But that doesn’t mean sexuality doesn’t matter.

Sexuality and fertility and, yes, love, are all mixed together for all of us.

If fertility is difficult, if your sex life is feeling stressful or unfulfilling, it can hurt your emotional well-being. It can hurt your relationship. It can hurt you.

For some couples, integrating your sexuality (your desires, preferences, and physical pleasure) into the process of trying to achieve pregnancy can make a big difference in the journey. Here are a few suggestions:

• Find a fertility counsellor. These counsellors specialize in fertility issues and are familiar with the stresses involved, including on your sex life. Here’s a list of Toronto-based ones.
• For women and their sexual partners — check out OMGYES. Based on a large-scale study of women (cisgendered), this modern website features thoughtful, graphic videos of sexual techniques that can elicit more pleasure, and assist you in reaching orgasm. It’ not a free service, but you can start with a free sample video to try it out.
• For men — it can be touch to talk about, but sometimes the pressures of “making a baby” can overwhelm sexual desire. If you have concerns, consider starting here and reach out to us if you are interested in referrals. Many men will temporarily use Viagra, for example, to assist in the fertility setting. And don’t hesitate to seek therapeutic support: for many, the quantification of sperm at a fertility clinic (the detailed discussion of how many, or how few, sperm are present) can take a toll on sexual self-esteem. Of course, logically we know that sexuality and sperm counts are different things. But for many men, the two feel like one and the same. An experienced therapist can help you, and your partner, regain confidence.
• Nowadays, many modern, independent sex shops offer educational courses and workshops led by professionals on sexual topics, including improving your sex life. While these events may not be geared specifically toward those trying to conceive, they can help you learn new techniques and approaches. These events also tend to be more LGBTQ-friendly.

Do you have other tips or resources? Feel free to share them in the comments.

The post My fertility struggle is taking the pleasure out of my sex life. What can I do? appeared first on Fertility.ca.

However, there are some logistical challenges limiting choice. There is only one Canadian sperm bank: ReproMed, based in Toronto.

To allow for a greater variety of sperm available to Canadians, Health Canada has allowed for the importation of non-altruistically-donated sperm. Including ReproMed, there are three organizations that import sperm, the other two are Outreach Health Service and CanAmCryo. At our clinic we endorse Outreach and ReproMed.

When you choose sperm, Health Canada recommends that women who have never been exposed to Cytomegalovirus (i.e. “CMV negative”) should choose sperm that is also CMV negative. We test for CMV status for all women considering donor sperm.

When you make a purchase you’ll be offered washed and/or unwashed sperm samples. We re-wash the sperm regardless. From our perspective, there’s no functional difference which sample you’d choose to purchase. We see equal pregnancy rates from either approach.

When doing donor sperm inseminations, we ask that women trigger ovulation (usually with Ovidrel), to ensure that the timing of insemination is ideal. We use one sperm unit per cycle.

We’ll provide you with information on the count of the sperm being inseminated, and the average motility. Using fresh samples as a reference frame, we like to see at least 5 million sperm in the washed sample with 80% or greater motility. We won’t always see these numbers with frozen-thawed sperm: you may have a reduced success rate.

The success statistics that support the donor-sperm program are available from your clinical team and can be individualized to your specific situation by your doctor.

Next post, we’ll be covering guidelines for known donors.

The post We’re considering using an anonymous sperm donor. How does it work in Canada? appeared first on Fertility.ca.

As physicians, it’s our duty to inform all patients that this is accepted dogma and that there is no minimal dose that is known to be safe and, therefore, no one should use any such substances.

But, speaking to patients who, regardless of the advice above, are going to continue with the lifestyle that they have chosen, we have the following to share.

(And on a personal level, we understand how some people come to those choices. After all, fertility is not something that lasts a couple of weeks, or even a month. It can last six months, twelve months, and longer, and it can be a dramatic and isolating lifestyle change for people to make at a particularly vulnerable time in their lives.)

So, if it comes to harm reduction – if you are looking to minimize stress, knowing that you should really be doing it through going to bed on time, eating better, and exercising in an appropriate fashion – you might also want to have a glass of wine with your friends from time to time.

Please understand we are not talking about excessive drinking or other abuses of alcohol. We all know that alcohol can be used for self-medication purposes. But, it can also be a gentle part of a social lifestyle. Red wine contains resveratrol, part of the antioxidant family that may or may not be beneficial for eggs. So if you are going to have alcohol, perhaps a glass of red wine with friends, as is socially appropriate to your life, would be the best choice.

And what about smoking? It’s true that smoking residues are found in seminal fluid and in the follicular fluid, i.e. the fluid that aids eggs and sperm. What would be an appropriate therapeutic dose? We aren’t sure, but it seems self-evident that if you can minimize smoking as much as possible, you can feel confident that you’ve done all you could at this short time in life to maximize the chances of pregnancy. Once you’re pregnant and delivered, as long as you aren’t smoking around your child, then it’s your decision to make.

We cannot be as calm about marijuana use. It’s very clear that it reduces sperm counts and quality for men, often dramatically. Yes, of course, you all know people who will smoke pot daily and father a pregnancy, but for many men who have average sperm counts, the use of marijuana decreases it substantially.

So, what about eggs? We can’t tell if egg quality changes with the use of marijuana or not. The effects are so profound for sperm that, by extrapolation, we are more worried about pot than cigarettes or alcohol.

And, of course, we cannot advocate for cocaine, MDMA, or other stimulants. We recommend a lifestyle change—perhaps aided by support groups, substance abuse treatment, or therapy, if you’re having a hard time discontinuing use of these substances—if you wish to get pregnant.

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In the context of fertility, erectile concerns can often be interpreted as ambivalence about having children. Some men may refuse to have intercourse, or otherwise turn away. They may claim that they no longer want to have children, when really what they are saying is that the situation has created a deep sadness in them.

If your partner might be experiencing male subfertility, talk to him. Validate and listen to your partner’s feelings within the relationship and in the bedroom. I strongly recommend counseling to assist both of you in maintaining healthy communication and a supportive partnership.

The post The emotional side of male subfertility/infertility appeared first on Fertility.ca.

In the meanwhile, if you can tolerate it, home inseminations are an option. Here’s how it works:

• Your male partner should collect his sperm in a sterile container.
• You should wait 10-30 minutes at room temperature for the seminal fluid to liquify.
• The seminal fluid could then be pulled into a sterile syringe and placed into your vagina. You should be careful to leave the seminal fluid there, rather than trying to insert the sperm any deeper or into your cervix.

However, complications are possible with any procedure. It’s theoretically possible that a non-sterile procedure could lead to infection. But it can be a straightforward process for many couples. A fertility nurse can help demonstrate how this works, and advise you on the process in more detail.

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