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Fertility + Anxiety

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  • Fertility + Anxiety


    My husband was diagnosed with TC in October. He had an orchiectomy and his pathology results came back as 100% seminoma. We know this is a good diagnosis. The advised protocol from our doctor at UPenn was surveillance (I emailed Dr. Einhorn for confirmation as well). Before surgery, he did do a semen analysis and bank the sperm, but we only got 2 vials. He was then told he had ogliospermia and only had 1.9 million total motile sperm.

    I vacillate between concerns about having babies (we have none yet) and anxiety about surveilance - which leads me to guilt that I am concerned with anything other than his continued health. I can't help but worry and wonder about if his sperm count will improve or if we'll have to move on to IVF/IUI. As of now, we would not (most likely) conceive naturally.

    Could you speak to IVF/IUI/natural conception after surgery? Is it likely that his sperm count was always low or could it have been caused by the cancer? How do I deal with my anxiety around surveillance? I can't believe I'll have to be this bundle of nerves about CT scans every three months for the foreseeable future.

    I've found great comfort in reading the words of people who understand. Everyone in my life is so optimistic, which I appreciate, but I wish I had someone who had "been there". I guess that's why I'm writing here.


  • #2
    He might have always had lower counts. Unless of course the one they took was the really good one which is possible. As far as surveillance, as annoying as it would be his fertility would be much worse off if he has to do chemo or radiation. I know that doesn't alleviate the anxiety of the what if it isn't gone, but fertility at least shouldn't change, and if anything might get better with time. Remember the body is recovering from a trauma. In this case a drastic drop in testosterone which can affect a lot of things. As time goes on the remaining one is supposed to compensate but it won't be instant. Like everything it takes time to heal.

    For now though instead of being stressed and anxious over the constant tests try look at it in a more positive way, that way your stress and anxiety doesn't transpose onto him adding to his stress and anxiety. I know it may seem like how can you make some thing like this positive, is actually easier than you think. Instead of looking at the surveillance and stressing over that instead say at least we caught it early enough that surveillance is an option. Or at least it's a pure seminoma and not a non seminoma. Trust me that's a huge positive thing seminomas are slow growing.

    Natural conception may still be possible, but always looking at it from a negative view which increases stress and anxiety reduces that possibility. Remember right now he's going through a life altering situation. On the one hand he is thinking about life, he's most likely confused about how it happened, on top of being worried about is it really give note will come back ect. On the other hand he has you. He's worry about what if it's not gone, what will happen to you, ect add to that the fact that you are adding the fertility issues and your own stresses. On a scale of 1 to 10 his stress level is probably a 20 with all that which will affect performance as well as fertility. Even if he don't show it chances are he still thinking about it.

    Hence why thinking more positively could help the situation.


    • #3
      He may very well have naturally low sperm counts. This is very common in those with TC. I was shocked to have oligospermia as well. However, I do think much of it was due to a fast growing tumor in my remaining testicle. Although I probably have low normal counts in the best circumstances. However, his sperm count can improve. Sperm count is very sensitive to stress, BMI, nutrition, and exercise. You can look into Fertilaid which has many components that have been proven to improve sperm count. I think it's possible that you can conceive naturally. If not, IVF (most likely with ICSI) will be successful. One thing you are lucky about is that your husband HAS a sperm count. I know several men to find out they have none!
      Diagnosed at age 31. Treated in NYC. Now living in Ottawa, ON, Canada.

      7/1/2015: felt tiny lump on side of R testicle
      7/30/2015: Ultrasound shows 2 intra-testicular masses.
      7/31/2015: tumor markers normal, CXR clear
      8/5/2015: R orchiectomy
      8/11/2015: Pathology: 1.2 x 1.0 x 1.0 cm, embryonal 80%, seminoma 20%, with LVI and rete testis invasion
      8/14/2015: CT abdomen/pelvis clear, Stage 1b
      8/24/2015: started 1 x BEP


      • #4
        As a uniballer from birth having TC was a major issue for fertility for me! Immediately after my diagnosis I banked and my count was majorly in the dumps, around 30-50,000/ml. I banked 14 vials in 2 visits. Count is plenty good for IVF w/ICSI, but not nearly enough for any other form. After the orchie and chemo were all complete we began IVF with the stored semen. First IVF attempt we transferred 2, had a single pregnancy, and miscarried at 7 weeks. Second IVF attempt we transferred one, had a single pregnancy, and have a healthy boy inside at 21wks, due March 30th, 2017! We have 3 more embryo's stored so if and when we decide to have another we shouldn't need to do another retrieval, just a transfer. Long story short, IVF is an emotional and expensive process, but it certainly makes the impossible possible and with quite decent probabilities if you are relatively young and willing to try 2-3 times.
        6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
        6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
        7/7/15: bHCG 56, AFP 42, LDH 322
        7/13/15 - 9/18/15: 4xEP
        10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
        10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
        4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
        4/20/16: RPLND @ IU - teratoma only!
        3/29/2018 all clears up to this date!