Genesis Fertility Clinic Blog
July 20, 2010Quebec IVF Funding
As of August 5, 2010 the Quebec Provincial Health Plan will cover the cost, including medications, of three IVF cycles. There remains much to be sorted out, for example whether there will be an age limit, whether additional IVF cycles will be funded if a child is born from IVF, how will a wait list be managed?
While the details remain to be clarified, this is a very exciting and important opportunity for people in Quebec. We are watching closely and continue our efforts in BC to have IVF and other similar fertility treatments funded here, like they are in BC.
Stay tuned to see how things unfold in Quebec. Exciting times….
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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July 10, 2010New Doctor Joining Genesis!
Dr. Sonya Kashyap is joining Genesis! She will be the fifth member of the physician team. To say I am excited that she is coming is an understatement. Dr. Kashyup is energetic, well educated, kind and experienced. She has already published more research papers than most REIs publish in their careers. She has been in practice at the University of California in San Francisco but decided it was time to return home to Canada. I am looking forward to having her share her experience at another large, successful IVF clinic.
To be a top IVF clinic you need to have an excellent lab, competent staff, smart doctors and to be constantly examining the research literature to learn new ways to do better. Dr. Kashyap not only has several ongoing research projects in IVF but is known to be “on top of the literature” as we say.
She starts August 16th. She truly will be a great addition to the Genesis team.
I’ll post more as her arrival approaches. You can read more about Dr. Kashyap here.
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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July 5, 2010Home inseminations
Two patients in one day is not a pattern. It might just be a fluke, but it does make me wonder. Today two of my patients had a positive pregnancy test who had been trying to conceive with a known donor at home for at least a year. Single women, women whose husband’s have poor or no sperm, and lesbians will sometimes use sperm from men the know, at home, to conceive. We call the men “known donors.”
It’s not a recommended practice as known donors used at home are not screened like unknown/anonymous sperm donors are for infectious diseases, drug use and genetic conditions. So, it can be risky. It can also be harder to conceive. The semen is ejaculated by the known donor, put into a cup or syringe and then inserted into the vagina. It might cool down (cooling damages sperm), be placed too low in the vagina or be of poor quality such that conception is unlikely.
I don’t have a sense of how many women are using known donors for home insemination. Not many come to the clinic with a donor they want to use because the screening of the donor is complicated and involves a 6 month quarantine of their sperm at a lab in Toronto before inseminations can begin. For some women this “hassle” serves as a barrier and instead they just try home vaginal inseminations.
When women have been using a known donor for a while and haven’t conceived and then conceive the first time they use anonymous donor sperm at the clinic it does make me wonder about the technique they were using at home and/or the quality of the donor’s sperm.
The good news is two more women learned they were pregnant today. They might have learned they were pregnant a year or more sooner if they had a different donor or different technique to try and conceive.
Live and learn. Thoughts for the day!
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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July 3, 2010Health and relationships
With the HST, school-board funding cuts, and numerous other political bad news stories many of us are disillusioned with government these days. There is a small good news story, however. The provincial government is introducing a new initiative that focuses on the relationship between health care providers (e.g. family doctors) and patients. The concept is that if patients have meaningful, trusting relationships with their health care provider they will have better health outcomes. They assert that care happens within relationships built over time and providing care, as opposed to delivering depersonalized “units” of health service, makes people get better faster, and feel better about their care, while bringing deeper meaning to the work of providers.
You can read the Vancouver Sun report here.
The government is trying to help people who want a family doctor find one, help family doctors communicate with other physicians more efficiently and improve patient’s relationship with their physician.
There is no doubt in my mind that if a patient interacts with their physician over time in a positive way, trust is built, both parties understand each others needs better and testing/technology/treatments are better personalized.
For more information the BC Medical Association’s report on this initiative can be read here
Some good news out of the legislature! Now, if they could legislate some sunny days….
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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June 20, 2010Osteoporosis
Ok, infertility and osteoporosis aren’t intimately related, but as a “public service announcement” I thought I’d post that all women should be taking about 1,000 – 2,000 IU of vitamin D per day (depending on how much vitamin D you get in your diet and from the sun).
On Saturday I gave a lecture at a Women’s Health Symposium for physicians, and the speaker before me was an osteoporosis expert. He reviewed the (new) Canadian guidelines for vitamin D intake. The Osteoporosis Society, Cancer Agency and a few other international organizations have recommend that we supplement between 1,000 – 2,000 IU daily. Most recommend 1,000 IU. Also, we should be consuming 1,000 mg of calcium per day – many of us get at least some of that from our diet so may need to supplement less.
The way Vancouver’s weather has been, we can’t rely on getting much vitamin D from the sun!
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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June 16, 2010AMH
Fertility declines with age because egg number and quality decrease over time. This happens to all of us (unless you are a celebrity it seems! Ok, that’s a donor egg discussion I’ll leave for another entry).
To get a sense of how many eggs a women has left, and therefore how long she might be able to conceive, we test “ovarian reserve.” In general the two most commonly used and reliable tests are day 3 FSH and Estradiol levels and an ultrasound to count antral follicles (antral follicle count; AFC).
At Genesis we typically combine the information we get from the FSH level and AFC to get a sense of how many eggs are left – are you running low or do you have a good number for your age? You can read more about ovarian reserve testing elsewhere on this site.
There are other tests of ovarian reserve. It seems every few years a new one pops up, but until recently none has proven to be better than the FSH and AFC combination. Recently, anti-mullerian hormone (AMH) has been examined in large populations of women. It seems to be as good (some argue a little better) than AFC and FSH combined. I don’t think it’s better, but it can be helpful if the FSH and AFC are borderline or inconsistent.
It’s now available in BC through Lifelabs but for a fee of $225. I suspect in time it will be covered by MSP, but we’ll see.
FYI
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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June 8, 2010How do people choose a clinic?
Driving down the strip in Las Vegas this past weekend while on vacation I heard an advertisement on the radio for a fertility clinic. My gut reaction was “ugh.” It sounded like they were announcing a mattress sale or deeply discounted used cars. It just didn’t feel right, and it made me wonder how many people choose a fertility clinic based on similar advertising.
In Canada, most doctors and clinics do not advertise. The main reason is medical advertising is generally frowned upon by provincial medical regulatory bodies (e.g. The College of Physicians). They loosened the rules from prohibiting advertising to allowing it for public information a few years ago. As a result, we see and hear more medical clinics advertising.
The reason advertising doesn’t feel right for me is that I hope people choose their physicians based on a physician or clinic’s track record of consistently good outcomes, their integrity and quality of care. I hope people hear this from their family doctor, friends or family — not from a paid announcer in a radio ad.
I hate to think that someone would get lower quality care because they listened to an advertisement instead of doing research on their physician/clinic to find out who is best for them.
Am I misguided?
Dr. Beth Taylor MD, FRCSC
Reproductive Endocrinology & Infertility
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May 30, 2010Lubricants
Olive oil, KY Jelly®, saliva, baby oil, FemGlide®, Astroglide®, Replens® are commonly used sexual lubricants and have all been shown to reduce sperm motility and thereby reduce fertility. All should be avoided by couples trying to conceive. The only “sperm friendly” lubricant shown to have no significant impact on sperm motility is Pre-Seed®. It’s not widely available in Canada for unclear reasons. You can buy it at Genesis though.
It does not enhance fertility. It’s best to avoid all lubricants if possible, but some couples require a lubricant for intercourse, so Pre-Seed® is a good option.
Just a little FYI….
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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May 28, 2010Pregnant at 47
John Travolta’s wife is pregnant at the age of 47. I bring this up because daily since the news broke a patient who is aged 43-50 has asked me how they could get pregnant yet she can’t.
CNN has an on-line article that discusses this issue which I found refreshingly accurate.
Is it possible she conceived with her own eggs? Yes. Is it likely? No.
It’s not her obligation to disclose how she conceived, but it is an obligation of infertility specialists to inform the public how someone typically gets pregnant at age 47 (donor egg). It’s important that women don’t wait to conceive out of a belief that conceiving at 47 is possible, probable, or even easy. As long as we all have realistic expectations….
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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May 16, 2010Infertility Awareness Week
May 16th to 22nd is Canadian Infertility Awareness Week. There are several events to raise awareness of infertility, including a webcast and public forum here in Vancouver.
The Infertility Awareness Association of Canada’s (IAAC) website is a valuable resource for information about this important week and infertility issues in Canada.
I am speaking at a public forum along with IAAC’s Executive Director Beverly Hanck, Lorne Brown, a Chinese Medicine specialist, and Sue Dumais, a mind-body specialist, about infertility on Wednesday, May 19th. The event is at the Vancouver Public Library, downtown from 6:30 to 9:00pm. It’s free to attend and will be webcast. More information is available at the Family Passages website.
Raising awareness can help couples access care, help remove the stigma of infertility, and promote infertility as an important disease to government.
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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