For a year, Derin Gebhardt and his wife, Sandra, tried every took and trick in the book to have a baby, religiously using a basal body thermometer to track ovulation and keeping an eagle-eye on Sandra’s menstrual cycle – but with no luck.
Meanwhile, Derin’s physique was changing, inexplicably.
He was a volunteer firefighter, and devout to eating only his home-cooked meals, yet Derin’s active, nutritious lifestyle was doing nothing to stop him from gaining weight.
A trip to the family doctor in the couple’s hometown of Roundup, Montana, in early 2017, revealed that Derin’s testosterone levels were low.
There were a few possible explanations, but biomarkers in Derin’s blood pointed toward one that confounded the couple: a brain tumor.
One week later, the Gebhardts learned that Derin, 37, had a benign mass, called a pituitary tumor, in his brain.
The pituitary gland is crucial to the body’s regulation of testosterone and semen production, and the tumor was interfering with the hormones the gland produced, resulting in Derin’s fertility and weight issues.
The couple sought treatment at the Mayo Clinic in Phoenix, Arizona, where doctors first prescribed Derin medication to shrink the tumor, and then performed surgery to remove it.
Six months into treatment, Sandra became pregnant and, in June 2018, their son, Gage, was born.
Gage will be turning one year old this month and the couple tells DailyMail.com that they never Derin would need to undergo brain surgery in order for them to have a child.
Derin Gebhardt, 37, from Roundup, Montana, and his wife, Sandra, 38, tried getting pregnant for a year between 2016 and 2017 with no luck. Pictured: Derin (right) with Sandra and their son, Gage
After undergoing tests at their family doctor, Derin discovered that his testosterone levels were low and that he might have a tumor. Pictured: Derin with Gage
In March 2017, Derin was diagnosed with a pituitary tumor, a benign tumor that grows on the pituitary gland in the brain. Picture: Scan of Derin’s brain
Sandra told DailyMail.com that she first saw Derin online, during a Facebook campaign set up by his friends to get him on NBC’s The Biggest Loser in 2010.
He wasn’t cast in the show but, months later, Sandra learned they had mutual friends.
‘He popped up in a picture [on Facebook] with one of my nephew’s moms,’ Sandra, 38, said.
‘She was trying to set me up with somebody – and it turns out it was him – and I was like: “I know who he is. I have a bit of a cyber crush on him”.’
The couple immediately began dating and married in March 2014.
After they got married, Sandra noticed that Devin was still putting on weight despite eating home-cooked food and living an active lifestyle.
‘I was doing all the cooking and he was active,’ she said. ‘I said: “It doesn’t make sense why you keep getting weight.” I think at his heaviest, he was 460 [pounds].’
Visits to several doctors confirmed that Devin had high cholesterol and high blood pressure, and was pre-diabetic, but not what was behind these conditions.
The tumor was inhibiting Derin’s testosterone and semen production, and was also behind his weight gain. Pictured: Derin and Gage at the Roundup Volunteer fire station
During this time, Sandra and Devin were also trying for a baby. For about a year they tried, unsuccessfully.
‘I had the thermometer [to check my ovulation], charts, all the research from websites,’ Sandra said.
‘It was definitely frustrating. There was a lot of frustration and humiliation, and Derin was as down as I’ve ever seen him.’
Derin said the struggle to conceive spun him into a depression-like state.
‘There’s obvious frustrations when your body doesn’t work the way it’s supposed to,’ he told DailyMail.com. ‘I figured that it was all a product of the way I had been living.’
The couple seemed, at one point, resigned to the fact that they would never have a biological child and started discussing adoption.
‘There were talks about whether we would adopt an infant or an older kid who needed a home,’ Sandra said.
During a routine visit to his family doctors, the Gebhardts had Derin’s testosterone levels checked and found they were quite low.
‘The doctor said he didn’t know they could even go that low,’ Sandra said.
Derin had a blood test performed, and the doctor delivered some shocking news: there was a chance Derin had a tumor, but the blood work need to be sent off to confirm the results.
One week later, while the couple was on vacation with friends in Mexico in March 2017, they learned that Derin had a pituitary tumor.
Pituitary tumors are benign tumors that grow in the pituitary gland in the brain.
The tumors are relatively common, with about 10,000 diagnosed each year in the US, according to the American Cancer Society.
‘Think of the pituitary gland as a bit of a symphony conductor,’ Dr Bernard Bendok, Derin’s neurosurgeon at the Mayo Clinic, told DailyMail.com.
‘Hormones are so critical to regulating body function, and what can happen sometimes is that the cells in the pituitary can overgrow.
‘This can either overproduce a hormone, which can affect other hormones, or [tumor] cells can push on the pituitary and suppress hormones.’
Doctors at the Mayo Clinic in Phoenix, Arizona, prescribed medication to shrink the tumor in May 2017. Pictured: Derin and Sandra sleeping at the Mayo Clinic, date unknown
Derin was told he need to lose weight before he could have surgery. He started living in ‘Sandra starvation’ mode in May. Just five months later, in October, he had lost 80 pounds. Pictured, left and right: Derin and Sandra
In Derin’s case, he was producing too much prolactin, a hormone that can stimulate breast development.
But, in men, high prolactin levels can impair testicular function, and affect testosterone levels and sperm production.
‘The other thing it does is it results in severe weight gain, which adds to the inability of Derin and his wife to have a baby,’ said Dr Bendok.
Derin and Sandra said that, despite the crushing news, they were relieved when they received his tumor diagnosis.
‘It gives me a relief because at least we have a reason I have all these problems and you have an action plan on how to deal with what’s in front of you,’ Derin said.
Sandra added: ‘It was, devastatingly, the best news we ever had.’
The couple went to work on researching hospitals and settled on the Mayo Clinic in Phoenix because Derin’s sister works there, and they hoped she might be able to help them get an appointment more quickly.
At the first appointment in May 2017 with an otolaryngologist, Derin was told he was too heavy to operate on so he would need to lose some weight before they could perform surgery.
In the meantime, he was prescribed bromocriptine, a drug that decreases prolactin secretion and shrinks tumor size.
Derin was put on what he and his wife called the ‘Sandra starvation diet’, where his wife counted every calorie and tracked everything that he was eating.
‘Sandra packed all my meals, and the diet was miserable,’ he said. ‘But it’s something you have to deal with. I wanted to be a candidate for surgery in the next few months. I was in a time crunch.’
In December 2017, Derin had surgery, which involves an endoscope that is inserted through the nostrils. Pictured: Derin outside the Mayo Clinic
Derin’s recovery went smoothly and within a couple of weeks, the Gebhardts was cleared to return home to Montana. Pictured: Derin and Sandra, February 2018
Derin started living in ‘Sandra starvation’ mode in May. Just five months later, in October, he had lost 80 pounds.
In mid-November, he and Sandra learned that she was pregnant.
‘We were, honestly, very excited,’ Derin said. ‘I’d been praying for it for a long time. I was not surprised, but very thankful.’
Finally, after all the hard work, in December, he underwent surgery.
Dr Devyani Lal, a professor of otolaryngology at Mayo College of Medicine and Science – who treated Devin – says the procedure involves using an endoscope that is inserted through the nostrils.
It’s life-changing, but ultimately not that invasive.
‘There are no cuts, no bruises,’ she said. ‘We create a passageway by removing tissue that gives access to the tumor, but does not change facial structure or appearance.’
Derin’s recovery went smoothly and within a couple of weeks, the Gebhardts were cleared to return home to Montana.
Sandra learned she was pregnant in November 2017, six months into Derin’s treatment. Her pregnancy went smoothly and gave birth their son, Gage (left and right), in June 2018
Gage will be turning one year old this month, a week after Derin celebrates his first Father’s Day. Pictured: Sandra (left) and Derin at Gage’s baptism
Six months after going home, Sandra gave birth to the couple’s son, Gage, six weeks early on June 25.
Even though Gage’s arrival was early and unexpected, the delivery itself was smooth and free of complications.
After a harrowing, medical whirlwind the couple has a happy, healthy baby who is about to turn a year old – and Derin has a tumor-free first Father’s Day to look forward to.
The couple, and the doctors from the Mayo Clinic, say that although many people don’t think of infertility as the traditional first sign of tumor, it’s important for couples to cover all their bases.
‘The symptoms can be subtle or there may be lack of knowledge’ said Dr Bendok. ‘It’s not the first place people look when they can’t have a baby, but it’s important to get it checked out.’
Derin says he also wants to encourage others to see healthcare professionals.
‘If you think you know something could be wrong you should get checked out,’ he said. ‘If you don’t like what you hear, get a second opinion or a third opinion.’