Ask A Fertility Expert
Education and Advocacy Dr. Heather Shapiro sits down with Mediaplanet to answer questions about fertility, infertility, and getting pregnant.
On Oct. 1, Health Minister Dr. Eric Hoskins confirmed the government’s plans to fund a single cycle of in vitro fertilization (IVF) in Ontario. What are the details surrounding the program and what does this mean for patients?
People with fertility issues, regardless of the cause, and regardless of their sex, gender, sexual orientation, or family status have government support for one cycle of IVF — excluding the cost of medication. This support will ease the financial burden for people, but not completely eliminate it. Not everyone has benefits that cover the drug costs (averaging $5,000–$6,000), nor will everyone be successful in one try. Given the need for IVF, relative to the budget allocated, treatment may not be immediate for everyone. Wait times for people who are self paying will not be affected.
What therapy options are available for infertility? How much time does each treatment require?
Fertility treatments need to be personalized. Medical, emotional, interpersonal, and financial needs must be taken into consideration when patients and their doctor make a plan. Sometimes advice as to when the most fertile period is will suffice. Other times, surgery for either the man or woman might be required. Commonly, couples choose fertility drugs that increase the number of eggs produced combined with sperm inserted into the uterus. If this option is unsuccessful, IVF is usually the next step. The chance of pregnancy in each individual try varies depending on the treatment, and the woman’s age, and her response to medication. Couples often choose to try another treatment if there is no success after three attempts.
What are the causes of infertility in females? In males?
Sometimes there are obvious causes for infertility such a low sperm count (or even no sperm), or blocked Fallopian tubes or irregular periods. These are generally not age related. However, most commonly, the explanation is not clear and is presumed to be related to poor quality egg production. This outcome is often a result of ovarian aging. It is also not uncommon for a couple to have more than one factor contributing to their difficulties. That is why it is important to do full testing on everyone.
What type of screening requirements are needed before a patient can start an IVF cycle? Is there an age cut-off?
Women should ensure they are immune to rubella and varicella. IVF laboratories will want to know if there is any risk of infection from hepatitis or HIV. The doctor will need to determine the proper dose of medication based on blood and ultrasound testing of the ovaries’ function, and will check to make sure the uterus is normal by either a special ultrasound or by looking in with a camera. Fertility declines with age, even when advanced technologies are used. North American and worldwide statistics would suggest the chance of having a healthy baby when the woman is 42 or older is less than 10 percent.
