Male Fertility After Transplant?

[smcd23]

This is a 2 part question - men and women feel free to chime in because my question is mostly about male fertility, there is a small part about female fertility, too.

The back story: My SO is the one on dialysis now. We have one amazing 2.5 year old that I conceived 4 months after I donated to him and carried to term with minor problems. But while I was pregnant, he had to start dialysis. Since going on dialysis, especially in the last 1.5 years or so, his testosterone has all but vanished, and we have a pretty much, how should I put it... remained celibate for most of this time  Plus since starting dialysis, he doesn't work so we live off of my income, which is manageable but not the best. We have our son in daycare so that eats up a LOT of our funds, but neither SO or I feel he could watch a crazy toddler all day long.

I've always wanted 2 kids. We have our 1, and I am patiently waiting for him to get a transplant so he can get back to work and we can start trying for the sequel. I wanted to be done having kids by the time I turned 30, but since that's only 6 months away, I don't think that's happening.

So my question is, when he gets a transplant, will his testosterone levels rise and return? And will the drugs he is on post-transplant have any impact on his fertility? I did some searching and I found an article on here that the Valcyte can cause fertility issues in men. Does anyone have any experience with this? I get really sad watching our son watch other kids with siblings play together. I am almost 10 years older than my brother and we were never close, and I always wished I had a sibling closer in age (3-5 years apart) because I feel like we'd be closer. And I don't want my little guy to be alone when he gets older because he really has no family close to him both geographically and in age.

And I guess the 2nd part of that is does anyone have experience having kids with only 1 kidney? I know my first pregnancy went well enough, but I worry the older I get, the harder it might be on my remaining kidney and me physically.

Any input would be great!

[Chris]

My testosterone levels were never checked pre and post transplant, so I don't know if mine were even low. However after finally settling down with health issues post tx, my interest in dating picked up that I haven't had thatstarted just being a diabetic and not kidney failure.. So it maybe due to increased testosterone, but have never asked a doctor. It's just something I haven't needed to ask.

[jeannea]

I'm not a male. But when I went in for my transplant evaluation, the doctor told me that a transplant could restore my fertility. Being over 40, I wasn't all that interested. I'm 6 weeks after transplant now but I don't know what's going on with that yet. For me it's not a big deal but I understand it is for you.

Has he considered getting treatment for this problem? I don't know if he needs antidepressants or testosterone cream or what but maybe there is help available. Or maybe you could talk to your doc about IUI. Explore your options. Don't let dialysis define your life.

[smcd23]

He is on an antidepressant now, and has had like 2 "urges" of that nature since starting them 3 or so months ago. The psychiatrist always wants to give him the little blue pill, too. At the first psychiatrist visit we brought up the low testosterone thing because he has had a blood test for that, and we did see an endocrinologist. The endocrinologist is a fruit loop - he said "Oh well yes, you do have rather low testosterone (lets be real, it's the testosterone level of an 85 year old man) but I think you need a sleep study first." Yes, a sleep study is an EXCELLENT idea for someone who is on home dialysis every night. Moving all that stuff into the sleep lab is NO PROBLEM. Argh. Anyway.

So we told the tx psychiatrist and he said he'd talk to the transplant doc about giving him something for it, but that was the only time it's been mentioned. He's lost 20lbs in less than 6 months, and 60 total since starting D. The first 20 was from cutting out dairy, but I think the last 20 has all been muscle, because he never had much chub on him anyway.

I am just worried about the little swimmers not working, or dying off or whatever. I mean I'd do IUI, but I'd want the other part to be from him since I already know we make beautiful kids and I just worry that the dialysis and then the tx and tx drugs might eliminate his ability to do that. I was hoping someone would chime in and say they had no problem with this after tx buuutt it doesn't appear many people have. Sucks being so young going through this, because I just don't think this a problem most D and tx patients worry about.

[Chris]

With so much going on, it isn't at the top of the list of things to worry about. Just with diabetes and the progression of side effects, the main concern was to keep a job, roof over head, stay out of the hospital, stay alive. Then with D, things get worse and priorities shift even more especially when I had no s.o. to fall back on. This is also not an easy topic so it may take some time for others to chime in.
 
Hope you got a different endo, sounds like a relative to mine with stupid ideas. My ex endo didn't want to give me an insulin pump until after I had my kidney and pancreas transplant. Why would I need it then if I have a pancreas now, so that doc was fired and I found another. Hard part is getting a good doc who listens and works with you, not against you.
 
Hopefully you will get some help to your question.

[MooseMom]

Sucks being so young going through this, because I just don't think this a problem most D and tx patients worry about.

I suspect that EVERY D and tx patient who is of childbearing age worries about this.  I am hoping Poppy will come on and advise you.  She recently donated a kidney to her husband, and I know she would like to have punkins at some time in the future, so she is pretty much in your same situation.  Perhaps you could PM her?  Her screen name is Poppylicious in case you don't already know.

[smcd23]

Hope you got a different endo, sounds like a relative to mine with stupid ideas. My ex endo didn't want to give me an insulin pump until after I had my kidney and pancreas transplant.

Umm I am glad you fired that doc! That's absolute insanity! Let's not give someone with diabetes an insulin pump to keep them alive until after they have a transplant. That seems like a fabulous idea.  Doctors amaze me with how stupid they are sometimes!

MooseMom - I know she is going through some of the same stuff, she mentioned it in another post - not this specifically but similar stuff relating to her. I just need someone to say Yup! Got pregnant no problem, it was cake! I just hope he gets a tx soon, because our little man will be 3 in Sept so I want to get started on the sequel in the next year or so. The new facility he is in the process of switching to seems to think he will be their next transplant when they move his time because the wait list in our home state is shorter because they are the only facility in the state and get first dibs on any organs offered in our state. Crossing fingers...

[jeannea]

I wish I could give you good news. I was 22 when I was diagnosed. I ended up focusing on working to keep my insurance. Then I went home to sleep. And this was before I needed dialysis. I gave up on the idea of ever having someone in my life and having a family. On dialysis it often seems impossible to think about the future and a happy family and all that sort of thing. That could be part of his problem. You are planning for the future when he feels like he doesn't have one.

[MooseMom]

You are planning for the future when he feels like he doesn't have one.

I think this may be very much the case.  Very insightful, jeannea.

[lainiepop]

Hi. Is this not something you can talk to your transplant co-ordinator about? I'm sure they must get asked this type of question all the time. In fact mine asked me if i planned to have any more children after transplant. I laughed thinking it was a joke (i'm 30 with a 4 yr old son and 10mth old daughter, the daughter killed the kidney off lol). They said my fertility would return if i wanted more but both myself and hubby feel we have 2 wonderful kids, and i am not gonna risk the kidney my dad donates to me by having another! (Hubby then made this not an option ever by having the snip a couple weeks ago, think he was worried i'd get broody when Elena gets bit bigger and i feel better  ) But obviously for you it's different as it's your man with the kidney issues and u that would be carrying the baby. I don't see why if i was told i can have another after transplant then the same must be true for men.

I understand your worry about the drugs affecting sperm quality but wasn't he on some sort of medication when you conceived your son? I was on medication when i conceived both of mine. And to be honest you can't really plan sperm quality or anything to do with fertility anyway, we conceived Andrew pretty quick, but Elena took around 18mths, i assumed as my kidney was worse from having drew, but hubby did a sperm test and we found out although he had good count and motility the quality was rubbish, they told me not to expect to get pregnant again (i did a month later), but he is 29, healthy and never been on medication.  I can sort of understand that you don't want your son to be an only child, but like a pp said i think at the moment maybe there are more important things to get your man through like the dialysis and getting a transplant, have you talked to him much about it, maybe like someone else said he doesn't feel he has a future so can't plan for one. I'm having a transplant in 3 weeks and the last thing i'd want to be thinking about is i need to have a baby by such and such a date so there's not too big an age gap. I'd want to recover and get back on my feet and enjoy the family i have. Plus being an only child is not too bad, i'm the only one and i love it, im very close to my parents, have lots of friends (always have) and have made a family of my own. If Elena hadn't happened i would not be disappointed for my son but just thankful i could have one, as some even healthy people can't have that.

Finally your question does anyone have experience of having a child with one kidney, well i had 2 kids on my imperfect scarred kidney so i'm sure yours will be fine if your were able to donate! To put it into context my parents were told i would die when i was born cos my one imperfect kidney was scarred, but its done 2 yrs and 2 kids, the docs were surprised it did the last one on 17%. Andrew was born 39weeks 5lbs12, Elena @ 35weeks 3lbs 12, both perfectly healthy. I had extra scans etc and was kept an eye one but i had relatively good pregnancies apart from being sick for 15weeks with lainie but that was just hormones. We know someone (in their 80s) who only found out she had one kidney when she had her son lol. If you have one healthy kidney it's generally not thought a high risk, it's only when you don't have good function to start with then the pregnancy will put more strain on and it may not recover.

Sorry i can't be of more help, not being a man But wish you luck anyway and hope someone still comes on and says they had no issues after transplant! But def ask the doctors they will know for sure x

[Poppylicious]

I was going to steer clear of this thread because it makes me sad, but as I've been mentioned I couldn't just read and run! 

Blokey got his sex drive back hugely post transplant, but then the freakingly massive hernia got in the way (both physically and emotionally) and now he's still recovering from that major surgery.  Give me another two weeks and I may be able to comment properly on the amazing amount of sex we're indulging in!! *grin*

I don't think having only one kidney is an issue, whatever the age.  I know that any pregnancy of mine will probably be monitored more than others, but that will be partly due to my age as well.

As for this thread making me sad ... having just one child would make me feel so hugely blessed and humble, especially with everything we've been through.  I'm older than you and I see my chance slipping away with every day that passes, particularly as I'm getting to the age where other opportunities will also stop being available to me if I can't conceive naturally (whether that's due to Blokey's fertility or not, or even mine.)  However, I'm a BIG believer in Fate so if it happens, it was meant to happen.  And if it doesn't, I can't let it control and consume my life (I've seen friends go through so many hoops and I couldn't put myself through that) however much my heart will break with every pregnancy announcement I hear and with every burpy baby, smiling toddler and proud parent I have to talk to/see pictures of. 

For what it's worth, I think your positives with regards this far outweigh the negatives, both pre- or post- transplant.

[smcd23]

Poppy, have they said anything about his swimmers being below par? That's what I'm worried about. And I am
happy and feel blessed with the one little guy (even though many days I am willing to give him away to the first willing victim, I mean person) but in the past year both my grandparents have died and I watched my dad and his siblings pull together to make arrangements, plan and stick together through the tough times.  I don't want that to all fall on my little guy, and have him be alone. Just a big fear I guess.

And no, my SO wasn't really on any meds when I got pregnant the 1st time, just blood pressure meds if I remember right. The first transplant center talked about freezing some for the future. We haven't really been able to get a straight answer from the current facility.

[Katonsdad]

Today my wife and I have a healthy 10 year old boy. I was on dialysis in 1997 when we got married and transplanted in 1999.
Due to my have Diabetes , and heart issues  (and my families terrible healthe issues , diabetes , heart cancer etc)  we decided to go
with a donor for my part.  Was ths a hard choice ... NO ! .  I have had increased bad health that recently causeds me to collaspe at work
and I now carry what is called a Life Vest around my neck , waiting for the 50 day point to get a defibulator inserted in my chest.
Seeems like they are just waiting for me to drop.
At 10 yrs old , our son knows how he was brought into this world and why we chose to have a donor.  He will be healthy !

This may not answer your questions but is a way to have a healthy child . I have some many tubes and wires sticking out of me right now I dnt see
how I would be appealling to my wife.

Katonsdad

[MooseMom]

smcd, does your husband want more children?  I keep reading about what YOU want, but I'm unclear as to what HE wants.

As for your son being "alone" when he gets older, is there a reason why you think he may not marry and have a family of his own?  Just because he may not have siblings doesn't mean he won't have a wife and wonderful children of his own.  His wife might have plenty of siblings who will become HIS family, too.  You do not know what the future will bring, and there are no guarantees that a sibling will necessarily be a GOOD person.

I was unable to have any more children due to my kidney disease, so I thought I was very lucky to at least have one child.  However, it turns out that he is autistic, and he is 20 years old now and will probably never find someone to marry him.  I will never have grandchildren.  There are worse things than having only one healthy, normal son.

[smcd23]

I'm afraid my son will be like my brother. My brother is "normal" but has no desire to get married or have kids. I don't even think he's had a girlfriend or boyfriend. He's hard to describe but it's weird haha. Can't put it into words.

And yea, my SO is not opposed to a second child but he wants a kidney and to get back to work first. We've talked about it but the whole him not working and needing a transplant is the hang up at this point. And that I'd what makes me wonder if it's going to be possible then.