What is infertility? By Jas Grewal Msc, Dr. Sonya Kashyap MD

Page 16In Canada, one-in-six couples are diagnosed with infertility.

Infertility is defined as the inability to achieve a pregnancy after one year of unprotected intercourse.

What can I do?

The best way to conceive naturally is to conceive naturally. This means that while you are trying have sex 2-3 times per week. Why not look into something like fertility pills, to help increase the chances of getting pregnant faster. Avoid lubricants, ovulation kits testing, cervical mucus testing or basal body temperature testing unless your cycles are irregular. If you want a completely natural method of conceiving then products like OvaLife supplements use natural ingredients to improve your reproductive health. You should avoid tests and lubricants because all of these interventions can add stress and stress can decrease your ability to conceive naturally. The sperm live for 2-3 days and the egg lives for 12-24 hours so it is better to have sex before ovulation than waiting for changes in the above tests.

Things to avoid:

  1. Smoking: decreased egg count for women and sperm quality for men.
  2. alcohol: more than 3-4 drinks per week has been associated with decreased fertility for men and women
  3. being over or under weight: this can interfere with ovulation. A healthy body mass index (BMI) is between 19 and 25. BMI higher than 30 have been associated with lower pregnancy rates even with treatment such as in vitro fertilization ( IVF).

When should you see a specialist?

Infertility can be daunting but sometimes the factors effecting infertility are easy to detect and treat whereas some may require further investigation.

Patients should consider having a fertility evaluation done by a Fertility Specialist if they have been trying to conceive for a year or more.

However, if a female patient is 35 years or older it is recommended to have an infertility evaluation done sooner than later i.e. typically after six months of unprotected intercourse.

If there are any causes for concern such as irregular menstrual cycles then patients are advised to seek care earlier to investigate any underlying problems.

It is important to find a reputable fertility clinic that you trust, are comfortable with and one that fits your needs.

What is a Fertility Evaluation?

A Fertility evaluation will typically include blood tests to measure hormone levels i.e. an AMH level test will provide information about the ovarian reserve. An ultrasound should also be performed to “ count eggs” ( antral follicle count) and look for abnormalities of the uterus or ovaries.

An evaluation of the Fallopian tubes and uterus with a special x-ray called Hysterosalpingogram (HSG) will often be performed to evaluate tubal patency.

How does infertility impact men?

As 40% of fertility problems are due to male factor, it is important for a male patient to complete

specialized sperm test to determine the quantity and quality of the sperm.

Treatment for male factor infertility may include antibiotic therapy for infection, varicocele repair (dilated or varicose veins in the scrotum) or duct obstruction, or medications to improve sperm production.

This information, along with the results of other infertility investigations, is used to individualize the best treatment plan to help you conceive.

What are my options if I want to delay pregnancy?

Delaying pregnancy is now a common choice for couples in today’s age. There are now a broad range of services available to help preserve fertility for future use. Women who wish to delay pregnancy can opt to have egg freezing done by vitrification or choose to have IVF with embryos frozen using her partner’s sperm or donor sperm.

There are many situations that could interfere with your future fertility. These may include treatments such as chemotherapy and radiation therapy for cancer patients, endometriosis, pelvic infections, and ovarian surgery to name a few.

Many men decide to freeze sperm as a safeguard against unforeseen future circumstances or before vasectomy.

How to get support?

Infertility is a medical condition that has many emotional aspects. Specialists understand that the procedures and sensitive questions involved in an infertility evaluation can be difficult. It is important to remember that you are not alone. It is always important to ask questions and express any concerns.You may also benefit from seeing an experienced reproductive health & fertility counselor who can help you cope with any challenges that may arise.

We can help. We want to help. Genesis Fertility Centre 604 879 3032.

7 tips to improve Fertility ( Sonya Kashyap)

  1. Don’t smoke
    With the depleting nature of ovulation, it is important to avoid things that accelerate the loss process. A common bad habit that many do not take into account with regards to their fertility is smoking. Both cigarette and marijuana smoke can negatively affect not only ovulation, but sperm as well.
  2. Take Coenzyme Q10 (CoQ10) daily
    Though further research is needed, studies have shown that supplements such as CoQ10 may assist egg quality.
  3. Decrease alcohol intake
    Consuming more than three to four drinks per week has been associated with decreased fertility in both men and women.
  4. Have sex
    Trying to conceive can become quite the stressful and unsexy process when you start including thermometers, ovulation kits and processes such as mucus checking in the bedroom. Stress can decrease natural conception, which is why it is important to take time to have sex for pleasure, not just conception, two to three times per week. Sperm also live for three days and the egg lives for 12-24 hours inside a woman’s reproductive tract, so do not feel rushed or pressured when trying to conceive naturally.
  5. Avoid hot water
    Hot tubs, hot baths and generally increased temperatures around the testicles can negatively affect sperm production. The external temperature that testicles typically find themselves in is ideal for sperm, so when it undergoes a drastic change the creation process is slowed.
  6. Do not hesitate to seek help
    If you are under the age of 35 and have been trying for a year with no results, it is important to consult with a physician right away to determine if there are underlying fertility issues you and your partner may not be aware of. Same goes for if you are between the age of 35 and 40 and have been trying for 6 months with no results. If you are above the age of 40 it is recommended you speak with a doctor as soon as possible, as conceiving naturally becomes more difficult at this point in life.
  7. Consider egg freezing
    If you do not plan on having children until later in life, freezing your eggs now can save you difficulty down the road. Substantial gains have been made in egg freezing technology, which have translated into more successful pregnancy rates.

From Fertility Authority August 12, 2013 written by Sonya Kashyap

You have just left your doctor’s office. She has told you that your best option for conceiving the child you so desperately want is to have in vitro fertilization (IVF). You look at the piece of paper the receptionist has given you with the name and contact information of the fertility clinic your doctor has recommended. You trust your doctor but there are so many questions! How do you know that this particular fertility clinic is the best place for you? There is a lot on the line here. Now, added to the physical, psychological, and emotional cost of infertility you are facing a significant financial cost.

Unfortunately, there are a very small number of provinces in Canada and states in America that provide coverage for fertility treatment. Ultimately, all fertility clinics are commercial enterprises competing for your business. Similar to being comfortable with your doctor, you want to feel comfortable with the fertility clinic that is providing your treatment. As a starting point, the websites of fertility clinics will provide information regarding services offered, statistics and fees. Statistics regarding success rates can be used as a marketing tool. Typically, high success rates will attract more patients. How to interpret success rates will be the subject of another blog however, knowing if the success rates have been independently verified is important. Fees also don’t necessarily reflect the quality of services provided. For example, higher fees may be a result of major investments to achieve high quality services.

In Canada, the medical systems of most provinces will cover the cost of consultant appointments and diagnostic tests leading up to in vitro fertilization. This creates the opportunity to get the “feel” of a fertility clinic before undertaking expensive fertility treatments.

Here are some questions to ask:

  • How long has the fertility clinic been open?
  • Who is the laboratory director and what is their reputation?
  • How experienced are the embryologists?
  • Are the pregnancy statistics independently verified?
  • Has the consulting doctor at the fertility clinic completed a reproductive endocrinology fellow ship? Where, and are they board certified?
  • Is there psychological counseling support available?
  • What nursing support will you receive during your fertility treatment?
  • Does the fertility clinic have accreditation through a governing body?
  • Can they understand you and be compassionate both medically and culturally?
  • Here are some observations to make:
  • Are your questions being answered to your satisfaction?
  • Do you feel you have a connection and that the fertility clinic feels like a good fit for you?
  • Do you feel like the fertility clinic team is fully invested in your outcome?

There are likely other questions will want to ask in relation to your personal situation. Having as much information as possible before making that all important decision will help.