Dan Hammers: Infertility in SCI
In June 2012, Dan Hammers marked the 20th anniversary of an accident that changed his life. At the age of 19, he dove off a 10-foot building into a pool containing 4 feet of water. "It's one of those things you do when you're young and don't think about it," he says. "I'd made the dive before, but this time it went wrong. It's amazing I'm alive." Hammers, who is a C4 quadriplegic, considers himself better off for the experience. "I had a wild teenage life in Chicago and would have ended up dead or in jail," he says. "I moved south with my parents, got my life straight and started going to church, which is where I met my wife, Kari."
Infertility Treatment for Men with Spinal Cord Injury
In 2009, after seven years of marriage, the couple decided they wanted to have a child. They started the process with a urologist in Lake Charles, Louisiana, where they reside, and eventually made their way to TIRR Memorial Hermann's Outpatient Medical Clinic to see John Bertini, M.D., F.A.C.S., a urologist. Dr. Bertini and his partner, James M. Harris, M.D., provide unique care that's difficult to find in the community - infertility and impotence services for men with spinal cord injury (SCI) and complex services for patients with urogenic bladder.
"Infertility in SCI is a challenge. Because the male reproductive tract is at the end of the spine, virtually all lesions along the spine affect fertility," Dr. Bertini says. "Most men with significant spinal cord injury are unable to ejaculate. We have several techniques we employ to produce an ejaculate, which is given to a fertility specialist to insert into the cervix at the time of ovulation to produce conception."
"One of the challenges with Dan was the amount of time that had passed since his injury. SCI patients who want to have children need to find a physician with experience in infertility issues soon after their injury. The earlier we can get started, the better the chances are. Unfortunately, the reproductive issue often gets pushed into the background because there are so many other issues to deal with - seating, pressure ulcers, bladder and bowel. We like to bring it forward to patients early and talk about the possibilities with them."
Low Chance of Conception
Intrauterine Insemination (IUI)
In 2009, Dr. Bertini and the couple did a successful trial run using vibratory stimulation to test Hammers' ability to ejaculate. But when Kari Hammers saw a Houston fertility specialist, she discovered she had stage 4 endometriosis and learned that there was less than a 1 percent chance she'd become pregnant using intrauterine insemination (IUI). The couple tried their first IUI in April 2010. A second was done in November of that year, without success.
"The infertility process is very emotional in itself," says Margaret Rogers, B.S.N., B.C., coordinator of urology services, who works with Dr. Bertini. "It's very time consuming and requires a lot of planning. There's great potential for frustration."
In Vitro Fertilization (IVF)
After the failure of the second IUI, the couple took a break. Then in the fall of 2011, they decided to try in vitro fertilization (IVF). Out of 11 eggs, they produced four good embryos. Two were implanted without success. "We were devastated," says Hammers, who is now 39. "We'd spent nearly $16,000, plus the expense of traveling to Houston 25 or 30 times."
After they tried a second IVF procedure in January 2012 with the remaining two embryos, they learned they were pregnant.
"Without TIRR Memorial Hermann and the support of Dr. Bertini, we would have been stuck forever," Kari Hammers says. "Dan's doctors told him after his injury that there was only a 50-50 chance he would be able to have a child."
Asked about his success rate, Dr. Bertini says the numbers are skewed by his selection process. "I tend to enter into the infertility challenge if there's a reasonable chance of success. There are a lot of barriers - expense, the couple's stability and the biological issues themselves. I get an ejaculate and review the results with the couple. In Dan's case, the quality of the ejaculate was good. Margaret and I work closely with our patients. We're tremendously excited about what's happening for Dan and Kari."
The Hammerses are thankful they found TIRR Memorial Hermann and Dr. Bertini. "First of all, the man is awesome," Dan Hammers says. "He's a doctor all the way, but he's very down to earth. He made both of us feel comfortable throughout the process. We're so glad we found him, and with the Lord helping us, we have our little miracle on the way."
The Hammerses welcomed their baby girl, Giada Claire Hammers on August 14, 2012. Congratulations!