Wednesday, 9 August 2017

When in Doubt, Cut it Out


I decided, since I have enough sperm in the bank to do seven rounds of IVF, (and since I'll never be able to afford that many rounds anyway) that it would be prudent to follow up with my surgeon again about having ol' Lefty (my left testicle) removed, or as the formal surgery is called, an orchiectomy. I wanted to be absolutely sure I was making the right decision so I did my research before my appointment. What I learned was initially reassuring, but the further I went down the rabbit hole of self diagnosis, the more worried I became. I learned that ol' Lefty was so much bigger than ol' Righty, not because ol' Lefty was big, but because ol' Righty was small.

My actual birthday card from my work team.
It is noted in a previous chapter that I had a correction surgery for an undescended testicle on the left side when I was a child and that this was the suspected cause of my infertility. In my search for certainty I found out that my right side also had an issue which was something called a "retractile testicle". This basically means my right nut moves freely and painlessly between the scrotum and the abdomen. I always thought this little mutation was cool because I was able to freak out any girl I was with by making my right nut disappear like a freak-show act from a travelling circus. Unfortunately, this also meant that my right side could be the culprit for my issues, and this concerned me. When a testicle is surgically removed, as a general rule, the remaining testicle makes up for the loss by switching into overdrive and bumping up its sperm and testosterone production. I wasn't worried about it not making up for my sperm production - I had enough sperm frozen for a lifetime of fertility treatments - but living with low testosterone was something I was positive I didn't want.


I read all about testosterone replacement therapy. The creams that make you grow hair at the application site, or the daily injections for the rest of your life, or the risk of growing boobs, or even an increased risk of getting cancer. Teenage me probably wouldn't have minded having boobs for a day or two, but I don't think future me would have the same appreciation for them. What it came down to for me though was that I would be having surgery as a preventative measure of getting cancer, only to possibly have to go on hormone therapy which could actually cause cancer. It seemed to me like I was being chased, but I was running in the wrong direction - and none of these decisions were good options. I decided to reserve my decision until I followed up with my doctors.

When I saw my family doctor, she was awesome, and encouraging. She explained that the way she understood it, only my sperm production should be affected, and since I was very masculine looking with facial hair and a muscular build, I shouldn't be worried about a small drop in testosterone production if that was the case. In her words - "when in doubt, cut it out". She did, however, encourage me to ask my surgeon to make sure. I saw my surgeon shortly after, who said that as far as she knew, there is no test to see which testicle is the problem and that removal is a risk, especially given my issues with both sides, even for my testosterone production. She was very empathetic to my situation and offered me an alternative; observation. She explained that I would have alternating MRIs and Ultrasounds every six months for two years, following which I would have an MRI every year after that. This way, if something did grow back, they could catch it before it became a problem.

After a little bit of discussion, I opted for door number two and I left the surgeon's office with renewed comfort from the decision I had made. Although, I must admit, I was slightly disappointed that I wouldn't be able to make all the "balls of steel" jokes I had planned for my post-prosthetic surgery.


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