Apr. 04, 2010
"It's time to wash the sperm," says Zeki Beyhan, rendering the list of sentences I never thought I'd hear one shorter.
Beyhan, 44, is an embryologist at the Sher Institute fertility clinic and my tour guide for one of the weirdest and most fascinating adventures in this series. He hands me a test tube containing 2.5 milliliters of exactly what you think it is. It was self-extracted about an hour ago by a patient in his late 30s -- in a restroom containing a couch and reading material significantly unlike that in the waiting room.
In two more hours, Dr. Jeffrey Fisch will introduce the sample to the patient's partner in a process called intrauterine insemination. But not before Beyhan and I process it first.
I've helped to create a lot of things in my life, but another life has never been one of them. And that's not for lack of trying. In fact, my wife and I tried for two years before she tired of repeated relations with me with no upside. Researching fertility treatment was how I discovered the existence of the only job I am willing to try that involves handling what's between my thumb and forefinger right now.
"Now place it in the centrifuge," Beyhan says.
Washing sperm means spinning them really fast. During the process, an added colloid of tiny silica beads separates the weak warriors from the strong ones more likely to result in an addition to the family that grows up resenting your authority.
About 10 percent of U.S. women (6.1 million) ages 15 to 44 have difficulty getting or staying pregnant, according to the Centers for Disease Control and Prevention. The Sher Institute's valley branch sees about 600 couples per year.
"The best part is giving them hope," Beyhan says. "Not all of them, but at least a good percentage are walking out of here with a baby."
The success rate for intrauterine insemination, according to the CDC, is 12.5 percent. But at $1,000, it's cheaper than in vitro fertilization, in which eggs are fertilized outside the womb and then implanted. This costs about $10,000 and, according to the CDC, is about 50 percent successful for fresh embryos, 30 percent for frozen. (Beyhan's duties also include injecting sperm into eggs during in vitro fertilization.)
"Gently," Beyhan tells me.
Spilling another man's seed upon the ground would be a really big oops for me, but it's not the biggest one possible for an embryologist. Last September, an Ohio woman gave birth to a 5-pound, 3-ounce boy that wasn't hers because of a fertility clinic error. Embryologists are never more than one misplaced embryo away from involuntary retirement.
"Fortunately, we haven't had that happen here, and we hope it never will," Beyhan says.
Just to make sure, every sample is labeled and color-coded for each patient. Ours is red.
I close the lid of the IEC Centra CL2 and press its blinking green button. A slowly building whoosh signals the start of a 15-minute cycle. Beyhan ignores my joke about when to add the fabric softener.
Like many embryologists, Beyhan began in the animal field -- as did the technology we're using, which was invented to breed livestock.
"How we treat the sperm is exactly the same," Beyhan says.
Beyhan -- who sired two kids of his own, au naturel -- earned a veterinary degree in his native Turkey. Instead of practicing, however, he moved to the United States in 1995 for graduate work in reproductive endocrinology. He was teaching animal science at Michigan State University when the recession hit.
"Having tenure was rather tough, and I said, if I have the chance, I'll move to the human field," he says.
The pay is better, he says (as much as six figures annually), and none of the animals Beyhan ever helped impregnate openly wept or named their firstborn after him.
"Although I don't think any people named their son Zeki, either," Beyhan says.
The sperm is done. The whooshing sound stops. Unlike my mother's old Maytag, there is no buzz.
Our prewashed sample was 44 percent motile (alive and swimming). Earlier, a microscope connected to a computer revealed a cross-section of hundreds of sperm. Most stood still, but some darted around on little sperm errands, while others moved in hopeless circles. (I suspect I came from one of these, because that's how I spend most of my day.)
"It's a little less than we want to start with," Beyhan said, "but not that big of a deal." (The best samples are at least 50 percent motile.)
The problem with my warriors (since you didn't ask) is high morphology. They're motile enough, but they're funny-shaped. My jokester friend Roy asked if that meant they had big heads with small bodies and highlighted hair. ("They're not funny-shaped," he said. "They're just Corey-shaped.")
Beyhan removes the bad guys from our sample. They have risen to the top -- just like in middle management. Getting rid of them clears obstructions for the good guys, who arrive at the egg healthy -- although probably a little dizzy.
Beyhan dabs another speck onto a glass slide to check for improvement. He has good news. The computer shows 89 percent motility.
Our part of this procedure was a complete success. Although we won't know for sure to hand out cigars until after this article publishes, Beyhan says "we've done all we can do."
He extends his hand for a shake.
Fear and Loafing runs on the first Sunday of every month in the Living section. Levitan's previous adventures can be found at www.fearandloafing.com.