here’s a how-to,” “Here’s the medical reasons why,” and all that. We just have so many similar experiences of some of the embarrassing testing that you go through.
Steve: The emotional heartache, the stuff that your wife has to face. Infertility, as far as I’m concerned, it affects women differently than it affects men. Men tend to deal in one way typically, and women deal with it another way typically. We just talked about how this big monster called “infertility” has your wife by her throat and how you have to get through that with each other in as best way as you can.
Jonathan: For both of us, humor is a big part of it. We decided that rather than write a depressing, emotional book, it was more of the light-hearted. I’m trying to relate to those not identical but similar circumstances and situations that we all go through as part of the infertility journey, those treatment programs.
Kristen: Isn’t that amazing how you found each other? If you have that spiritual side, people that you need are brought to you. Here you are, bringing your wife sick and then you have this amazing connection, and you turned it into service. The male voice of fertility needs to be heard and you put that out there, so congratulations.
What Lengths Would You Go to Achieve Your Heart’s Desire?… Rob & Ben Clyde
Kristen: I found you! It was awesome. What I loved about the little snippet that I was able to see? Don’t think I was stalking you. I wasn’t. It just came in and I was like, “This is awesome!” because I think you just got it. For me, it was the desperation that brought me right back to being that woman.
I own my own business. I own my own house. I was the president of the Chamber. I was making it happen. Just get out of my way, Type A kind of woman, and then boom! I just couldn’t create a baby. Don’t think that doesn’t cross every woman’s mind what your movie is about. Let’s back up and let me introduce you the right way because I’m obviously excited.
Our topic is “What Lengths Would You Go to Achieve Your Heart’s Desire?” The Clyde Brothers are writers and directors based out of Los Angeles. You’re brothers, of course. Both are writers and directors and recently finished filming their Short Film called If I Could Tell You about a couple at the end of their rope after years of trying to conceive.
I’m just going to let you explain to Sara and me why you chose this project.
Rob: There are a lot of reasons. One, we felt that the subject matter is just very compelling for the reasons you said earlier, Kristen. I’m Rob, by the way, and this is Ben.
Rob: I’m the older brother and he’s a few years younger than me. My wife and I have an eight-year-old son named Cason . We didn’t have any problem getting pregnant. When we decided we wanted to, we did. We had been waiting a couple of years. We were older because we put our career in front of having kids.
Rob: We were artists. My wife is an actress, and she is actually the person who stars in our movie. But when we went to have our second child, all of a sudden there was a problem. The doctor said that basically her egg count was low and that we were going to need help having the second baby if wanted to.
We turned to traditional fertility treatments. We had a limited amount of cash available because we’re struggling artists, at all times month-to-month. We did. We had just enough money to do one good round of IVF and we did. You’ll find out about some of this. Our movie is definitely not an autobiography. It’s not a true story, but it’s inspired by Avery and I going through the desperation of trying to get a kid.
Ben: Like you were saying, Kristen, it’s like the control part. That was very prevalent for Rob’s wife. She’s a very strong, independent woman as an actress. This was for her something that was like, as she was sharing with us what she was going through, we were just like, “Man, this is right.” This is a movie and nobody has really done something – there are different films and different things about the fertility but we saw a unique one and we wanted to tell it, and so we did.
We got to writing and in the midst of that, we discovered the second layer that the film is all about, which is underground fertility treatments. In our research, we thought it was kind of cute and funny, just this whole Craigslist sperm donors kind of a thing out there. We originally just had it as a scene in the film where she was online searching going, “Wow. This is crazy that this stuff is out there.” Then suddenly it became what the whole short film became about.
Rob: Kevin Richardson who stars in the movie – he plays our sperm donor, actually – is a good friend of mine. He’s one of the Backstreet Boys for anybody who doesn’t know who Kevin Richardson is. It’s not a household name. He and his wife are good friends.
Kristen: I have to hold up my poster. You’re already making me sound like a groupie, so I’m not going to do that.
Restoring Intimacy & Healing… Tamara Green, LCSW
Kristen: Tamara, I’m so excited. Before we get into our big conversation, I just want to read your bio and let everybody know who you are and what you do, and then we’ll pick it up from there.
Today’s theme is “The Stress of Sex.” Tamara and I are talking about restoring intimacy and healing. Tamara is a veteran Loving Relationship Expert. She’s a Psychotherapist, a Meditation Facilitator and Certified Hypnotherapist. She specializes in coaching singles to find their soulmates and couples to heal their relationships through deep spiritual guidance. Elle magazine (I love seeing you at Elle magazine) dubs her the “Soul-centered Psychotherapist and Loving Relationship Expert.” She is an exciting catalyst for profound healing who has devoted her life to helping people rise out of pain and fear and into overflowing abundance and meaning.
Oh, that is so perfect! I’m so honored, and of course I don’t think everybody knows, but Tamara and I are great, great buddies. She has in an in-person office in Manhattan. You can find her at her website.
Tamara, I would love to hear some of your wisdom. All week long, we’ve been talking about sperm, testes, mobility, the mechanical parts, and of course sprinkling in the emotional component of when family creation diagnosis is male factor. I would love to hear from you some tips that you share when a husband and wife show up in your Manhattan office. What can you offer, especially for men who are grieving?
Tamara: Stress is really hard on a relationship. One of the first things that I do is really get to what each person in the couple – the man and the woman – is telling themselves about the situation that they’re in. Once I hear what’s actually going on, then we can take it from there and start to break it down in terms of how it may be adding to their stress and getting in their way to what they really want. Let’s face it: the end goal is for this beautiful couple to come and get pregnant.
Kristen: Part of our conversation was with Eric Schwartzman and he has a DI Dads, a Yahoo group about men who create their families through donor sperm. But what was so amazing, the theme about this whole week was really about creating healthy families. We’re talking all sorts of couples – maybe two women or maybe two men or maybe a man and a woman – but how do couples stay balanced and healthy when they’re under stress?
Tamara: So many times when couples come into my office, they’re telling me how hard and difficult everything is. I hear that so much of the time. When you’re telling yourself something is really hard, guess what? It’s really hard. And if you’re telling yourself that this fertility thing that you’re going through is really stressful and difficult, it’s going to continue to be stressful and difficult.
One of the first bits of advice that I would want to give everybody is stop telling yourself that something is so hard. When you’re working really hard for something, you’re literally pushing it away from you.
You have to start changing the mindset so (you don’t have to believe this, by the way) your brain believes what you tell it. So if you’re saying, “This whole fertility thing just keeps getting easier and easier,” something about it just keeps getting easier. Again, you don’t have to believe what you’re telling yourself. But keep telling yourself, and guess what? It gets easier. “This isn’t hard. This is easy. We’re in a flow here. We’re creating.” You start to change your inner dialogue and with each other.
Kristen: That has a chemical trigger within your system. In my book Love & Infertility, I have a whole chapter about faking it until you make it. There was a part of me way back when that you’re a little at odds with yourself, because you’re like, “I’m basically lying to myself right now.” You feel like you’re not being truthful or maybe in your integrity with yourself, but what you’re actually doing is uplifting that energy.
Tamara: I don’t know if it’s okay if I can get a little woo-woo here. Ever since I was a kid, I could see energy when somebody was acting a certain way, what their behavior was, or what their words were. I could see the energy whether it was contracting and not making them feel so good or expanding and it feels light, peaceful, and serene.
What you want to do even though your brain, your ego, may not believe what you’re saying, you want to say things that are in alignment with a very nice expansive, open, heart-opening thing. The more you say it, the more your body is just relaxing because your body and your heart actually know what the actual truth is, and the truth is anything is possible, even having a baby.
Kristen: Part of the conversation all week was about open or close and the brave men who have come forward and walked through the stigma and the shame of being the partner within the relationship that is having a proven medical condition, and how men stay open. I have to tell you, Tamara, this whole week I am overwhelmed with the bravery.
We talked to Remagineit earlier this week and this young man had cancer, overcame cancer, had lost twins, one thing after another, and he finally has a baby girl who has Down Syndrome. What he kept saying was, “I had to keep focusing on my wife and making sure she was okay.” What was so amazing with the other gentlemen – and it goes to what you were talking about, quieting that mental chatter – was when these men who were sharing their stories said their instinct was to close down and not talk.
Tamara: It may not be their instinct but their pattern maybe
Men Are from Mars, Women Are from Venus… Dr. John Gray
Kristen: Hi, everyone. I am so excited for today of the Making Dads Summit. I am beside myself to have Dr. John Gray here with us and, of course, Sara my co-host.
Welcome, Dr. John Gray and Sara. I am so thrilled just to have this time with you, so thank you.
Sara: Awesome. Today, we’re really focusing on relationships, and who better to have with us than Dr. John Gray who is best known for his amazing seminal work, Men Are From Mars, Women Are From Venus”
Dr. Gray has his training in psychology and is really a pioneer in gender communication. He has gone on to produce other works talking about men and women in the workplace, Work With Me: The 8 Blind Spots Between Men and Women in Business, which I think is critical with all the recent works about women and men in leadership. I think it’s critical to have those discussions.
More recently, he has been getting into underlying health and nutritional factors that contribute to relationship dialogue and diving into how nutrition impacts hormones and how hormones impact psychology and relationships. His new book is Staying Focused in a Hyper World: Natural Solutions for ADHD, Memory and Brain Performance.
You’re really spreading out and getting super holistic about how the whole body integrates with these communication topics. I’m bubbling with questions to understand. Maybe you could just give us a snapshot of what you’ve been doing recently.
Dr. Gray: I’m really excited to be talking at this summit because the same issues that are plaguing our children today – called ADHD, hypersensitive, hyper-distracted, hyperactive, or hyper-compulsive – is becoming a big issue for adults.
I went into the issue because 15 years ago I was experiencing early-stage Parkinson’s and found a natural solution for it. But when I started providing the right supplementation to reverse my Parkinson’s, which I’ve now done for many people as well, it also reversed something I didn’t even know I had, which is symptoms of ADHD.
I found that there were immediate improvements in my ability to communicate with my wife. She noticed it. She said, “You’re not rushing me. You seem to be more relaxed and more present. You’re naturally more interested.” It was amazing. It affected my sex life. It improved the passion in it.
It all had to do with improving dopamine function in the brain. Dopamine is the brain chemical of pleasure, focus, motivation, and interest. Here’s what’s interesting when it comes to fertility, so I’m really excited to do this show.
Much of the research on fertility shows there’s a hormone called prolactin that’s very high when there’s infertility. When there’s high prolactin – and that’s usually after sex with somebody you love – prolactin goes really high so that you don’t want to have sex right away with somebody else.
This is a natural mechanism that happens with married men. Married men, because you’re having sex with people you love, you’ll tend to have higher prolactin levels and lower testosterone levels. That is a challenge for people who want to be fertile if they go too low testosterone/too high prolactin.
The research shows that what lowers prolactin and raises the testosterone back to normal so you can now create a healthy sperm count is dopamine. Dopamine is this big factor. We’re all being affected by it. Women sometimes are being affected by inhibited dopamine function. They become overwhelmed with too much to do. That’s how it affects women.
The way it affects men is different. It tends to lower their testosterone so that men lose their interest in their family and their relationship. They love their partner, they love their relationship, but the passion tends to go down.
For younger men, it shows up as an inability to make a commitment. For older men, it shows up as dementia. For children, it shows up as ADHD. It’s this phenomenon that’s happening. You can say a big part of it has to do with one challenge that is dopamine. That is then affected by this whole hormonal imbalance that we’re experiencing today, the toxicity causing excess estrogen which lowers testosterone in men and lowers progesterone in women.
Once again, this all influences fertility tremendously.
Kristen: We’re talking about a person being mind, body, and soul and, of course, what you eat. Is there a great correlation between what we’re eating as a society and this chemical mix-up of what’s happening?
Dr. Gray: It’s so connected, it’s unbelievable. I spent 40 years in my life as a marriage counselor. I still marriage counsel as well as supporting people with health. Often when we say somebody has a health problem, we’re thinking they have cancer, heart disease, diabetes, or a flu or a cold.
There’s a much wider range of challenges to our health which I would say is libido, which is sperm count, which is testosterone levels, feeling passion in your relationship, staying focused and interested in your work, having energy, and sleeping better. These are all the aspects of health. If we don’t have that together, then what we have is the opposite which is stress. We also know that high stress levels are going to influence our sperm count as well.
What I’ve found is the bottom line is we have toxicity. Ironically, when it comes to sperm count, you go to Italy and it’s one of the lowest in the world. I go to Italy and I wonder, “What could it be?”
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Or learn more about the hosts of Marking Dads Summit:
Kristen Darcy: www.kristendarcy