Born Without a Vas Deferens—and the Guilt That Followed

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.

This next reader shows a lot of self-awareness and self-reflection over the trying process he put his wife through, and what they endured together:

I have a genetic abnormality which results in the absence of the vas deferens (the duct which conveys sperm from the testicle to the urethra). This means that IVF—via medical extraction of sperm directly from the testicles—was the only way for my partner to get pregnant with our child. It also meant, ironically, that many prior years of contraception to avoid getting pregnant was pointless.

I still feel guilty about the IVF process my partner had to go through, which was entirely because of me. Lots of time consuming and distracting medical appointments. Lots of effectively voluntary medical procedures. Increased risk of various forms of cancer.

All I needed done was an extraction needle-gun shot into my testicles every now and then, to get the sperm out. (Although yes, that was as painful as it sounds—give me a basketball or a football to the groin any day.)

The IVF treatments became an obsession. Everything else —jobs, friends—took a back seat. We were initially cautious and put back one embryo each cycle, but it kept not working. Time was getting away from us (my partner was approaching 35), so we started putting two embryos in each cycle.

After half a dozen cycles—voila—boy/girl twins. We were grinning ear-to-ear coming out of that ultrasound room. It was a stressful, high-risk pregnancy, but in the end they were healthy babies born close to full term in the end.

But there was another thing to feel guilty about: That twin pregnancy did a lot of damage to my partner’s body. Fortunately only muscles and no internal organs or spine or anything, but still.

Again, because time was still running out, we crazily decided to go a few more times (my partner was approaching 40), but we were clever this time; we only put one embryo back each cycle. After a few cycles, the signs were good.

Then it was time for another IVF pregnancy ultrasound. You have never seen a couple so devastated by one of those ultrasound confirming a pregnancy—identical boy twins. (IVF increases the risk of embryos splitting, result in identical twin pregnancies.) Our existing twins were about to turn three.

More guilt, but this time for being disappointed when anyone else without children trying to fall pregnant would have been elated. It was a more stressful and even higher-risk pregnancy, but again we were fortunate to have healthy babies born close to full term in the end.


One thing which amazed us about the whole IVF process was how uneducated society in general was about fertility decreasing with age. Some well-educated friends of ours told us the first they heard of it was when they first told their doctor their intention to get pregnant and universally, the doctor’s response was something along the lines of “better get a move along then!”

IVF can be seen as an excuse delay pregnancy, but it shouldn’t be viewed like that at all. It should be viewed as a last resort. It is expensive, invasive and stressful. There are no guarantees it will work. We made some bad decisions (delaying having children; putting back multiple embryos; trying for a third baby) and had some very lucky outcomes. Not everyone is so fortunate.


My partner would have considered adoption, but I only wanted to have genetic children. But the moral dilemma of potentially passing on my genetic abnormality to any male children was an interesting one: When do you get a boy tested for the absence of the vas deferens? Do you really want an 18 year old running around thinking they’re bulletproof because they can’t get anyone pregnant? On the flip side, do you want an 18 year old having a masculinity crisis of confidence for the same reason?

We still haven’t decided when to tell our boys and/or get them tested, but we continued on regardless because we thought that at least IVF will improve in 20 years time, so our sons would always have it to fall back on, just in case.