I often find myself reviewing material and content on male fertility. But never have I been more emotionally invested or moved like I have been covering BBC's Room Five: Medical Mysteries Series 2, Episode 4: Gareth.
Is it because our sense of hearing is more sensitive to emotional cues than others? Perhaps. Or is it because of the amount of raw emotion on show on this masterfully put together show that takes us on the rollercoaster ride that is fertility treatment with its highs and lows? I suspect it is a bit of both. Host, Helena Merriman, dives straight in by introducing us to guest, Gareth, and the story of his and his wife Anna's struggles with infertility. A story that has all the makings of a Hollywood movie. The episode is structured into three acts.
In the first act we have our exposition, where we are introduced to Gareth, a wedding videographer from Dublin. At first, Gareth's demeanour on the radio is so relatable that you won't be mistaken to think of him as a friend. Someone you are rooting for from the very beginning. Someone you'd gladly be in their corner. A protagonist to our story. As he peels off the multifaceted layers of his story, you begin to hear the melancholy in his voice as he reflects on his struggles to start a family with Anna. His diagnosis of having no sperm was very abruptly and harshly delivered to him in what seemed like a very dismissive and blunt manner. A manner that extinguishes hope, that shatters dreams, that breaks men. Without an explanation as to why that's the case, or even, as Gareth very humanely put it, why him?
'Whatever you say, say nothing'. Quoting Irish Poet, Seamus Heaney, the old stereotype of men not talking about their emotions or acknowledging their feelings is again very true. Our protagonist resorts to escapism in the form of alcohol and video games, and treats his emotions the same way the doctor that delivered his diagnosis treated him.
In the second act, Gareth confronts his diagnoses head on. As he and Anna continue to navigate their fertility journey, they come across Jonathan Ramsay, a consultant urologist and male fertility specialist in London. Ramsay explains how he is determined to find out the reason why Gareth does not have sperm, and reminiscent of a certain famous detective, he inspects the clues and evidence, not just the ones presented to him, but he also peers into and explores Gareth's past to try to piece together the puzzle and solve the mystery of his infertility. And he does. Klinefelter's syndrome affects one in 650 men, that one being Gareth.
Klienfelter's syndrome presents itself with an extra X chromosome to the male sex-determining XY chromosomes, giving a sex chromosome combination of XXY. This doesn't make a male a female, but the extra X chromosome can affect testicular development, reduce testosterone production and cause infertility.
Twelve years of working at fertility clinics taught me that very often patients reach a point where they just want to know why they are not getting pregnant. Yet, the answer to this question is not always straightforward. So many factors are at play that sometimes it is difficult to pinpoint and put your finger on a single one. Unexplained infertility accounts for 33 percent of cases of infertility. In the case of Gareth, not only did he get the answers he sought, he finally got to understand why he is struggling to have children and he even made sense of certain aspects of his own childhood as a result of this diagnosis. He found closure.
But there was hope. There was still a chance with Gareth's diagnosis of retrieving sperm surgically. With expectations raised, the build-up to this moment was tense, I found myself filled with optimism, hoping to hear the news we all want to hear for him, the news he deserves. Alas, just as hope can lift moods, it can also bring them crashing back down from previously unscalable heights. It felt like a rug was pulled from underneath my feet, so I cannot fathom what Gareth must have been going through. Our protagonist was defeated. Or was he?
Cue the final act, the moment in a movie where our protagonist becomes a hero and rises up from the ashes to overcome adversity. Showing immense strength of character and grit, Gareth comes to terms with his diagnosis and being so adamant and determined on pursuing his goal of having a family and not giving up, pushes forward and explores the avenue of sperm donation. To me, this part played like a montage from a coming-of-age-movie, where the audience watches the protagonist prepare for the final showdown with their archnemesis, infertility. Gareth and Anna navigated the intricacies and conceptual challenges of sperm donation and to our elation after their third round of IVF are blessed with twins. A very happy ending to a story that ever so often pulled at our heartstrings in such a short amount of time.
Gareth's role in opening up and talking about his and Anna's experience cannot be understated. His emotional, endearing and relatable retelling of their story was as immense as it was important. It serves as a very important reminder that you are never alone.
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