Intro to Fertility Services
The world of fertility is confusing! This article will help cover the basics for those just beginning their family-building journey.
What causes infertility?
Infertility affects men and women equally. In heterosexual couples experiencing infertility, approximately 35% is due to male factors, 35% is due to female factors, 20% of cases have a combination of both male and female factors, and the last 10% are unexplained causes.
Common causes of female infertility:
Age: As women age, the quantity and quality of their eggs decline, making it harder to conceive.
Ovulation disorders: Irregular or absent ovulation, such as polycystic ovary syndrome (PCOS), can lead to difficulties in conceiving.
Fallopian tube issues: Blocked or damaged fallopian tubes can hinder the egg's fertilization or the embryo's passage to the uterus.
Uterine or cervical problems: Abnormalities in the uterus or cervix, such as fibroids, polyps, or cervical stenosis, can affect fertility.
Endometriosis: A condition where endometrial tissue grows outside the uterus, potentially causing infertility due to scarring and adhesions.
Hormone imbalances: Hormonal disorders, such as thyroid disorders or problems with the hypothalamus or pituitary gland, can impact ovulation and fertility.
Pelvic Inflammatory Disease (PID): Infections, particularly sexually transmitted infections like chlamydia or gonorrhea, can cause inflammation and damage to the reproductive organs.
Common causes of male infertility:
Sperm disorders: Issues with sperm production, quality, or motility can affect fertility. These may include low sperm count (oligospermia), poor sperm motility (asthenospermia), or abnormal sperm shape (teratospermia).
Varicocele: Enlarged veins in the scrotum can lead to overheating of the testicles and impaired sperm production.
Hormone imbalances: Hormonal disorders, such as low testosterone or problems with the hypothalamus or pituitary gland, can impact sperm production.
Genetics: Certain genetic conditions can affect sperm production or function, such as Klinefelter syndrome or Y chromosome microdeletions.
Testicular damage or disorders: Injuries, infections, tumours, or certain medical treatments like chemotherapy can harm the testicles and impact fertility.
Erectile dysfunction or ejaculatory disorders: Difficulties with achieving or maintaining an erection or ejaculatory problems can interfere with fertility.
Factors that can impact both:
Lifestyle and environment: Factors like obesity, smoking, excessive alcohol consumption, drug use, exposure to environmental toxins, or high levels of stress can influence fertility in both men and women.
Unexplained infertility: In some cases, the cause of infertility cannot be identified despite comprehensive testing and evaluation.
What are common remedies for infertility?
The remedies for infertility depend on the underlying cause and can vary from person to person. It's essential to consult with a healthcare provider or fertility specialist to determine the most suitable remedies for your specific situation.
Here are some common medical remedies a fertility specialist may recommend:
Medications: Fertility medications can help regulate ovulation and hormonal imbalances for people with ovaries. These medications may stimulate ovulation or support the development and release of mature eggs. For people with sperm, certain medications can improve sperm production or address hormonal imbalances.
Assisted Reproductive Technologies (ART): ART procedures, such as in vitro fertilization (IVF), involve combining eggs and sperm in a laboratory setting to create embryos, which are then transferred to the uterus. IVF can be used to overcome various infertility factors, including tubal issues, sperm abnormalities, or unexplained infertility.
Intrauterine Insemination (IUI): In IUI, sperm is prepared in the lab and then directly placed into the uterus during the female’s fertile window. This procedure helps increase the chances of fertilization by placing sperm closer to the fallopian tubes where fertilization occurs.
Surgery: In some cases, surgical interventions may be necessary to correct structural abnormalities or address conditions like endometriosis, fibroids, blocked fallopian tubes, or polyps. Surgical procedures can potentially improve fertility outcomes.
However, not all infertility requires medical intervention. Fertility health can begin with lifestyle and behavioural changes.
Education and navigation support: Education serves as the foundation for informed decision-making, and navigation support adds a crucial layer of support that can lead to personalized guidance, targeted solutions, and timely advice.
Lifestyle modifications: Certain lifestyle changes can positively impact fertility. These may include maintaining a healthy weight, adopting a balanced diet, exercising regularly, avoiding tobacco, minimizing alcohol consumption, and reducing exposure to environmental toxins.
Fertility support supplements: These include prenatal vitamins, antioxidants, or herbal supplements.
Counselling and emotional support: Dealing with infertility can be emotionally challenging, and stress can negatively impact your fertility health. Seeking counselling, therapy, or joining support groups can provide emotional support, coping strategies, and a safe space to discuss concerns and emotions related to infertility.
You can take steps to improve your fertility health well before you intend to have children. For more information on proactive fertility health, click here.
How much do fertility treatments cost?
The following summary is for Canadian health providers. Please note that costs will vary by province and by clinic.
| Financial Investment (median; $CAD) |
Time Investment | |
|---|---|---|
| In Vitro Fertilization (IVF) | Procedure: $10,000
Medications: $4,000-$8,000+ |
|
| Intrauterine Insemination (IUI) | Procedure: $1,000 (covered by OHIP)
Medications: $200-$2,000 |
|
| Frozen Embryo Testing (FET) | Procedure: $2,500
Medications: $200-$2,000+ |
|
| Egg Freezing | Procedure: $8,500
Storage: $500 annually Medications: $4,000-$6,000+ | Ovarian stimulation and egg retrieval: ~8-14 days |
| Sperm Freezing | Procedure: $500
Storage: $500 annually | 1 appointment |
| Preimplantation Genetic Testing | Testing: $3,000-$7,000 (package for multiple embryos) | 1-2 weeks |
| AMH Testing | Testing: $100 | 1-2 weeks |
Many provinces offer coverage for fertility healthcare costs. A summary by province can be found here.
When should you see a doctor for fertility support?
If you are in a heterosexual relationship, it typically makes sense to try to conceive on your own before getting a referral to see a fertility specialist. For a female under 35, it is recommended you consult a fertility specialist if you have been trying to conceive naturally for 12 months. For a female between 35 and 40, consult after 6 months; if over 40, consult after 3 months.
If you intend on building a family without a partner or if you and your partner require donor eggs, donor sperm, and/or a gestational surrogate, then we recommend contacting a fertility physician as soon as you are ready to start your family.
How do I know which fertility clinic is right for me?
There are a number of factors to consider when evaluating fertility clinics, including service costs, doctor availability, waitlists, specializations, and access to funded services (i.e. coverage by provincial government healthcare). You can find clinics in your area on the Provider Search on your Sprout portal, then speak with your Family-Building Advisor about recommended clinics for you.
