Our family's struggle with male infertility

Male factor infertility accounts for a third of infertility cases — maybe more — but many couples find that talking about it is still shrouded in secrecy and shame. In honor of National Infertility Awareness Week, one family shares their story. 

When Brienne Alves was in kindergarten, her classmates stood at the front of the room and declared what they wanted to be when they grew up. While other kids in her West Virginia classroom talked about becoming firefighters and doctors, Brienne stood up and said, “I want to be a mom.” 

More than 600 miles away in Massachusetts, Eric Alves always knew he wanted to be a dad. The idea of reading to a child, playing catch outside in the yard and instilling life lessons into a son or daughter was something he dreamed about.

The two met in 2010 while at college in Boston and followed the “boy meets girl, they fall in love, they get married, they buy a house,” story line until it came time to fulfill their dreams of having a child. This is their story.


After we got married in 2014, we were still using birth control for a while. After about two years, Brienne stopped taking the pills. We weren’t actively trying to get pregnant, but we were OK if it happened. 

In 2018 Brienne went to her yearly physical and her physician asked how long we had been having sex without using birth control. The doctor said, “You guys haven’t had a scare or anything? That's a little strange.”

We had thought nothing of it.

At that point we were becoming a little more serious about starting a family and still nothing was happening. That’s when the doctor suggested that perhaps we should seek out a fertility specialist.


I remember we made an appointment with the fertility specialist. It was April 2018, but then we both decided, “There's probably nothing wrong,” so we canceled that appointment.

We kept thinking, “Everything's fine. We're just not timing it right or we haven't actually been trying, so that's why.”

So we canceled that first appointment and thought, “OK, well, we're going to actually time it over the next few months and see what happens.” That's what we did. By July of that year, we still never had a positive test. So we made the appointment and finally went in. They started by doing all of the testing on me and everything came back fine.


At first I was thinking that the worst that could happen would be me having something like a low sperm count or low motility, something that would be a quick fix. They would be able to prescribe me medication, and then we'd be on our way. 

I was born with undescended testicles that weren’t corrected until I was 9, so we did know there was a possibility that there could be issues related to fertility. But at the same time, I don't think we expected it. My grandfather had the same condition as well as my dad, and they both had kids naturally. So I was thinking it's going to be something like that, where they can quickly fix it and then we will still be fine. The clinic gave us the option to do the first semen analysis test at home just to be a little more comfortable, so we did. 

Later that day, we got a call from the office saying that they didn't find any sperm. I asked, “What does that mean?”

The doctor said, “Well, you did the test at home — any number of factors could have messed it up. Come into the office and do the test again.”

The same results came back again — no sperm.


The doctor told us the diagnosis was azoospermia and that she would refer us to a urologist for Eric, but there was ultimately nothing that could be done. She told us we would be wasting time and money, and our best bet was to use a sperm donor, embryo adoption or traditional adoption. (Editor’s note: Azoospermia, defined as the absence of sperm from semen, can be caused by a blockage preventing sperm from entering ejaculate, or low sperm production. Johns Hopkins Medicine estimates 10% of infertile men, and 1% of all men, have azoospermia.) 

We weren’t willing to accept that answer, so we began doing a lot of research. We spoke to two specialists over the phone. They both said that this wasn’t the end of the road — Eric's hormone levels were on the low end of normal but they looked good, so the chances of finding sperm were promising. Then we found Cleveland Clinic, which has a very renowned urology department and male infertility specialists, so we moved on to working with them.

At the same time, our relationship was suffering. Eric and I had a lot of arguments and fights and very bad nights.

There were definitely times where I thought, “That's it — it would be easier to just leave, be divorced, find somebody else and not have to deal with this.” That was something we went through for a long time. 


It was very isolating. This was my biological purpose. I was coming to grips with the fact that I might need to adopt or I need to raise a child using another man’s sperm. There was a lot going on mentally that was isolating, and then there were things going on that people don’t see, like the personal turmoil and relationship strains.

As more and more people found out, it didn't make it any easier because people didn't really understand. They're making comments like, “Just relax,” or “God has a plan.” They think they're helping but they’re making it worse.

Our new doctor told us to bring any previous test results. We had piles and piles of paperwork, test results and my pediatric records. We came prepared with it in a giant folder.

He sat down for a while, read through every sheet of paper and saw the fertility specialist’s notes she had left after the semen analysis. We began a year of taking vitamins, multiple medications, blood work and semen analysis tests every three months. My body was feeling different. My hormone numbers were jumping to where they should have been, but still — after five semen analyses — we were getting nothing.

Our doctor said we could continue with the medication or we could have a surgical procedure called microscopic testicular sperm extraction done to check for viable sperm. We opted for the procedure, which is done under anesthesia. They cut into the testicles, examine the tubules under a microscope and remove samples of tissue. An embryologist then searches for sperm.


I was ready for Eric to have the surgery, to just get it over with and get an answer. Every single semen analysis test was gut-wrenching to me and would put me into this dark hole for days. I was like, "I want an answer. I want to move on. I want to know what path our life is going to take.”

I was prepping for my egg retrieval at the same time. I had started taking all the medications and doing all the shots. We got sticker shock when we found out the cost of our medicines: We weren't prepared for a $6,800 bill. Just one more infertility shock!

The day of my egg retrieval was the same day as Eric’s surgery. My mom was our designated driver. We dropped Eric off at the surgery center on one side of the building and I went to my egg retrieval on the other side.

I was waking up and being wheeled over to go meet Eric at the waiting room, and our doctor stopped me in the hallway.

He said, “I just want to tell you personally — I have really good news.”

He told me they had found sperm. 

We knew right then and there that we had 17 eggs and there was sperm, but it wasn't until later that day that they called to let us know we had eight mature eggs and that seven of them had fertilized. 

They called us daily to give us updates on how the embryos were growing, and on day six they called to let us know that they had three embryos that they were able to freeze. Six months later we did a frozen embryo transfer.


Our son, Noah, was born in November 2020. We always say that he’s a miracle baby, not just because of infertility, but when we went in for the embryo transfer, he was the last operation they had that day. Later that evening, Ohio shut down all elective surgeries in the state because of the coronavirus. We were the last ones in. 


I think something a lot of people don't realize is the strain and the stress that infertility puts on your relationship and your lives. It's never the same again, even after having a baby — all of that pain is still there. The words that were said are still lingering in the back of your minds. We do have a marriage counselor and have been working through and trying to get over some of these things. It's definitely a trauma that stays with you for the rest of your life and I don't think a lot of people understand that this really impacts you in so many ways. There's the financial burden, the marital burden and the emotional drain on each of you.


You’re not less of a guy because you have to go through this situation. It's definitely scary and stressful, just because your journey has to be different. Even if you don't have sperm and you choose to adopt or use a sperm donor — it doesn't make you less of a guy or less of a dad. It's just that your family story is going to be totally different than somebody else's family story will be, and that is OK.

These interviews have been edited and condensed

Editing by Rheana Murray

Art direction by Tyler Essary