There is hope for those suffering male infertility which affects up to 40% of couples.
Time truly gallops away when you are oblivious and unmindful. The last cycle of the year of the Chinese zodiac Horse was in 2002. It was a remarkable year - the 17th World Cup was first held in Asia. It was an outstanding and extraordinary event co-hosted by South Korea and Japan. And now, we are all waiting in anticipation of the fireworks to sparkle in Brazil for the World Cup, co-hosted by Germany and South Africa.
Of course, 2002 was also a year of trial and tribulation. It was the year Queen Elizabeth celebrated her Golden Jubilee and saw the departure of Princess Margaret and the Queen Mother, three months apart. It also welcomed the independence of Timur Leste from Indonesia and it was the same year that Jakarta was haunted by the terrorist bombing in Bali.
On a personal note, 2002 was also a year of glory on the paternal front for me. My daughter was born in the spring that year. As my son Jack had a breach presentation during his birth in the year of the millennium, an emergency Cesarean was performed to prevent fetal distress. The obstetrician friend of ours had arranged to meet us to discuss Cesarean section delivery for my wife’s second pregnancy.
We sat down in the consultation room in Chelsea and Westminster Hospital and the obstetrician began talking about the pros and cons of surgical intervention.
As we finished the consultation, David started offering the preferential of horoscope timing for the arrival of the new member of the family. I was puzzled and amused by his suggestion. OK, we are Malaysian Chinese, but surely we don’t appear as a pair of “controlled freak” parents, who demanded even the timing of our daughter’s arrival to match our Feng Shui.
My wife laughed and dismissed the proposal as ludicrous and preposterous. However, I must confess that at that time, I was actually quite tempted! The problem was, I was simply clueless of even whom to ask for the auspicious timing of birth.
I guess we were lucky as Jade turned out to be absolutely brilliant in the last twelve years. I often wonder whether I would blame myself if things hadn’t turned out the way it did.
Twelve years on, we are welcoming another cycle of the year of the Horse. It's a very different world we live in now. Who would have imagined that the United States would have its first African American President or the rise of the Chinese super power in the new decade. The medical front has also seen advancement.
I recently came across a couple whose three-year marriage was plagued by the problem of infertility. The wife shouldered the blame for not bearing a child for many years before the husband decided to have a semen analysis. Believe it or not, male infertility actually affects up to 40% of couples facing. When Mr Lee discovered he has no sperm in his ejaculate, he protested with disbelieve and repeated the tests several times before “surrendering” to urological intervention.
A man “firing blanks” in his semen is a condition termed azoospermia. This condition is surprisingly common and most of the etiology is undetermined. Obstructive spermatic ducts or destructive spermatogenesis due to defective sperm generating cells can both result in azoospermia.
When men have such a predicament, the urologist will usually offer surgical interventions. The search for sperms can be performed with various forms of surgical methods including PESA (Percutaneous Sperm Aspiration), MESA (Microscopic Epididymal Sperm Aspiration) or TESE (Testicular Exploration Sperm Extraction).
When the options were offered to Mr Lee, he reluctantly accepted the surgery (with anesthesia, of course). Thankfully we found some healthy sperms that would be suitable for several cycles of IVF (In-Vitro Fertilisation).
In the follow up, the couple was overwhelmed when they discovered the eggs that Mrs Lee produced were fertilised successfully, and the embryos were ready for implantation.
“Doctor, we hope to defer the implantation date until we identify an auspicious date that is in sync with our Feng Shui!” Mr Lee requested. “We would also like to have a boy first!”
I was stunned. Auspicious date? Gender selection? Is this legal? Is this moral? Is it possible with the current technology to accommodate such requests? But is this right?
“I also read recently on a BBC report of a company in the US doing genetic screening for genetic diseases,” Mrs Lee said. “Do you think it's possible for us to do the genetic screening for the baby during gestation?”
I was astounded and flabbergasted. I have not encountered such sophistication in requests in my career as a urologist. Before passing any judgment on the couple, all the requests made were within the reach in the marvel (or curse) of medical sciences. I admit, I was ashamed that the only response I offered was “I am not sure, better ask the obstetrician!”
Finally, Andrew Niccol 1997’s science fiction Gattaca has arrived. This is a portrayal of a society driven by genetic manipulation to ensure the best hereditary traits, with the contrasting struggle of those who are naturally conceived to overcome genetic discrimination. Of course, I think too much!
When I arrived home and looking at Jade, I'm glad the world of science was galloping at a slower pace in 2002 to let the marvel of nature take its chances! Anyhow, with that in mind, wishing all a “Happy CNY!”
> The views expressed are entirely the writer’s own.