After you pass the oversized petal-shaped pendant lights, fluted feature walls and Pinterest-worthy curved sofas with coordinating spherical throw pillows, you reach the changing room. Only, in this luxurious space, you get your own private room. There’s a soft cotton robe waiting for you and a pair of slides to slip on. Perfectly cozy, you sit back and wait to be called. But it’s neither a massage nor a facial that awaits you. At Pollin, Toronto’s newest fertility clinic, patients get a spa-in-spired experience every time they show up for their “veinsand vag”—that’s blood work and internal ultrasound per the make-light-of-it lingo fertility patients use for the countless pokes and prods they endure as their doctors watch their cycles. “I always tell patients, ‘I can’t change the fact that you have to cycle-monitor, but I can definitely make it a better experience,’” says Dr. Kim Garbedian, the clinic’s medical director.

It’s undoubtedly a far cry from the scene in a Manchester, England, hospital room where an embryo was transferred into a woman’s uterus around midnight on November 10, 1977, to become, almost 39 weeks later, the world’s first IVF baby, Louise Brown. Even now, 46 years later, modernized clinics like Pollin Fertility, Toronto’s Twig Fertility and Edmonton’s ARC (Alberta Reproductive Centre) are a step change from most, whose patients often use the word “cattle” when describing how they feel during the process. Considering the life-changing potential of treatments like IVF for LGBTQIA2S+ couples, singles and the one in six Canadians who experience infertility, there’s a huge population that stands to benefit from these reimagined, patient-centric approaches.

You could consider this wave of modern clinics a catch-up to the scientific advances in the fertility field. “The industry has come a very long way,” says Dr. Dan Nayot, medical director of The Fertility Partners, a network of clinics throughout North America. “We had very little basic physiology knowledge at the start—we didn’t know much about ovulation, sperm or the interaction.” Even since the birth of Brown, innovation has whizzed forward. The Brown embryo came from a single egg that was retrieved from the ovary of her mother, Lesley, via a laparoscope, mixed with her father’s sperm in a petri dish and, a couple of days later, transferred into Lesley’s uterus. Today, every part of the IVF process has been improved: There are medications that stimulate the ovaries so more eggs can be collected at once; those eggs can be retrieved with an ultrasound-guided needle through the vaginal wall; a selected sperm can be injected directly into a retrieved egg for fertilization; embryos can be biopsied and genetically tested; and they can be frozen and, remarkably, survive thawing for future use. Even our eggs, tiny single cells, can now be frozen and thawed.

“In our field, some say that the big scientific breakthroughs have already happened,” says Nayot. “We’re plateauing in our success rates, but a lot of us think that now the big innovations are going to be in access to care and patient experience.”

While there’s a need—especially in rural areas—for more clinics in Canada (there are roughly 35), the good-news story when it comes to access is that there’s new funding for the treatment. A single round of IVF can cost about $15,000, and many patients need more than one. Increasingly, employers in Canada—from the Big Five banks to Apple to Starbucks—are introducing fertility benefits, and British Columbia just confirmed that it will become the eighth province to offer coverage or reimbursement to those undergoing IVF. (Notably, the B.C. announcement came in the days following the Alabama Supreme Court’s ruling that frozen embryos are considered children, which made operations at many of the state’s fertility clinics grind to a halt for fear of criminal charges that could follow the routine disposition of surplus embryos or accidental damage that can happen during biopsies, transporting and more. “It’s an interesting dichotomy today that in Canada, we’re standing by fertility treatment and IVF and investing in it [while], unfortunately, south of the border, things are getting more restrictive,” says Garbedian. Nayot sees more medical tourism in the future.)

Outside of clinics, there are a growing number of products that support the fertility journey at home. Toronto-born Bird&Be offers test strips that can help screen for low egg counts via urine as well as a digital test that measures sperm’s ability to swim forward. Both are designed to help educate consumers about their own reproductive health and, if needed, empower them to contact a doctor sooner. (With age being a key factor when it comes to fertility, saved time can translate to better outcomes.) Other at-home offerings, like DIY insemination kits, allow some to dodge the treatment route altogether. Sold by Mosie Baby in the U.S. and Béa Fertility in the U.K. (neither of which currently ship to Canada), they’re at-home options for those looking to conceive without sex, including people usingdonor sperm or experiencing sexual dysfunction.

These products are hitting the mainstream in tandem with the rising fertility chatter online. TikTok’s #TTCcommunity (short for “trying to conceive”) has 3.7 billion views. Amy Schumer took to Instagram to solicit advice from fellow IVFers, and Chrissy Teigen reminded her followers that sometimes what looks like an early pregnancy bump can actually be an IVF bump. “We’re making strides on reducing the stigma,” says Garbedian. “More people are comfortable being open about their fertility struggles, but we still have a ways to go.”

Better societal support means understanding how complex and all-encompassing fertility issues can be. “There’s a huge psychological impact of infertility, and it’s not just the infertility,” says Garbedian. “It’s the weight of coming in for blood work and ultrasounds multiple times a month, the roller coaster of ovulating and negative pregnancy tests, the financial burden, putting your life on hold—all of these things.” She points to a study that found that depression levels in patients with infertility are comparable to those in patients diagnosed with cancer. “There’s a lack of control with fertility,” explains Garbedian.“Infertility happens to you; you don’t cause it. When you break your arm, you go to the hospital and they fix it. With fertility, there’s no guarantee you’ll wind up with a baby at the end. That’s the hardest thing about it.” This is part of the reason Garbedian made sure that Pollin offers counselling resources along with naturopathic medicine and acupuncture. And, yes, even the decor is strategic. “Fertility is chaotic,” says Garbedian. “Patients need a minute to breathe, so we developed the space to feel relaxing and calm.”

“Better societal support means understanding how complex and all-encompassing fertility issues can be.”

But that’s not to say the industry’s progress is all light-toned woods and shearling armchairs. In labs around the world, researchers are tapping the latest science for fertility. And Nayot is in the optimistic camp that expects new breakthroughs to come. In fact, he’s doing his part to try to make sure of it: He’s also the co-founder and chief medical officer of Toronto-based Future Fertility, a company whose technology harnesses AI to assess egg quality and is used in clinics in more than 20 countries, including Canada. “The egg is the most important piece of the reproductive puzzle, and there was no way to visually assess an egg,” says Nayot. This made it difficult for egg-freezing patients to get a good sense of the quality of their frozen eggs. “If you apply artificial intelligence to thousands and thousands of eggs and you know the outcomes of those eggs, you can train the machine to create a spectrum of better-quality to lower-quality eggs, and that unlocks personalized feedback and predictions for patients.”

AI is also being explored as a means of guiding embryo selection (choosing which to transfer to the uterus for the best odds of a live birth) as well as a way to predict which treatment protocol might work best for a patient based on their age, hormones and so on. “The use of AI has become less sci-fi and more inevitable,” says Nayot.

Perhaps more firmly still in the sci-fi realm, IVG (invitrogametogenesis) involves making eggs and sperm from stem cells. Japanese geneticist Katsuhiko Hayashi has already taken skin cells from mouse tails and created mouse eggs. Other research looks to discover the egg stem cell that could reverse menopause; re-energize aging eggs by injecting them with cytoplasm from another female’s healthy eggs; and thicken the lining of the uterus using PRP (yes, the same spun-blood technique that the vampire facial popularized) to make it morereceptive to an embryo.

Whatever the next big breakthrough is, both patients and clinics like Pollin will be watching. “With fertility, the success rates aren’t 100 percent,” says Garbedian. “Even doing IVF, the success rates can range by person from 20 to 60 percent, so any little thing that can nudge them forward—even 1 or 2 percent—and give our patients an edge makes a difference.”

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