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Written by | Department of Reproductive Andrology, West China Second Hospital, Xiao Xiao
If it is said that "the walls of the hospital listen to more sincere prayers than the church", then this wall of our department must have heard countless prayers about "good pregnancy"! The joys and sorrows of human beings are not the same, and there are people in this world who are distressed every day because of pregnancy, some because they are pregnant, and some because they can't conceive at all.
Every day, patients entering and leaving the human sperm bank in Sichuan Province are bustling, all of whom come with the hope of fertility. But some reaped surprises, some left with regrets, and some finally chose to give up......
Do you only have one child?
"Do you only have one child?"
When I asked this question, a sense of guilt and shame suddenly rose in my heart. Every family with a child who is seriously ill will want to have one more child, I don't know what this kind of good means, maybe not all lost.
Their child had just been admitted to the best local high school, and when he was found to have a problem during the entrance physical examination, he was finally diagnosed with acute myeloid leukemia.
Feng Shuangfu said: "God is too poor for our family. One sentence expresses the grievances in my heart.
During this time, the child was very silent.
With the early diagnosis of tumors, radiotherapy and chemotherapy, the 5-year survival rate of some hematologic malignancies has exceeded 80%, and the focus of treatment of cancer patients has shifted from the previous single life continuation to higher requirements for subsequent quality of life. However, both the tumor and its treatment process may lead to a decrease in semen quality, and even irreversible damage to fertility, and the loss of the opportunity to have children in a later stage.
The child in front of him is about to undergo chemotherapy because of leukemia, and these treatments may make him lose his fertility in the future and lose the opportunity to be a father when he grows up, so the hematology doctor suggested that they should freeze the sperm before chemotherapy, so that they can preserve their fertility function through the frozen sperm or tissue in the future, and have the possibility of having offspring.
When he came to the sperm bank for the first time, the child was very nervous, Feng Shuangfu embarrassedly explained some precautions for sperm retrieval to the child as a father, the child tried twice, and it took more than twice as long as others to take out 2.5ml of semen, and after professional processing by the laboratory teacher, two specimens were successfully frozen.
When I came the second time, both the child and the father relaxed a lot, talked to me about some treatments, and successfully froze two specimens again that day. For male fertility preservation, we will generally recommend freezing 6-8 semen specimens according to the assisted fertility method adopted in the future, but because the child's tumor treatment is also urgent, it was decided that only these 4 can be cryopreserved.
Feng Shuangfu said, do your best, obey the destiny of heaven, and now do everything you can do.
Later, we received a message from Feng Shuangfu on WeChat, saying that "the child is recovering well after bone marrow transplantation", and I was sincerely happy at that moment.
He also said that another leukemia doll I know is also coming to you to freeze sperm, and I pushed your work WeChat to him, thank you.
I didn't know what it was like, and I replied to him: Come on, I'm lucky to be able to do fertility preservation (semen freezing) before treatment.
Life can be courageous, but there should be a Plan B.
Failure is the norm in medicine
When the couple surnamed Li first came, it was in 2020, because of the pre-birth examination, the two looked 30 years old +, full of energy, talking and laughing with the checklist, the man said don't wait here in the afternoon, go back to work early, the lady smiled and nodded and said okay.
The second time the woman came alone, she asked: Teacher, is there really no way to get pregnant if you have azoospermia?
I read the report in her hand and told her that the chance of natural pregnancy is really low, and she can try to see if she can find sperm to freeze and then do assisted reproduction.
After a long time, they were not seen again. The weather in Chengdu is getting more and more humid and cold, and the patients are wrapped in thick down jackets, looking at their warmth, I feel that the winter is not so difficult.
"Doctor, let's freeze some sperm. ”
As soon as I looked up, I saw Mr. and Mrs. Li, and after talking, I realized that they went to many places for medical treatment, Chinese medicine and Western medicine saw a lot, and the quality of semen is still good and bad, sometimes it can be found, and many times it can't be found.
I told them that freezing was the best option in this case.
The woman nodded and said, "Yes, we have seen that many experts say so." As soon as we found the sperm, it was easy to do, so we decided to freeze the sperm first. ”
After the results of the pre-freezing test were obtained, the doctor recommended sperm freezing, which is most suitable for his case of occult sperm disease with low sperm count and poor motility. Conventional freezing techniques are difficult to succeed, and sperm freezing is promising.
They came twice and didn't find sperm. The man also asked us about donor sperm assisted reproduction, and they should have made a lot of preparations. The teacher of the Department of Reproductive Medicine also suggested that they do simultaneous sperm retrieval, but they were still worried that they would not find sperm in the end, wasting time.
The man said, "Why don't you give up." ”
The woman shook her head.
The third time we were full of hope, and the laboratory teacher patiently searched for nearly three hours, and only caught two sperm under the microscope, and only saw a slight swing in the tail, which is likely to be not effective after resuscitation after freezing.
They can only be informed that "there is still no way to freeze this time".
The azoospermic patients who came with them that day have been successfully frozen through sperm freezing technology, and some patients at the same time, their wives are pregnant, but they have tried so many times, but they still can't successfully freeze.
I saw two disappointed faces, and at the end they said, "Forget it, we gave up on ......"
In the field of reproductive medicine, patients should see the day their child falls to the ground as a happy end, and this is the end point that we very much hope to reach. However, there are still cases where the best efforts of patients and doctors are still disappointing. I don't know if people can understand it, or if they can accept it, but failure is the norm in medicine.
The end of the documentary "The World" says: "The blizzard will eventually end, and people who have lived through it will not remember how they survived." "And in the blizzard of the fertility dilemma, I have seen many people separate, and I have seen many people finally survive because of hand in hand, there is no right or wrong, there is no right and wrong, and there is not even a choice, looking at their backs holding hands and going out, I think that children may not be the necessities of our lives, and the lovers who support each other must be.
Support each "different", we help you save the "farewell gift"
"I want to have sex reassignment surgery," the 20-year-old boy in front of me said to me.
Sex reassignment surgery - I think you are not unfamiliar with it, psychologically speaking, this part of the population who wants to have sex reassignment surgery belongs to gender identity disorder, which refers to a person's psychological perception that the gender is different from the biological sex, and there is a strong desire to change gender. In the World Health Organization's International Classification of Diseases, gender identity disorder has long been classified as a mental disorder, and it was only in 2019 that the World Health Organization revised the International Classification of Diseases for the 11th time, removing it from the classification of mental disorders and putting it under the column of "sexual health".
The strongest desire to freeze semen is not the boy himself, but his parents. The boys kept saying that I did this for them. The parents' faces were full of unwilling but helpless expressions.
In the end, the choices of life are made by oneself, and it is oneself who bears the consequences, and the bystanders, even their parents, can only accept it. I hope that we will have no regrets about the choices we make in the future. And while choosing to be yourself, isn't sperm freezing a farewell gift?
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Source of this article: Medical Editor-in-Charge: Xiang Yu
*The Medical Community strives to be professional and reliable in its published content, but does not make any commitment to the accuracy of the content.
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