NOVA

This is what I.V.F. looks like.

Wow.

This is what my life is going to be consumed of.

All these meds in 20 days,

thousands of dollars.

This is I.V.F.

Infertility just feels like a special little corner of hell

that just goes on and on and on.

Every community has that taboo subject,

that thing they just don't talk about at the dinner table,

and fertility is ours.

Black women are struggling with infertility

at almost two times the rate as

our Caucasian brothers and sisters.

I think there's an infertility pandemic.

And I think it's getting worse.

Infertility rates are quoted as one in eight

but I think it's much higher.

Men from the general population, we found that their sperm counts

had dropped 50% in 40 years.

There's no embryo that has all normal cells.

Mother Nature's all about spectrum.

If you want to see the belly,

I'm actually wearing a whole, like, belt underneath my shirt.

One thing that people would always say

is that two men can't make a baby.

And so, I'm sort of like,

"Watch us."

No one likes hearing

that you take Black women from America,

put them in other countries that are supposedly

lower resourced, and they do better.

That is shocking.

I don't like to say that it's a miracle.

Because that doesn't have the smack of truth to it.

She is the spoils of war.

I met Zack and he was a guy

that I just found myself falling in love with.

And he brought out the best of me.

You just get excited

about the prospect of having a family

and you meet the girl of your dreams

and then you decide, you know, to get married.

And you hope that kids are the next step.

In my family, my sisters got pregnant right away,

my mom got pregnant right away.

So, I never thought that infertility would be a word

that I would have to use in my own personal life.

And we tried for years.

Everybody gave us advice...

"Well, you just need to relax

"and, you know, it'll happen.

Just... you guys are just too stressed."

And we kept trying

and eventually we both reached a point

where we said something's wrong.

After a year, I went in to the doctor.

They took my labs, a few days later they called me back

and said you know, "You ovulate regularly,

all your labs, hormonal-wise, are in check."

And so the next step would have Zack go in.

Of course,

my husband did not want to go in

to the doctor.

So, he waited for about six more months.

So, I thought there's nothing wrong.

There can't be anything wrong.

That would be crazy that something was wrong.

The doctor called me and he told me the news

that Zack had zero sperm in his semen analysis.

And that was the first time...

we heard it.

Having no sperm

is not very uncommon.

But most of the time there's an obvious cause...

a man who's had a vasectomy,

men who are taking testosterone.

So, in Zack's case,

unexplained no sperm with no blockage

is relatively uncommon.

Sometimes, we find genetic reasons.

That's not the case in Zack's case.

When you're told you don't have sperm,

you feel like you're less of a man.

You feel like, "Well, why am I different"

"than all the other guys that are out there?

And how am I less qualified?"

Dr. Milbank, you're in good hands. I know.

I just have to have faith that everything is going to work out.

I was diagnosed with non-obstructive azoospermia,

which by definition means that there are zero sperm.

The doctor proposed that we go in surgically

and look in the testicle and see if there is sperm there.

In a patient who has non-obstructive azoospermia,

what that means is that the sperm production

is likely very compromised.

And so, in order to get sperm,

the urologist is making an incision in the testes

and pulling out some of the little tubules

that will contain small amounts of sperm.

Contrary to popular belief,

male infertility is as common as female infertility,

and has many causes, including abnormal sperm production,

chronic illness, injury,

or lifestyle choices.

Very good.

All right, Jeff, find something good.

Okay.

So, we want sperm that has

a normal shape to it.

The sperm that has the most normal shape

is usually going to have a better chance for fertilization

than sperm that has abnormal shapes.

Found one?

Yeah, there's a few sperm in here.

Nice!

This is a sperm that really has a nice head, midpiece, and tail.

You can see it right kind of here at the center.

So, if you think in terms of what

Zack's chances are of having a child

without any intervention, it's zero.

We have moved him from zero percent success to,

at this point with sperm in the lab,

probably about a 50% chance

of having a child that is genetically his.

I love you.

I love you, too.

I'm of course happy that they did find sperm.

But you still have all those questions about what is next.

If we take an average man today,

and look at his sperm, his father's sperm,

his grandfather's sperm...

we see that he has on average

about half the number of sperm as his grandfather.

So, what we found when we looked in Western countries...

That is men from the general population

who didn't know whether or not they were fertile...

we found that their sperm counts had dropped 50% in 40 years.

Because it's not likely to be genetic.

Why? Because it's too fast.

It's too fast a decline for a genetic change.

So then it's environmental.

Lifestyle factors like smoking too much,

binge drinking, stress.

A man's body weight, his obesity

is directly related to his semen quality.

Another is the chemicals in our daily life

that have the ability to interfere

with the production, distribution,

and utilization of testosterone.

And they are part

of a category called endocrine disruptors.

Endocrine means hormone.

Testosterone is a hormone.

So, chemicals in plastic,

soft plastic in particular,

have the ability to decrease testosterone.

We know that the chemicals in personal care products

include many endocrine disruptors.

The chemicals come into the mother's body,

they get to the fetus,

there's no question that they get to the fetus.

So, this is a really critical link to the picture.

These chemicals can reduce testosterone

in the developing fetus...

and that can affect males' sperm production

and health later in life.

The consequences,

one of which is lowered sperm count,

and we see a lot of that in... all over the United States.

It's not just the number of sperm that we care about.

We also care about the shape of the sperm,

which has gone downhill as well.

It's got to swim straight.

Circles won't do.

It's got to get to the target.

So, what we're seeing is

that the sperm are failing the test,

in lots of ways.

But healthy sperm are just one piece

of the fertility puzzle when it comes to making a baby.

In order for natural conception to occur,

there are actually a lot of things that need to go right.

So, the very first thing that needs to happen

is there needs to be ovulation,

which means that one mature egg

is released from the ovary.

That egg then needs to be picked up by the Fallopian tube

and it lives there for about 24 hours.

If there's sperm around,

the sperm needs to find the egg in the Fallopian tube

and then they join together, which we call fertilization.

The egg now transforms and becomes an embryo.

Reproduction is really exciting

because it's the best example of multiplication you'll ever see.

So, the embryo goes from one cell

to two to four

and it just keeps doubling.

So that by the time the embryo gets into the womb,

it's hundreds of cells.