Becoming a Dad is a series of autobiographical posts about my journey into fatherhood. By definition, it’s a journey that doesn’t end. I’ll try to tell the story in a somewhat chronological order, with some minor details changed for privacy. In general though, I hope it provides some insight into manhood and fatherhood today as gender roles change and men search for a more meaningful, positive, and fulfilling role at home, at work, and with the people we love.
My journey into fatherhood didn’t start on March 3, 2018 at 9:46 AM when Elin was born. It started almost two years earlier, when Erin and I were first debating when - and how - to start our family. The portion of our journey before Elin’s birth helped us establish foundational knowledge and habits on how we would show up as parents.
The journey started in earnest with a conversation about IVF in a doctor’s office on Bay Street in Toronto in 2016. This conversation would start the ball rolling toward Elin’s arrival, and require both Erin and me to undergo medical procedures that tested, stretched, and grew our relationship as parents.
Here is my part of this journey as the father-to-be, before Erin underwent her procedures and I switched to a support role in her longer and more draining part of the journey.
I remember the space felt more like a living room than a doctor’s office. Two comfortable sitting chairs, stylish enough to be in your parents’ house sitting next to a fireplace, with another chair set up across from them for the doctor. There isn’t the typical fluorescent lighting buzzing overhead. Instead, a floor lamp cascades light off the ceiling and walls, painting a back lit glow to the room that softens the expressions on people’s faces.
Between the two chairs where Erin and I sat, there is a small table with magazines and a fresh box of Kleenex. The warmth of the room is manufactured to ease the weight of the conversation. It’s not disingenuous; it’s well-engineered for a carousel of young couples all facing a similar harsh truth.
Dr. Richard speaks with a purposeful pace. She asks herself rhetorical questions, “What if you want to have the baby at a specific date?” and then responds confidently to her own inquiry, “Well, we work back from that date and determine the best time to start the process.” She’s expressive in an empathetic way, her face stretching and deepening as she takes on the emotions she knows Erin and I must be feeling based on countless consultations just like this one with other couples.
She makes us feel good. There is an intensity to her, matched with an ability to listen and respond, that puts you at ease. And that’s when it starts to seep in. This isn’t an easy or natural process. It’s long, scientific, probabilistic, draining, and uncertain. Erin reaches for the Kleenex. Dr. Richard falls silent and we all three sit in the back lit glow. The process has started.
For reasons I won’t go into here, Erin and I knew that In Vitro Fertilization was going to be our only way to conceive a child. Our bodies (mostly mine) weren’t pre-programmed in a way that would allow our DNA to mix on its own. But with a little help from modern science, Dr. Richard had every confidence that we could have a healthy baby that was genetically our own.
In a way, this certainty that IVF was the only option made the process considerably more linear. Most couples need to endure over a year of trying, with different options like timing the cycles, artificial insemination or other procedures I don’t even know about before they can consider the “full service” IVF procedure (as I’m calling it). We were able to jump right to the end conclusion: retrieve my sperm, stimulate and retrieve her eggs, combine the two together, wait five days, see how many embryos grow, then prep her uterus for implantation, and finally implant and see what happens.
What seems like a relatively simple process is anything but, though. It’s weeks and months of visits, injections, blood tests, waiting-and-seeing, victories, and losses. And as with many biological inequalities, Erin was going to bear the brunt of these treatments (which I’ll go into detail on in a later post). For me, it was much more straight forward.
Dr. Knightley handed me the piece of paper and then said nothing. I looked down and there was a big ‘0’ written in blue ink. I looked back to the doctor. He started slowly, “Now, as expected, there weren’t any sperm detected. But that doesn’t mean you don’t have sperm.” I nodded in agreement. This wasn’t a surprise to me. I had found out much earlier in life that I was essentially born with a vasectomy built-in. My vas deferens doesn’t do its job of allowing sperm to pass through. I didn’t need a doctor’s note to tell me that.
Yet, a few days before that appointment with Dr. Knightley where I confirmed what I already knew, I walked into a hospital in Toronto prepared to take the test that would confirm I couldn’t procreate naturally. I’m not sure what I envisioned as the process for this test, but what I experienced certainly wasn’t it.
It was a crowded waiting room in a urology department in an older wing of the hospital. After checking in and sitting down, I was called back up to the desk. The nurse handed me a specimen container and a paper bag. “There’s a washroom on the third floor. You can go there, deposit your specimen, then come back down and give it to someone behind the desk here.”
“What?” I thought. “This is how you take sperm specimens from patients? They are just randomly jerking off in washrooms all around the hospital?” I thought about what I’d seen in movies where characters go to sperm banks and get a clean room and “materials” to help in the act. Shouldn’t I at least get some kind of doctor’s room to do this?
Alas, I took my container and paper bag and headed up a few floors. The washroom was a single stall room right off the main hallway. “Lots of privacy here” I thought as I closed the door behind me. After getting over the awkwardness of the situation and finally “getting down to business”, I hear a knock on the washroom door. “Occupied” I squeak. A split second later, another knock and a door handle jiggle. “OC-CU-PIED!” I yell back as I bang my free hand on the door along with each syllable.
All out of sorts, I pause and sit. Is this my life now? Confirming what I already know, in a run down washroom on a random floor of a hospital, fending off random people as I will myself to “deposit the specimen”? I don’t even have the right specimen.
A little while later, after mission accomplished, I head back to the waiting room and hand over my paper bag, unwilling to make eye contact with the people behind the desk. We exchange the details on when I’ll hear the results and I turn to leave, wondering how many other people in this room have visited that same washroom on the third floor, wondering if they also will be the reason their wives have to get IVF, wondering if their wives will be able to endure the weeks and months of injections, early mornings, uncomfortable cramping, and dangers of egg retrieval and ovary over-stimulation. All these questions culminating in one pathetic act in a single stall washroom off the main hallway on the third floor. It seemed an incongruous experience for the weight of its importance, and consequences of its results.
With test results in hand from Dr. Knightley, Erin and I returned to Dr. Richard ready to take the next step. In the meantime, Dr. Richard’s office had moved from its living room-like setting on Bay Street to a sparkling, bright, and modern penthouse on Bloor Street that bustled with mostly female nurses and doctors efficiently serving a constant flow of moms-to-be in front of floor-to-ceiling windows that overlooked the Toronto skyline.
But before Erin would be herself one of these hopeful moms-to-be, Dr. Richard first required my sperm to solidify that I would be the male component of this two-sided embryo. With an end implantation date set for early to mid 2017, I booked my appointment with Dr. Jerry in January 2017 to retrieve my sperm.
The procedure is called a Percutaneous Epididymal Sperm Aspiration, or PESA for short. It’s relatively simple, and would be the only procedure I would be required to undergo throughout the whole IVF process. After a consultation with Dr. Jerry where he felt his way around to test my suitability for the procedure, we were set for the retrieval.
I arrived at the hospital one morning with Erin by my side. I was told it might be best to have someone else drive me home, as the area can be tender afterward. In no time, I was lying on my back in a hospital gown pulled up to my chin, and Dr. Jerry was preparing to go in. The procedure involves two steps: first, freeze the testicles, and second, insert a needle into the epididymis, which is the duct that attaches to the teste and lets sperm pass into the vas deferens. From the epididymis, sperm can be extracted through the needle and used in IVF.
Dr. Jerry and his assistant began with the freezing; a few small needle pokes to inject the freezing compound. Yes, this was uncomfortable, but not as bad as I expected. The needle pokes are more around your testicles than actually in to them. After waiting a few minutes for the freezing, Dr. Jerry was ready for retrieval.
A larger needle comes out, and Dr. Jerry is holding the epididymis steady while he extracts. This is the uncomfortable part. If you’ve ever been kicked in the balls, you know sometimes you feel a numbing pain in your gut as well. This experience was like only feeling the pain in your gut, but not the kick itself, since that part is frozen. So the pain wasn’t acute, it was slow and dull, and makes you want to puke.
After each extraction, Dr. Jerry walks over to a microscope and deposits a tiny amount on a slide to check for sperm. “Hmm, I don’t see any here yet…but I’m certain they must be somewhere.” My heart dropped a little, as I lie on my back and turn my head to see Dr. Jerry crouched over the microscope. There must be sperm. Every doctor I’ve spoken with has been certain there is sperm here.
Attempt number two. “I still don’t see any. Maybe we need to try something different.” I get a little more anxious. Honestly, in my whole life, from the day I realized that my vas deferens had given me a pre-emptive vasectomy and natural conception wasn’t going to be an option, it never occurred to me that I might not be able to have children that were genetically my own. I had just assumed this PESA procedure would be a success. But now, lying on the hard, cold hospital table with my business all open for the world to see, I had doubts for the first time. Is this how I find out? Pants off and gown up, numb from the waist down?
Dr. Jerry goes with plan B. He gets what I can only describe as a staple gun. It makes a “ka-CHUNK” sound when he tests it and he brings it toward my boys. Its function is to skip the epididymis altogether and go straight to the source: the testes. The “ka-CHUNK” sound is a tiny blade that goes through the skin and takes a small chunk of the teste back with it in the hopes that some sperm are present. Dr. Jerry lines up the gun and fires, “ka-CHUNK”. His assistant quickly covers the tiny hole with gauze until the slight bleeding stops.
Dr. Jerry returns to the microscope. I don’t look over this time, I just look straight up to the ceiling. I can hear his voice, “Okay, let’s see what we have here. Oh, I think…yes, that looks like it. All right, fantastic, we have some live sperm that look great!” I laid motionless, eyes tearing up just a little bit as the weight left my body, “Awesome. Thank you so much.”
Within a minute, bleeding subsided, I was walking to the door to get changed. Dr. Jerry handed me a little bottle, like an old film canister. “Take this to Dr. Richard today, and keep it cool.” Inside this non-descript bottle was half the genetic blueprint of my future children, ready to be paired with Erin’s codes. In somewhat anti-climatic fashion, Erin and I walked to the car after I was changed, placed the bottle in the cup holder, and drove to Dr. Richard’s office to hand it over. My part was done.
As a man, you don’t really think as much about having kids when you’re growing up. It’s just not something that’s on our radar, or that we view as so impactful to our lives that we should think about and plan for it even in our childhood. As I got older though, and met the love of my life in Erin, I wanted kids more and more. Unfortunately for me, that process wasn’t going to be that easy.
You don’t envision having kids as something that begins with a single stall washroom in a public hospital and ends with a bandaged scrotum and a piece of your testicle in a film canister. However awkward this experience was though, it pales in comparison to the day in, day out grind that Erin went through. IVF isn’t easy on anyone, but being there together - Erin and I - from day one in Dr. Richard’s office to the end when Elin popped out to finally say hello, created the bedrock upon which our relationship as parents and partners would be built.