Our In Vitro Fertilization Journey to Parenthood


Our In Vitro Fertilization Journey to Parenthood

See Also:

The Great Sperm Hunt

Double Trouble: The Embryo Transfer Gamble


It didn’t feel real until I heard the first cry echo out from the other side of the blue curtain in the operating room. After a nearly two and a half year journey, my wife, Claire, and I were finally parents to a healthy little girl, and I was mere seconds away from the moment all my dad-friends had been hyping up for months, when I would first lay eyes on my child and the whole world would change.

The anticipation was almost too much to bear. A million questions flooded my mind. Would she have my eyes? Her mother’s perfect nose? Time stood still until the obstetrician hoisted all 12 pounds, 4 ounces of her above the curtain with a grunt and a chuckle, and the chorus in my head fell abruptly silent. My initial reaction was brief panic and my first thought was, “that can’t be my kid.”

Maybe I had seen too many switched-at-birth sagas on late-night TV, but given the circuitous path it had taken to get to that point, I couldn’t put it out of the realm of possibility that there may have been some sort of mistake along the way. We knew when we first started exploring in vitro fertilization that it is emotional for any family, but the logistical wild goose chase that my spinal cord injury added to the process made it feel like anything could happen.

It All Started with a Plan

When I first woke up in the ICU at Harborview Medical Center 17 years ago and doctors told me that my snow skiing accident was going to leave me paralyzed, a C3-4 quad, for the rest of my life, I only had one question: Can I still have children? Their hesitant response in the affirmative gave me all the hope I needed. I didn’t put much thought into the actual process until a decade later, when the blue-eyed occupational therapy student I was flirting with said her greatest ambition in life was to be a mother.

My relationship with Claire was built on our mutual desire to be parents, but despite our best efforts in the bedroom over the years, we simply could not coax any of my little swimmers out the old-fashioned way. We knew we were going to have to explore other options, so we booked a consultation with the Men’s Health Center at the University of Washington for the week between our wedding and our honeymoon cruise to Alaska at the end of May 2018.

The fertility doc advised us to forgo any further attempts to stimulate ejaculation with a vibrator like Viberect or Ferticare, due to the high risk of autonomic dysreflexia and the low probability of retrieving usable sperm. Our best options were surgical, and we had two choices. The first, and least invasive, is called testicular sperm aspiration and the more involved is called microsurgical testicular sperm extraction. We decided to start with the less-invasive TESA in August 2018 and lined up Claire’s egg retrieval with UW’s women’s clinic a month later. “We naïvely thought we would be pregnant by September,” recalls Claire.

Husband and wife share a kiss over their welcome baby bump.
Husband and wife share a kiss over their welcome baby bump.

Setbacks and Struggles

When my retrieval surgery only yielded 6,000 sperm with decent motility, we were a bit disappointed as, by comparison, a typical man’s ejaculation results in millions of motile sperm. But we did our best to remain cautiously optimistic behind the theory that we only needed one to make a baby. We had the doctors pop those bad boys in their fancy freezer and put the focus on harvesting Claire’s eggs.

Compared to the egg retrieval process, sperm retrieval looked like a leisurely afternoon stroll. Claire had to become a pharmaceutical expert almost overnight, juggling multiple pricey medications designed to hijack her reproductive system for the fertility specialists to work their magic, each medication with differing timelines, dosages and locations for administration.

Next came a seemingly endless string of appointments for blood draws to monitor her hormone levels and ultrasounds to track the progress of her ovarian response. “I was getting up at 6:30 in the morning to drive to Seattle for my appointments before work, giving myself injections in the car,” she says. After a few calamitous tries at the subcutaneous belly shots of estrogen, she figured it out. Her body responded beautifully in September, producing 33 eggs, 21 of which were mature and ready for fertilization.

Little Ila asleep in her father’s lap.
Little Ila asleep in her father’s lap.

But when none of my sperm survived the thawing process, we were devastated. It had always been a foregone conclusion that I would be a father, and suddenly we were facing the stark reality that it may not happen. The fertility doc agreed to do a microTESE but counseled that the biopsy results meant we needed to prepare ourselves for the very real possibility that using my sperm may not be a viable option.

We reached out to a local physiatrist who is a fellow wheelchair user to get a second opinion, and he said there was anecdotal evidence that certain diets could aid the sperm generation process, called spermatogenesis. He advised me to adjust my medications and stop any supplements, like D-mannose, that may interfere. Instead he counselled me to add selenium, vitamin D3, vitamin E and astragalus root supplements to my daily regimen while snacking on copious amounts of dark chocolate and dark-colored berries in hopes of boosting my production.

Since spermatogenesis takes roughly 75 days from start to finish, we booked the microTESE for mid-January to give the supplements a chance to do their thing. Unfortunately, a December hospitalization for a UTI put me on IV antibiotics, which wreaked havoc on sperm production, forcing us to restart the process and push the procedure out to March. In retrospect, we needed that extra time to wrap our heads around the idea of possibly needing a sperm donor.

Initially, we bristled at the thought of using someone else’s seeds to start our family. I naturally couldn’t escape the idea that it was a referendum on my manhood but did not anticipate that Claire would take it just as hard. “It sort of felt like cheating on you,” Claire says. “I married you because I fell in love with the whole package, and suddenly we were trying to find the next best thing.”

We wrestled with our options for a few weeks, including adoption, but ultimately decided that was a sperm donor of a different kind. As much as I struggled with the idea of not being a biological father, I didn’t want to deprive Claire of the experience of carrying and giving birth to a baby.

Sperm Donor Tinder

I don’t know why we thought we’d have millions of donors to pick from. In reality we were choosing from a pool of a couple thousand, dispersed over a handful of websites that featured profiles of young men with pseudonyms like Dante, Neo, Timber and Rockwell. They were all broken down by height, weight, eye/hair color, genealogy and family health history, as well as a whole slew of additional information to help us make our choice. But first, we had to cross-reference them with Claire’s bloodwork screening to rule out any who might be genetic carriers for potential birth defects.

The big one we were advised to look out for was cytomegalovirus, a member of the herpes family that includes chickenpox, cold sores and mononucleosis. It’s a common virus that mostly lies dormant after an initial infection, but women whose first exposure is during pregnancy have a one in three chance of passing it onto the fetus. The baby then has a 10 to 15% risk of complications like hearing loss, neurological abnormalities or decreased motor skills. As a pair of disability advocates with close friends living with all sorts of diagnoses, it felt weird to be in a position to eliminate those potential life paths.

We found ourselves digging deep into the remaining donors’ essay questions, handwriting samples, voice samples, baby pictures and sometimes even photos of them as adults. The most surreal part of the profiles are the subjective descriptions written by the interviewers. Stuff like, “Donor 13547 is the epitome of a sexy man, with strong masculine features, broad shoulders and a muscular build. He has an attractive, rectangular face with a square chin, full lips, high cheekbones, tidy brows and dark eyes.”

There is nothing like picking out a potential surrogate father to root out even your mildest insecurities as you grapple with which of his traits you want to prioritize. Did we want someone who closely matched my physical attributes and academic achievements, or the intangibles like my sense of humor, emotional fluency or other aspects of my personality?

To help narrow the field, we created a spreadsheet playfully titled “Spinder” where we weighed out pros, cons, differences and similarities, and prioritized the traits we wanted to pass down to the next generation. We ultimately settled on a donor named “Jack,” and it was recommended that we buy two vials of his swimmers in case we would like to have a biological sibling sometime later down the road.

Claire, Ila and proud papa Kenny Salvini
Claire, Ila and proud papa Kenny Salvini.

A Masterclass in Managing Expectations

Fortunately, we didn’t need Jack. In March, the microTESE hit paydirt and retrieved 1.6 million sperm with moderate motility. That was enough to inseminate all of Claire’s 22 mature eggs that were thawed in unison with the procedure and have five extra vials to bank for later if needed. That momentary relief was quickly tempered by a seven-day emotional teeter-totter as we awaited daily progress updates.

After day one, we had eight successfully fertilized eggs, or zygotes. They had six days to reach the full blastocyst stage, which usually happens between days four and seven. Once they reach that stage, a few cells could be taken from their outer wall and sent for genetic screening to verify they were chromosomally “normal,” thus dramatically increasing our chances of achieving a live birth.

The number of “good” embryos were cut in half by day three, and halved again by day five, and none of the remaining two made it to the final blastocyst stage to be tested. Suddenly we were back at square one with even more questions.

Was my sperm or Claire’s eggs to blame for the lack of success? Did we want to try another round of egg retrieval? If so, would we use another vial of my sperm, Jack’s, or a combination of the two? Plus, there was also the financial aspect. Insurance had covered the TESA, but we’d already shelled out a lot on the microTESE, all of the hormones, Claire’s egg retrieval and donor sperm. We had enough money stashed away to cover another round but were unsure how much more her body and both our hearts could take.

The Emotional Toll Builds

Whereas most nondisabled couples have the option to navigate their highly emotional family-planning efforts behind closed doors, the extra logistics that come with our situation made maintaining the privacy of our struggles much more difficult. It’s easy to talk about your successes, but rehashing every unanticipated setback with an ever-widening circle of well-meaning family members, friends and caregivers began to add up. More than a decade and a half of SCI-life had taught me that it’s better to be an open book than to try and hide the nitty-gritty details, but Claire wasn’t as well versed in that PR strategy. Her being all hopped up on hormones didn’t help matters either.

During a brief social media hiatus, she took up journaling and watercolor painting as creative outlets to help sort through the endless barrage of feelings. She also found support from other quad wives and girlfriends who had been through IVF, and she connected me with quad dads who had utilized sperm donors, which was a good reminder that fatherhood went far beyond the contribution of a single cell. “That was a game changer for me,” says Claire, recognizing the tremendous value in sharing our up-and-down journey. “The more I shared, the more supported I felt.”

Success! We Implant Our Baby-sicle

With our heads and hearts in a much better space, we decided to go for one more egg retrieval on May 17, the day before our first wedding anniversary. Another 22 eggs were harvested and 17 were mature enough to be inseminated with a vial of my successfully thawed sperm. The insemination process gave us seven viable zygotes as an anniversary present to go along with a quick detour to the ER for Claire who experienced minor internal bleeding from the procedure. Another six days on the teeter-totter, and we had two blastocysts to send off for genetic screening.

We were notified two weeks later that we had one viable female embryo ready to implant. We were elated, but not yet out of the woods. Because we only had the one, the doctors strongly suggested we do a mock transfer first, which is basically a full round of hormones to set up the transfer, followed by blood tests and a biopsy of the uterine wall to ensure we had the optimal environment for implantation. This pushed the timeline back even further and added an extra cost, but we didn’t want to take any chances.

Claire and Kenny watch over Ila.
Claire and Kenny watch over Ila.

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Finally, on Jan. 13, 2020, we implanted our little baby-sicle, and the clock started on the longest two weeks of our lives as we waited to see if she took. Of course, we cheated and bought a pregnancy test the night before, so the next day we weren’t totally surprised by the news.

All that was left was 10 weeks of daily progesterone injections in Claire’s backside to finish the first trimester. My lack of hand or arm function meant we needed help. Thankfully, a slew of family and friends volunteered, which made for more than a few awkward but hilarious moments. We knew our little girl’s birth story was bordering on the absurd around the third or fourth time my burly, 230-pound neighbor came bursting through the door at 10:02 p.m. in a rush, apologizing profusely for being late and telling my wife to pull her pants down.

Once we cleared the 10-week mark, however, we were no longer considered a high-risk pregnancy, and were discharged back into the world with all the other eagerly expecting, scared shitless first-time parents … just in time for the COVID-19 pandemic. Despite the global pandemic, the remainder of the pregnancy was fairly uneventful, save for the normal first-time parent anxieties and a few growth ultrasounds that should’ve tipped us off about our “little” girl’s size. If anything, knowing the baby was over 12 pounds would have saved Claire 26 hours of fruitless labor, and my brief lapse in sanity when I first laid eyes on the adorable little chunk.

I guess we just needed that one last reminder that the path toward destiny and purpose are never pain-free. But isn’t that how it goes with everything? If we really knew what it would take to reach our goals prior to beginning the journey, we might be scared away from even making the attempt. It’s only when we look back that it all starts to make sense.

The in vitro process is a high-stakes, emotional pressure cooker that puts even the strongest relationships to the test. The steep financial burden, complete hijacking of hormonal systems and social schedules, and need for surgical procedures for one or both partners will put many existential and ethical questions on your doorstep. With a little luck and a lot of perseverance, you can make it through that gauntlet to witness one of the miracles of modern medicine, and life as a whole.

As we set out over the next 18 years to be this kid’s tour guide of the world, we need to figure out how to explain the whole ordeal when she asks where babies come from. “When two people love each other very much, they assemble a team of doctors and scientists. … And then we put you in the icebox for six months. … And then. …”


See Also:

The Great Sperm Hunt
Double Trouble: The Embryo Transfer Gamble


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Marna Peterson
Marna Peterson
3 years ago

This is such a heartwarming story. I can’t imagine all you and Claire went through, I do know that I prayed for this little one from the egg stage to birth. Every Monday at bowling we wanted the low down on baby girl ILA, how she, her mom and dad were doing. I felt so special to be able to pray for a perfect little girl and a smooth birth.
This is such a small world, my grandson and AJ Smith are very best friends, I got to meet his dad Erik and he was sharing they had the twins through envetro. Such a great family and I understand Erik is a very close friend of yours Kenny. Thank you for sharing this incredible journey, May it help others going through the inability to have a family without medical help. My continued prayers for you and your family, may God bless you richly and may you all have a very long happy life together.