This is a story that many people would keep private. But private is part of the problem. TMI is exactly what we need these days. Don't worry- Jason agrees.
On July 1st we found out that my husband Jason has severely low sperm counts (400K which is 1% of normal); the ones he's got don't swim and most of them are badly formed. Twenty years ago we'd have to decide between donor sperm or adoption as our only means of having children. Jason's hormone levels show high follicle stimulating hormone (FSH) and normal testosterone and prolactin levels. These tests allowed us to narrow down probable causes. He had no evidence of variceles (varicose veins), no history of mumps, and no physical injury. We wondered if his low sperm count could possibly be from ingesting party chemicals in his twenties or smoking too much pot. Quite simply, no. The urologist confirmed that his testicles didn't form properly-- that one of them is less than half the size of normal. Testicular size matters because it indicates how many seminiferous tubules there are (where sperm get made).They have always been that way, but it turns out that when men should worry about their ball size, they don't.
On July 1st we found out that my husband Jason has severely low sperm counts (400K which is 1% of normal); the ones he's got don't swim and most of them are badly formed. Twenty years ago we'd have to decide between donor sperm or adoption as our only means of having children. Jason's hormone levels show high follicle stimulating hormone (FSH) and normal testosterone and prolactin levels. These tests allowed us to narrow down probable causes. He had no evidence of variceles (varicose veins), no history of mumps, and no physical injury. We wondered if his low sperm count could possibly be from ingesting party chemicals in his twenties or smoking too much pot. Quite simply, no. The urologist confirmed that his testicles didn't form properly-- that one of them is less than half the size of normal. Testicular size matters because it indicates how many seminiferous tubules there are (where sperm get made).They have always been that way, but it turns out that when men should worry about their ball size, they don't.
So why are Jason's balls abnormal? A quick analysis of the available literature and my deductive reasoning skills produced a list of the known causes of testicular dysgenesis: mumps, infection (like an STD), severe injury, pesticides... Pesticides. The word emerged as the last possible option. If my husband had been born in the Rocky Mountains or in New York City, I'd shake my head. But he wasn't. Born in 1975, Jason spent his most susceptible windows of opportunity to be damaged by chemicals in Castroville, CA surrounded by artichoke fields. A host of toxins were used on those tasty flowers in the late 1970s ("they might've choked Artie but they won't choke me") including endocrine disruptors like endosulfan. Research is showing that these pesticides damage male reproductive organs and processes, often leading to infertility. Although many of the worst pesticides have been (or are in the process of being) banned, you can bet there are places on earth where they are being used. Endosulfan caused infertility among men who just happened to be working in cashew plantations in Indonesia but it's still being used there and in India. And here in the good ol' USA we have to wait until 2012 for all use to cease. And of course there are thousands of other pesticides and chemicals like it that are still being used today.
Farm workers all over the globe have been dealing with infertility problems for some time, but we live in a world that doesn't account for the quality of life and health of the poor. This is probably a particularly invisible problem because most men don't like to talk honestly about the size of their balls. I think about the women in India who are ostracized for being perceived as infertile when maybe it's their husband's fault all along. I've wondered if the issue needs a public face- I'm sure Jason's status as an attractive, masculine white man could help. It seems to me we should question the way we treat medical problems as individual, personal tragedies.
The wonders of modern technology means that Jason and I can have a baby by way of intracytoplasmic sperm injection (ICSI) with in vitro fertilization (IVF). This is a pricey procedure with the kind of odds that warrant patience and money: about 1 in 3 attempts results in a live birth. It helps if the woman’s eggs are reasonably young—they prefer if you’re under 37--but many women over 40 get pregnant this way, too. People using IVF often wind up parents of twins—this is because implanting multiple embryos improves your chances of having at least one baby; one woman I know had twins after they implanted four embryos in her uterus. I will have to take medication to stimulate my ovaries to produce more than one egg, and I will have to give myself shots as part of this process. They'll use a needle to harvest my eggs. Lots of women go through this process; I'll be okay. But it's not okay that we've ended up here because of the shortsighted actions of a few.
Farm workers all over the globe have been dealing with infertility problems for some time, but we live in a world that doesn't account for the quality of life and health of the poor. This is probably a particularly invisible problem because most men don't like to talk honestly about the size of their balls. I think about the women in India who are ostracized for being perceived as infertile when maybe it's their husband's fault all along. I've wondered if the issue needs a public face- I'm sure Jason's status as an attractive, masculine white man could help. It seems to me we should question the way we treat medical problems as individual, personal tragedies.
The wonders of modern technology means that Jason and I can have a baby by way of intracytoplasmic sperm injection (ICSI) with in vitro fertilization (IVF). This is a pricey procedure with the kind of odds that warrant patience and money: about 1 in 3 attempts results in a live birth. It helps if the woman’s eggs are reasonably young—they prefer if you’re under 37--but many women over 40 get pregnant this way, too. People using IVF often wind up parents of twins—this is because implanting multiple embryos improves your chances of having at least one baby; one woman I know had twins after they implanted four embryos in her uterus. I will have to take medication to stimulate my ovaries to produce more than one egg, and I will have to give myself shots as part of this process. They'll use a needle to harvest my eggs. Lots of women go through this process; I'll be okay. But it's not okay that we've ended up here because of the shortsighted actions of a few.
We're intending a happy ending to all of this, but it's still an awful situation: The latest research in epigenetics suggests that if we have boys, they could be infertile, too. If it does work and we have twins, I might not get to have a natural childbirth. If we don't get twins, I don't know if we'll be able to afford to create siblings. If it doesn't work the first time, I don't know where we'll find more money soon. IVF isn’t covered by most insurance. I'm supposed to feel lucky because I have 50% coverage of 1 attempt through my employer, but since I've been cut as of August 8th, I'll have to COBRA the benefits for a few months. All this, and the chemical companies that made the toxin (and profited from it) don’t have to pay a thing. Oh, and the research also suggests Jason has a higher risk for testicular cancer later in life.
About that heart shaped uterus: Last Wednesday the infertility specialist performed a vaginal ultrasound to count my follicles just for the fun of it, but then wound up worried and sent me for an MRI to check out my uterus. As it turns out I have a Mullerian tract defect called an arcuate uterus--it is the least likely of all uterine anomalies to cause problems during pregnancy. But the week between appointments gave me enough google time to walk down a "you must be joking” path as I learned that the nasty, endocrine disrupting drug DES--taken by my grandma and lots of other women in the 40s and and 50--caused uterine anomalies in DES daughters and may even cause third-generation effects. I'll never know why my uterus is heart shaped, but I'll always wonder. And I'll think of the women who couldn't have babies as a result of our man-made experiments.
The doctor says I don't have to worry about the "variation on normal" that is my uterus: we are good to go. So all of a sudden we are saying yes to IVF and soon. We want twins on the first try. Jason named our kids years ago: Jack Owen and Josephine (up for grabs). Twins that share a first letter (and with their dad, to boot) always seemed tacky to me, but Josephine is a family name for me, and Jack is a good, strong name (did I get that from a movie?). With fingers crossed that everything will work as planned, we'll be overjoyed to introduce them to you in a year. But what world will we leave them?
My hope is that our kids and yours will benefit from better science and greater awareness because so far we've mostly been screwed by how and what we consume and the powerful actions of the very wealthy few. We can turn it around. Living privately may seem like the safe thing to do, but we are safer when live and act in community; we are safer when we notice that what seems isolated and rare at the individual level has patterns and causes at the community level, and safer when we act together to make a difference.
There is a lot we can do about this, and I am still figuring it all out. Please send suggestions for actions, but please consider that we have choices about the pesticides and chemicals we choose to put in and on our bodies. Please buy organic as much as you possibly can, and please care about buying organic and explain to others why you care. Please share our story. If you'd like to know more about the impact of environmental toxins on reproductive health, this is a very good summary:
In the coming weeks I'll be doing a lot more research and will post information and knowledge as I uncover it. Also you can learn a lot by googling. Thank you if you're already on top of this.
