When it comes to reproductive medicine, I’ve been around the block more than most.
I became a father to twin girls through IVF. Then, after years of chaotic parenting and marriage, I made the deliberate choice to get a vasectomy. Done. Finished. Or so I thought — until my wife casually floated the idea that a baby boy would be awfully cute. One thing led to another, and I ended up undergoing testicular sperm extraction, a second round of IVF, and somehow walked away with a son.
📋Table of Contents
IVF — Checking My Pride at the Door
People are getting married later. That’s just the reality now — most couples want financial stability before starting a family, which means they’re also starting that family older. It’s no surprise, then, that fertility clinics are busier than ever.
For us, a year passed after our wedding with no luck. I wasn’t prepared to keep waiting, so we decided to get help. And honestly? My pride took a hit. As a man, there’s something quietly humbling about accepting that nature isn’t going to cooperate on its own timeline. But when you want a child badly enough, your ego becomes a pretty small thing.
The process starts with a full evaluation of both partners. Blood panels for hormone levels, imaging and structural assessment for the woman, semen analysis for the man. The semen collection, I’ll admit, is exactly as awkward as it sounds — a small dimly lit room, a plush single-seat sofa, a screen playing adult content, and a cup. You figure out the rest. You tell yourself it’s for the baby. You get through it.
The harder road belongs to the woman, without question. My wife had to self-administer daily hormone injections to induce hyperovulation — essentially forcing her ovaries to produce as many eggs as possible — before having them retrieved at the clinic using a needle that is, by no one’s definition, small. Some women develop Ovarian Hyperstimulation Syndrome (OHSS) during this process, which can make it genuinely miserable. Every time I watched her go through it, I felt a mix of guilt and gratitude I still don’t have the right words for.
Once both samples are collected, the embryology team does their work — pairing the best-quality eggs and sperm, cultivating the resulting embryos, and vitrifying (flash-freezing) the strongest candidates for transfer. And this is where it’s worth saying: the embryologists and lab technicians deserve far more recognition than they usually get. Their precision determines outcomes just as much as the physicians do.
We tried once at a local fertility clinic without success. The second attempt, at CHA Fertility Center, Seoul Station, worked on the first try.
Vasectomy — Shopping Around for a Surgeon I Could Actually Trust
The moment I decided to get a vasectomy, my brain immediately served up an unwelcome memory: getting circumcised as a kid. Same general vicinity, same dread. Not rational, I know. But there it was.
The procedure itself is genuinely straightforward. Local anesthetic to the scrotal area, a small midline incision, electrocautery to cut and seal both vas deferens, one suture to close. That’s it. I’ve never performed one myself — it’s outside my specialty — but I understand the anatomy well enough to know that the procedure isn’t technically complex. What kept nagging at me was a specific, very reasonable fear: what if the surgeon nicks a vessel?
Being a patient has a way of reminding you why patients ask for experienced hands. So I did something I’d never done before in a medical context — I went clinic-hopping. I visited several urology practices near my home, explicitly introduced myself as an emergency physician upfront to avoid any awkward misreading of my questions, and asked each surgeon directly about their experience and their approach to the risks I was concerned about.
The responses were revealing. One doctor appreciated the candor and admitted, refreshingly honestly, that he hadn’t done enough of these to feel fully confident about vascular complications. Another took my questions as some kind of challenge and told me to leave. The third walked me through everything calmly, addressed my concerns without defensiveness, and made me feel like I was in good hands. I booked with him immediately. The procedure went perfectly.
What I didn’t expect from the whole experience was what it showed me about primary care in private practice. There are physicians out there operating well outside their comfort zone without ever acknowledging it to patients. That’s a problem worth knowing about — whether you’re a doctor or not.
Testicular Sperm Extraction — Caving to My Wife (Again)
Here’s the thing about vasectomies: they’re effective. And here’s the thing about my wife: she’s persuasive.
“A little boy would be so cute, though.”
And that’s how I ended up back at CHA Fertility Center, Seoul Station, this time to discuss how to extract sperm from a body that had been surgically prevented from releasing it. The first thing I noticed was how much the waiting room had changed — a noticeably higher proportion of international couples than I’d remembered. Korea’s fertility medicine has developed a quiet global reputation: the outcomes are comparable to anywhere in the world, and the costs are a fraction of what you’d pay in the US, UK, or Australia. Word gets around.
My two options were vasectomy reversal or surgical sperm retrieval. Reversal makes sense if it’s been under five years since the vasectomy and you want the option of future pregnancies without intervention. But for a one-time attempt with no desire to restore natural fertility, retrieval is cleaner. I chose retrieval.
The procedure mirrored the vasectomy in approach — local anesthetic, small incision, tissue sample taken from whichever testicle showed better ultrasound characteristics. Having gone through something similar before meant the psychological weight was considerably lighter than it was the first time. My wife, meanwhile, went through the entire ovarian stimulation and egg retrieval process again. Same injections, same side effects, same needle. She didn’t complain once.
One constraint worth noting for anyone considering this in Korea: sex selection is not legally permitted. We started this whole thing hoping for a boy, but the honest answer was that we wouldn’t know until implantation. We got lucky. A boy was confirmed, and our family quietly completed itself — two daughters, one son.
Final Thoughts — Living Between the Beginning and the End of Life
Emergency medicine means I spend most of my professional hours at the other end of the life spectrum. People arriving in crisis. Families in the waiting room, watching the clock. That’s the work.
But as a patient, I’ve somehow accumulated most of my experiences near the very beginning of life. The hushed corridors of fertility clinics, the careful movements of an embryologist at a lab bench, the particular silence that falls when you hear the words “we have a positive.” I experienced all of it not as a physician, but as a husband and a father-in-waiting.
Doctors make the worst patients. We know too much and trust too little. But there’s something genuinely valuable in crossing to the other side of the examination table — you stop abstractly understanding why patients need clear communication and start feeling it. When I sat across from that urologist who calmly answered every question I had, I understood in a different way why that kind of interaction matters. Not as a principle, but as a relief.
I live between the beginning and the end of life. Most days, that’s just a description of a job. Sometimes, it feels like something more.
📚 References
– Vollweiter D, et al. “Vasectomy reversal or assisted reproductive technology?” Urologe. 2024.
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