Genesis Fertility Clinic Blog
searching: “clinic”
June 20, 2010
Osteoporosis
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
Save to Delicious · Share to Facebook
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
Save to Delicious · Share to Facebook
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
Save to Delicious · Share to Facebook
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
Save to Delicious · Share to Facebook
May 9, 2010Mother's Day
Mother’s Day can be a particularly painful day if you are infertile. An American Infertility Awareness Association speaks to the difficulties the day can bring for women and some tips to make it better. Read here.
Here’s hoping the day brings joy and hope….
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
Save to Delicious · Share to Facebook
January 3, 2010Public Vs. Private Health Care
Nearly every week either a patient or someone I meet socially will ask me whether Genesis is a “private health care clinic.” The short answer is “no.”
According to Health Canada, private health care clinics in Canada are “facilities that receive no government funding: the physicians are not reimbursed by the provincial health care insurance plan and their patients must pay the full cost of the services rendered to them.”
At Genesis, we are fully within the public health care system, i.e. MSP. The catch is that not all the services we provide are covered by MSP.
I admit that the public versus private health care issue is a bit confusing as there are gray areas. The health care system in Canada is publicly funded but mostly privately delivered. Most people are treated by physicians who are in their own private practice (including your GP). This means that they are not paid a salary by the government, but they bill MSP for your medical treatment rather than charging you directly.
We are just like any other physicians or medical clinic in this regard: we see you at Genesis and bill MSP for treatments they cover. This includes your consultation with us, surgery, ultrasounds to monitor menstrual cycles, and emergency room treatment. Even your fertility tests are covered by MSP. There are a number of treatments that are not covered by MSP and these include IVF, some sperm tests and artificial/intrauterine insemination. The reason for this is that Health Canada has decided that:
… a number of services provided by hospitals and physicians are not considered medically necessary [including vitro fertilization and artificial/intrauterine insemination] and, thus, are not insured under provincial and territorial health insurance legislation. Uninsured physician services for which patients may be charged differ from province to province.
At the moment, Quebec is the only province that plans to covers IVF (likely starting in the spring 2010). However, there has been some promising progress in Ontario as a report released in August 2009 by the The Ontario Expert Panel on Infertility and Adoption proposed that Ontario health care should fund up to three treatment cycles and one session of counseling. The report argues that health care costs would be reduced by funding and regulating IVF. Currently, these recommendations are being reviewed by Ontario healthcare (OHIP), and if they were adopted that would put pressure on other provinces to follow suit.
At Genesis, we have been long-time advocates for IVF to be funded by public health care, and Dr. Albert Yuzpe sits on a national board that is lobbying the government.
We are committed to promoting reproductive health and advancing fertility treatments. In addition to caring for our patients at Genesis, we work at VGH and BC Women’s providing gynecology services and teaching medical students and residents.
And while it doesn’t help you if you are trying to conceive with IVF or other uncovered treatments now, we do hope that our efforts are going have an impact on the delivery of fertility treatment in the future.
Because the decision to fund or not to fund fertility treatments is largely political, public pressure on both your MLA and on the BC’s health minister Kevin Falcon may help bring about change. If you want to express your views on the need for public funding for fertility treatments like IVF, you can e-mail Kevin Falcon at Kevin.falcon.mla@leg.bc.ca
Dr. Beth Taylor
Reproductive Endocrinology & Infertility