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| 1. What does We Care stand for? |
| We CARe stands for Westend Centre for Assisted Reproduction. |
| 2. What is Clomid (Clomiphene Citrate)/Serophene and what are its side effects? |
| This is a pill used for ovulation induction and it works by increasing a patient’s own FSH production which in turn causes stimulation of follicles in the ovaries to grow. Some patients experience side effects like: mood swings, breast tenderness, insomnia, nausea and vomiting, blurred vision (rarely), headaches, fatigue, irritability, depression, weight gain, ovarian cysts, and thinning of the endometrial lining. |
| 3. What is Femara (Letrazole)? |
| For ovulation induction, Letrazole is used to inhibit estrogen synthesis and thereby increase patient’s own FSH production. This results in increased follicular development. Letrozole is quickly cleared from the body and less likely to adversely affect the endometrial lining than Clomid. |
| 4. What is Human Chorionic Gonadotropin (HCG)? |
| HCG is a natural hormone produced by the placenta and it works to trigger ovulation. |
| 5. Are there side effects to HCG? |
| Some patients get: headache, irritability, restlessness, fatigue, breast tenderness and nausea. |
| 6. What is Lupron? |
| Lupron acts on the pituitary gland. This medication causes suppression of the ovarian response, unless the ovary has been stimulated with other drugs such as Puregon or Gonal F. |
| 7. What are the side effects of Lupron? |
| Some patients get: joint pain, headache, hot flashes, bruising and tenderness around the injection site. |
| 8. What is Gonal F/Puregon? |
| Both of these medications are made from highly purified human Follicle Stimulating Hormone prepared by recombinant DNA technology. Both contain FSH. |
| 9. Are there any side effects to Gonal F/Puregon? |
| Some women experience abdominal discomfort, headache, weight gain, irritability and breast tenderness. The most serious side effect is ovarian hyperstimulation. Hyperstimulation occurs when many follicles develop in response to Gonal F/Puregon stimulation. This causes sudden enlargement of the ovary and the abdomen may become distended with fluid. Hyperstimulation is usually mild to moderate, however, severe hyperstimulation occurs in 1-3% of patients. Treatment consists of bed rest and careful monitoring of fluid levels. |
| 10. How do I know I am ovulating? |
| Most of the women with regular menstrual cycles coming every 26-35 days are ovulating regularly. It is when cycles are outside of this range that ovulation may not be occurring in a predictable manner and then cycle monitoring is required. |
| 11. What is Intrauterine Insemination (IUI)? |
| IUI is an option for couples that wish to optimize their chance for pregnancy. IUI may be offered to couples that have unexplained infertility, or a history of slightly compromised sperm quality. When an IUI is conducted, the male partner provides a sperm sample, which is washed, and the resulting high-quality sperm are placed inside the woman's uterus. For a detailed explanation on IUI, please refer to our Services Section. |
| 12. How many cycles of clomiphene citrate with intrauterine insemination can I do? |
| We recommend 4-6 cycles. |
| 13. When is therapeutic donor insemination desired? |
TDI (therapeutic donor insemination) may be an option for treatment in the following situations:
- When the sperm count is very low or sperm motility is very poor and fertilization of the egg would not be optimal
- When a patient cannot afford to do IVF with intracytoplasmic sperm injection
- Single women
- Same sex couples
- When sperm cannot be obtained from the man’s testicle or if it is, it cannot be used for intracytoplasmic sperm injection |
| 15. Who qualifies for IVF? |
| IVF treatment was started to help women with blocked or absent fallopian tubes. Now a days it is also done for couples with unexplained infertility, ovulation disorders, endometriosis and male factor problems. |
| 17. What assistance does Health Canada provide to Canadians for infertility treatment? |
| The Ontario Health Insurance Program provides partial funding to patients for IVF who have bilateral blocked tubes to a total of three cycles. Ontario is the only remaining province to provide this. |
| 18. How old is too old to do IVF? |
| Success of pregnancy with IVF is very dependent upon the age of the woman and her eggs. Success decreases significantly after the age of 40. |
| 19. Are IVF cycles are ever cancelled? |
| Yes. Sometimes patients do not respond to the stimulation medications as expected. They produce too few eggs or eggs that are not growing at the same time. These women may benefit from stopping the cycle and starting again with a different protocol and/or a higher dose of medications at the start. |
| 20. Are the Procedures for IVF painful? Will I be awake during the procedure? |
| Pain relief and mild sedation is used during the procedure. |
| 21. How much does it cost to do an IVF cycle? |
| The cost can vary regarding what type of treatment is required. Please see our Cost Section. |
| 22. What happens when IVF fails? |
| Your physician will discuss the options for you; if you have frozen embryos left they can be transferred in one or two months time. You may also do another IVF cycle with a different protocol or use donor eggs for IVF or try surrogacy. If a number of cycles have failed and you do not want any more treatment, you may decide to adopt or choose a childfree life. |
| 23. What methods of payment do you accept? |
| We accept VISA, Mastercard, American Express, debit, certified cheque (with appropriate ID) and cash.
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| 24. When do I pay? |
| All payments for treatments and procedures are to be made prior to the process being carried out. |
| 25. What does the lab look at in the sperm analysis? |
| Your doctor will review the results of the sperm test with you and your partner. The sperm analysis looks at concentration, motility, how well they are swimming in a forward direction, viability, morphology (how sperm look), presence of infection and the total number of sperm that are moving. |
| 26. What can be done if the sperms are extremely low? |
| Sometimes IVF & ICSI are done after extraction of sperms from testicular tissue using a needle (TESA) this has proven to be successful. |
| 27. What is Polycystic Ovarian Syndrome (PCOS)? |
| PCOS is a condition that has 2 or more of the following features – irregular cycles, problems with acne or hair growth in a male pattern or elevated male hormones in the blood and ovaries that have lots of potential eggs most commonly arranged around the outside edge of the ovary. PCOS patients have insulin resistance, i.e. the body has difficulty handling glucose so the insulin goes up and therefore the male hormones go up and then the menstrual cycle gets interrupted. Some PCOS patients also have obesity or excessive weight. |
| 28. What can be done to prevent weight gain during infertility treatment? |
| Obesity is known to have a negative effect on reproduction. Both fertility and pregnancy outcomes are better when a woman is of normal weight. Weight gain during infertility treatment is not due to medications used during infertility treatment. Weight gain may be due to other contributing factors such as anxiety leading to compulsive eating or fear of exercising. Some women may find some weight gain due to water retention that may be related to ovulation but this would be minor. Prevention of weight gain by regular exercise and eating small healthy meals. |
| 29. Does weight gain affect the future baby? |
| Obese women have a greater chance of pregnancy complications. They have a higher risk of developing diabetes in pregnancy, blood pressure problems and having a cesarean section, which in turn increases their chance of having an infection of the incision site. Both diabetes and blood pressure problems can have negative effects on the developing baby. |
| 30. Can I exercise during treatment? |
| Moderate exercise is beneficial to the health and to reduce stress. Excessive exercise for the first time during treatment should not be done. |
| 31. What is endometriosis and how is it related to infertility? |
| Endometriosis is a condition in which the normal lining of the uterus is found outside the uterus, on its surface, in the ovaries, fallopian tubes and the walls of the pelvis.It occurs in 30-40% of infertile women, some times the ovaries, fallopian tubes and bowel are stuck together, so it is difficult for the egg to pass through the tube. Also the endometrial tissue may secrete hormones so that fertilization is affected. |
| 32. How is endometriosis diagnosed? |
| It is suspected by painful periods, pelvic examination and on pelvic ultrasound, but the definite diagnosis is only done by surgery. |
| 33. What is the treatment of endometriosis? |
| Sometimes no treatment or anti-inflammatory medication is given during periods. Hormonal treatment or surgery or both together are helpful for some cases. |
| 34. What are fibroids? |
| Fibroids are an abnormal growth of the muscle cells of the uterus. They can grow in the wall of the uterus, on the outside of the uterus and in the cavity of the uterus. They are almost always benign. |
| 35. How would I know if I have fibroids? |
| Ultrasound can detect most fibroids and measure their size and location. Some women will have an MRI to view their fibroids. |
| 36. What symptoms do fibroids cause? |
| Fibroids can cause many symptoms that are mainly in relation to their location. They may cause irregular bleeding if they are in the uterine cavity or the wall of the uterus. They can also affect fertility by decreasing pregnancy rates and increasing miscarriage rates, when they are in the uterine cavity. If fibroids are very large, they can also cause problems with pelvic discomfort, difficulty with urination and bowel movements and delivery. |
| 37. If I have fibroids, do they need to be removed? |
| Not all fibroids need to be removed. It depends on the size and location if they need removal before infertility treatment or IVF. |
| 38. Is sex life affected during treatment? |
| Continuing with your sex life is important during treatment. You may be advised to use condoms when having a test in which a pregnancy could be negatively affected (HSG, sonohysterogram). When women are undergoing IVF treatment, they may find intercourse uncomfortable when the ovaries are getting large during the stimulation. When it is approaching time for an insemination or production of sperm to be used in IVF, you will be advised to abstain from intercourse for at least 48 hours. |
| 39. What lifestyle behaviours are associated with infertility? |
| Smoking and recreational drugs affect both sperm and eggs in terms of their quality and therefore ability to fertilize. Success of IVF is also significantly affected. Excessive alcohol consumption is also known to decrease fertility. Stress also affects the reproductive tract in a negative way. A large amount of caffeine consumed on a daily basis also decreases fertility. |
| 40. What can be done to reduce stress? |
| Communication with your partner and doctor are very important, discuss fears, anxieties and financial concerns. Support groups, yoga and perhaps acupuncture may also be helpful. |
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