For now, it doesn’t have to. Today, Zika is not endemic to North America, so if neither you nor your partner travel outside of Canada, there are no direct concerns.

But many of us do travel.

If women have been to an endemic area, regardless of symptoms, Health Canada had been recommending birth control for 2 months. For men, it has been 6 months. Based on this advice, we have been refusing active treatment to patients who do not meet these criteria. The most up to date information is from March 2016 here.

But are we really saying that if men go to Mexico for a week, they cannot become fathers for six months? It’s a bold stance, one that could be more difficult to sustain when, it is anticipated, the lower US states become endemic this summer too.

What are “endemic areas”? Health Canada is keeping a list here and as of today, the United States isn’t on the list. Specifically, there are 0 endemic cases in the US as of April 13, 2016.

But the southern states are widely predicted to be endemic by this summer 2016. What does “southern states” mean? Does it mean, for example, you should not be visiting the US at all this summer, while trying to conceive? Does it mean a business trip to Houston in July means you cannot conceive until December?

No, it doesn’t mean that… not yet. The US isn’t considered endemic at this time, and I cannot help but think that Health Canada is going to revise its guidelines to account for personal responsibility and independent risk assessment. The United States too — where the issue is going to be very topical in the months ahead — is very publicly wrestling with their own advice for women hoping to conceive. For example, see this NYTimes article.

Information is changing quickly with regards to Zika. I will continue to do my best to keep you informed as to what it means for Canadian patients hoping to conceive.

Ultimately, we will defer to Health Canada recommendations, which can be found here. We continue to advise couples and individuals hoping to conceive to not travel to areas with endemic Zika exposure. There isn’t any treatment we can offer (IVF, for example) that would limit risks for an infected patient.

The post Zika: Now What? appeared first on Fertility.ca.

This is a fairly updated list of counsellors, therapists, psychologists, social workers, and psychiatrists in the greater Toronto area (GTA) who specialize in fertility issues. A few tips on how to select one:

• Contact a prospective therapist to find out his/her availability
• If you’re in financial need, ask about sliding scale pricing
• Go for an initial meeting to see if it’s a good fit
• If you haven’t seen a therapist before, try having meetings with a few different professionals, to get a feel for the kind of person who feels most supportive and helpful to you

If this is your first time seeking therapy, you can learn more about the basics of the process here.

The post How do I find a therapist/psychologist in Toronto who specializes in infertility? appeared first on Fertility.ca.

This Chatelaine article delves into new research with regards to timing your egg freezing. The analysis found that women who pursue egg freezing in their early or mid-3os can often retrieve — and preserve — a promising amount of healthy eggs. However, if they start trying to conceive in their late 30s, they’re often able to reproduce without using their frozen eggs — making the cost and labour of egg freezing unnecessary.

On the other hand, the article notes that women who pursue egg freezing in their very late 30s, or early 40s, have a less successful chance of retrieving healthy eggs — which means the expense of egg freezing may not be ultimately worth it.

The study suggests that, in general, the optimal age to freeze your eggs is 37: it’s likely to result in the preservation of healthy eggs, and your odds of actually using those eggs are higher.

However, if you’re considering egg freezing, talk a fertility doctor about whether any individual factors (such as cancer treatments, premature reduction of fertility, etc) should sway that number.

The post When is the optimal age (medically and financially) to freeze my eggs? appeared first on Fertility.ca.

Under Dr. Ellen Greenblatt’s direction, and with the support of the provincial government of Ontario, we will soon have access to public coverage of IVF in Ontario, allowing us to direct patients to this low-risk, highly effective treatment for all our patients.

There are many arguments in favour of public funding, from basic human rights to a reduction of long-term medical complications. Studies have shown that denying public funding is often more costly in the long run than simply offering it.

If you’re in a position to influence policy in your province, perhaps through your local MP, social media, or a professional organization, people will need some proof. Consider supporting your argument with reference to the following document from Alberta Health:

http://www.health.alberta.ca/documents/AHTDP-Assisted-Reproductive-Technologies-2014.pdf

I believe and hope that if funded IVF is recognized as a good idea for Ontario and Alberta, one day it can be recognized as a good idea for every province and territory in Canada.

The post Alberta health document supports publicly funded IVF appeared first on Fertility.ca.

It’s our recommendation, and the Canadian National Advisory on Immunization, Motherisk, Mount Sinai hospital, World Health Organization, and Public Health Agency of Canada all support this as well: the H1N1 flu vaccine (and similar vaccines) have not been shown to cause harm to pregnant women or their babies.

What’s more, as someone who’s trying to (or already) pregnant, you’re considered a “priority group” to receive the vaccine — because you and your baby are at specially high risk of being endangered by H1N1. This isn’t just a doctor’s nervous speculation: it’s what the medical community learned in 2009.

In 2009, pregnant women who caught the H1N1 flu were a staggering 400% more likely to be admitted to the hospital because of medical problems, and also had greater chances of experiencing pregnancy complications — including premature birth and loss of their pregnancy.

If you’re vaccinated, not only will you be better shielded from these potentially severe flu-related health and pregnancy complications, but the protective effect of the vaccine will be passed through the placenta.

In other words, the vaccine protects your baby as well — babies whose mothers received the vaccine were 60% less likely to have influenza in their first year.

So, as a fertility doctor, I urge you to get the vaccine.

To learn more about the science behind the vaccine and its effects on a pregnancy, read about it at Motherisk.

References:

Motherisk. Drugs, chemicals, radiation & herbal products in pregnancy: H1N1 Influenza in Pregnancy: Risks, vaccines and antivirals. Available at: http://www.motherisk.org/women/commonDetail.jsp?content_id=914, Accessed October 21, 2015.

Public Health Agency of Canada. FluWatch Weekly Report Apr 19-Apr 25, 2009 (Week 16). Available at: http://www.phac-aspc.gc.ca/fluwatch/08-09/w16_09/index-eng.php, Accessed October 27, 2009.

CDC. Use of Influenza A (H1N1) 2009 Monovalent Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009 MMWR 2009;58(No. RR-10) :1-8. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5810a1.htm. Accessed October 23, 2009.

World Health Organization. WHO recommendations on pandemic (H1N1) 2009 vaccines Available at http://www.who.int/csr/disease/swineflu/notes/h1n1_vaccine_20090713/en/index.html. Accessed October 29, 2009.

The post I’m trying to conceive or already pregnant. Should I get the H1N1 flu vaccine? appeared first on Fertility.ca.

The post Receive email alerts about OHIP-covered IVF in Ontario appeared first on Fertility.ca.

The government also reversed its recent move to cut funding for certain OHIP-covered fertility monitoring services (such as blood tests), which is a big relief for doctors and patients alike. It looks like those cuts are now off the table.

Read the government’s news release
Read the expert panel’s recommendations to the government

This is a big day for fertility care in Ontario — but there’s a lot of information we’re still waiting on.

We’ll keep this page updated with any information that comes in about the OHIP-covered IVF process, as well as answers to any questions you may have.

The post Important announcement: OHIP-covered IVF cycle to launch December 2015 appeared first on Fertility.ca.

(If you aren’t caught up, I recommend reading my post on the latest status of OHIP-covered IVF in Ontario.)

So far, all we know is that the expert advisory panel has recommended excluding women over 42, and severely obese women, from eligibility for this coverage — on the basis that they’re medically less likely to see success from IVF, and that IVF could be more risky for their health.

With the failure of Quebec’s provincially-covered IVF program due to ballooning costs, it’s not surprising that the panel is considering cost-efficiency.

However, this is also controversial news. Some experts believe excluding women like this could be unethical. (And, needless to say, heartbreaking and upsetting for women who find themselves ineligible for this free round of treatment.)

The advisory panel had more recommendations, but they won’t be released until sometime this fall. We’ll keep you updated here.

The post Panel advises excluding women over 42, severely obese women, from OHIP-covered IVF appeared first on Fertility.ca.

However, many questions about the coverage were unanswered — and unfortunately, still haven’t been answered. Now that we’re creeping closer to the end of 2015, patients and clinics alike are getting antsy.

From Quebec’s slow rollout, we already guessed that a January 2015 launch was wishful thinking, but we had hopes for a summer launch. Indeed, a very strong source told us that we’d receive more specific direction about offering OHIP-covered IVF by July 2015.

Unfortunately, summer has come and gone, and we still haven’t received critical guidelines or instructions about delivering OHIP-covered IVF to our patients.

So I’m sorry to say that for the moment, the answer is: we still don’t know. But don’t lose hope entirely: a spokesman for the Ministry of Health recently said we’ll learn more about eligibility requirements this fall, and the OHIP-covered IVF program should begin “before the end of the year.”

We expect to hear more from the Ontario government in the coming weeks, and will keep you updated here.

The post It’s September 2015, what’s the status of OHIP-covered IVF in Ontario? appeared first on Fertility.ca.

It is not popular because it is especially efficacious. It isn’t, really. And for many patients there are real risks for multiple pregnancy and ‘anti estrogenic’ side effects such as hot flashes and depression.

But clomiphene is inexpensive and easy to take. That’s why it is first line. When it works, it often works quickly to increase the chances for ovulation of 2-3 eggs at a time.

The problem is that the manufacturer of one of the versions of clomiphene mis-judged demand. That means there was a run on the other product too. Right now, in Canada, it is very difficult to find any version of clomiphene.

We have heard that availability may be anticipated for April 2015.

The post Why is clomiphene not available until later in 2015? appeared first on Fertility.ca.