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Baby Makes Three

Rocky Walker is a man’s man: He’s a muscular, tattooed, Harley-riding prison guard who lives in the blue-collar town of Bakersfield. But masculinity doesn’t exempt someone from needing male fertility treatment.

When Rocky and his wife Valerie Valdez decided to have a baby and were having difficulty getting pregnant, they had an idea of what might be the problem. Five years earlier, he had started feeling fatigued and gaining weight. At the gym, he could barely do a single push-up. He went to his doctor and found out that his testosterone was low, so he was put on a testosterone supplement gel.

While this treatment helped him feel like himself again, it also lowered his sperm count — an effect that many people are not aware of. They thought that perhaps the low testosterone, combined with the trouble conceiving, meant he also was dealing with a lack of sperm. A home sperm test confirmed their fears, and Rocky felt resigned to accept that he wasn’t meant to produce a child.

Valerie wasn’t going to give up that easily. A nurse for the Bakersfield City School District, she searched the internet and found that a male fertility specialist from Keck Medicine’s USC Institute of Urology, Mary Samplaski, MD, regularly sees patients in Bakersfield. Dr. Samplaski, assistant professor of clinical urology at the Keck School of Medicine of USC, is an internationally recognized expert in male infertility, andrology and microsurgery. She spearheaded the Male Infertility Program at USC in 2015.

“I pretty much figured, well, that’s just how it is,” Rocky says. “I was born sterile and that’s just life. Valerie wanted to find a local doctor to see if there was any hope there. I told her, ‘How can there be hope if there’s already a test that says zero sperm?’ But she’s the more hopeful person. She said, ‘Well, let’s just go talk to the doctor and see what happens.’”

A year later, what happened was that the couple had a healthy baby boy they named Alex. For Rocky and Valerie, it had been about a year before they sought help. Rocky was apprehensive going into his male fertility appointment after searching the internet and seeing the invasive methods that can be used to extract sperm in difficult cases. Valerie made the appointment and drove him there to be sure he went.

However, once he arrived, Dr. Samplaski quickly put him at ease.

“When I started talking to Dr. Samplaski, she spoke to me like she was my next-door neighbor, like a real person,” Rocky says. “During my first visit, I sat in her office for quite some time talking about both medical and non-medical topics. She made me feel extremely comfortable in believing that we would eventually have a baby. There were no sharp objects going near my testicles. We merely had a conversation about my low testosterone, and from that she identified the problem.”

“In men with Rocky’s condition, infertile after treatment with testosterone replacement, most of them will have resolution of sperm to the ejaculate with medical treatment,” Dr. Samplaski says.

The testicular gel he had been using was indeed bad for sperm production. Dr. Samplaski switched his medication, and that’s all it took. His testicular function recovered, both with respect to sperm and testosterone function.

“Not all doctors know that these medications can hurt sperm production,” Dr. Samplaski says. “Some doctors think you should treat infertility with testosterone, which is exactly the wrong answer. Testosterone has actually been investigated as a male hormonal contraceptive.”

Rocky couldn’t believe it was such an easy fix.

“That was quite a relief when she said it would likely be simple little pills that would cure me,” he says. “I was like, ‘Oh, no knives, no digging in, no cutting? I’m down for that.’”

He was in even greater disbelief three months later when Valerie woke him up at four in the morning shouting that she was pregnant. Rocky had reached his late 30s unsure if he wanted to have children, but that quickly changed.

“I knew he felt that way, but I had seen him before with his nieces and he always had this really good bond with them, so I always thought he was going to be a good dad,” Valerie says. “It turned out that I was right. It’s been amazing to see how much he loves Alex.”

Like many people, he wondered if he could continue living his life while taking care of another. Having Alex completely altered his perspective.

“I don’t know what life would be like without him,” Rocky says. “I’m quite glad he’s here. Raising a child that’s happy to see you when you come in the room is an incredibly uplifting feeling.”

Even though Dr. Samplaski’s work was done early in the process, she stayed involved by keeping in touch with Rocky to get status updates on Valerie’s pregnancy and Alex’s birth.

“She does a lot of follow-up work, and still today she emails me here and there to see how I’m doing and asks for pictures of the baby,” Rocky says. “She’s so friendly, outgoing and easy to talk to. I think she’s just super nice and super helpful, and a really genuinely caring individual. She is also incredibly intelligent and skilled at helping men become fathers: I think this combination is important for fertility issues.”

“Every time I get an email from a patient saying they’re pregnant with an ultrasound or with a picture of their newborn baby, it’s special because I know what they went through,” Dr. Samplaski says. “Every single person who struggles to have a baby knows how heartbreaking it is, and so helping them overcome that is a beautiful thing.”

In the three years since Dr. Samplaski started the male fertility program at Keck Medicine, Rocky is the first patient who has been interested in sharing his journey. Many men are afraid to talk publicly about infertility issues. These are deeply personal issues, which can be emasculating and scary to share with the world. Dr. Samplaski says. “Women are much more willing to talk about their fertility struggles.”

Dr. Samplaski encourages men to get checked for fertility issues, even if they don’t have immediate plans to have a child, because emerging evidence shows that infertility may be the marker for other underlying non-fertility medical issues.

“If you take all the men who have a male fertility evaluation, about 5 percent will have some underlying condition that could be a threat to their life — including testicular cancer, prostate cancer or thyroid issues,” Dr. Samplaski says. “So the underlying issue that’s hurting their sperm production would have otherwise have gone undetected.”

Rocky doesn’t mind if he gets a little ribbing from his fellow corrections officers at North Kern State Prison. He wants to encourage them and males everywhere not to be afraid to see a male fertility specialist if they’re having trouble conceiving.

“Stop with your egotistical pride and go check it out,” Rocky says he would tell those men. “It doesn’t hurt to walk into some place, and you might find out that you like it there, the way I found out that there was a way for me to both have a baby and keep my testosterone.”

He also likes the result of his visit — a future hog-riding bundle of joy.

By Matthew Kredell

Keck Medicine of USC is the University of Southern California’s medical enterprise, one of only two university-owned academic medical centers in the Los Angeles area.