If you’ve been thinking a lot about your own fertility lately, you’re not alone. Internet search results prove this. Questions like “Am I too old to get pregnant?” “Is fertility a ‘women’s problem’”? and “What reproductive options are available to me as a queer person?” are remarkably common. But when the digital rabbit hole is filled with so many myths and misconceptions, it can feel challenging to really own your own fertility.

That’s why, with Canadian Fertility Awareness Week upon us (it’s April 23 to 29, FYI), we’ve tapped three of the country’s top fertility specialists to deliver you the science-backed real facts. Here, they delve into everything you’ve been wondering (and unable to ask): what the egg freezing process looks like, what assisted reproduction options are available for the LGBTQ2SIA+ community, how IVF has evolved since the first successful transfer in 1978 and so much more.

Dr. Tamara Abraham, MD, FRCSC, GREI
Generation Fertility (Vaughan and Newmarket, Ont.)

What factors impact natural fertility for both men and women?

“When we’re talking about natural fertility the age of the female partner is a big factor. We recommend that women aged 35 years and older, who have been trying to conceive for >6 months, seek out consultation with a fertility specialist. That aside, we generally think about any lifestyle modifications that could be beneficial. And while there’s no specific diet or supplements that are proven to improve fertility, we generally do know that maintaining a healthy diet, exercising and maintaining a healthy weight are beneficial for both men and women from a fertility perspective. Avoiding things like alcohol and recreational drugs like marijuana is what we typically recommend to enhance natural fertility. For men, we generally recommend wearing looser fitting pants and limiting sauna and hot tub use as well.

“For heterosexual couples who are trying to conceive, trying to time intercourse during the fertile window – typically defined as five days prior to ovulation and the day of ovulation itself – is key. For some people, that means tracking their cycles by using either the calendar method or an app, or it could be using ovulation predictor kits to potentially time intercourse appropriately. For other couples, it’s too stressful to be tracking their cycles this way, and in those scenarios, if you’re having regular intercourse two to three times a week, you should be falling within that fertile window.”

For members of the LGBTQ2SIA+ community, what options are now available for assisted reproduction?

“There are lots of assisted reproduction options for the LGBTQ2SIA+ community to access. If we’re talking about couples in a same-sex relationship, they will often require donor gametes, whether that’s a donor egg or donor sperm; this could be from someone anonymous or someone in their life who wants to act as a donor for them. Sometimes individuals don’t have a uterus and they require a surrogate, so that option is available as well. Finally if people are considering transitioning their gender, we are happy to talk to them about freezing their gametes prior to gender transition so that they have more options available to them in the future.”

Dr. Ginevra Mills, MD, FRCSC, GREI
Olive Fertility Centre (British Columbia)

What should someone expect from their first visit with a fertility specialist? And what types of fertility tests might be required?

“Your first consultation is an opportunity for you and your fertility specialist to meet and start the process of determining a treatment plan. The doctor will listen to your concerns, discuss the required testing (some clinics will ask you to complete the testing before your consultation), review your medical history and take the time to understand your individual needs and goals. With this insight in hand, the doctor can formulate the best treatment plan for you.

“The required testing may vary from person to person; however, some fertility tests you can expect are: blood work to determine hormone levels that are key to the development and quality of eggs; imaging tests such as ultrasound and sonohysterogram; a urine test, vaginal swabs or a Pap test to check for infections and cervical irregularities; and a semen analysis to determine semen quantity, movement and appearance.”

Infertility can be emotionally challenging. What are some ways that patients can take care of themselves during this time, and how do fertility providers help facilitate this?

“Many patients describe infertility as an emotional roller coaster. It is important for a clinic team to support the emotional needs of the patient in addition to providing excellent medical care. Clinics that are good at this will make sure the patient knows and feels that their care team is available to them to answer questions or help alleviate anxieties. Additionally, studies have shown that adopting lifestyle changes like moderate exercise, a whole-food Mediterranean-style diet and adequate sleep can help manage stress and improve well-being. We may also encourage patients to seek counselling support and explore additional wellness services like acupuncture treatments and mindfulness programs specific to those undergoing fertility treatment.”

Dr. Tannys Vause, MD, FRCSC, GREI
Ottawa Fertility Centre (Ottawa)

The first IVF baby was born in 1978. How has IVF evolved since then to help people conceive?

“Infertility was vastly different 45 years ago. When the original IVF was performed, it was for blocked fallopian tubes, without fertility medications and with the egg removal done under general anaesthesia. Today, fertility medicine benefits from technological progress in everything from initial diagnosis, medications, egg removal under mild sedation and advanced laboratory techniques to select and preserve the best embryos. Moreover, infertility is no longer an overlooked and experimental field of medicine, as this widely recognized issue affects one in six couples. Decades ago, fertility struggles were secretive and silent or associated with guilt and shame. We have learned so much since. Anyone can experience infertility—and so many do. If you ever face infertility, you no longer have to face it alone. There are also so many more resources out there to help you navigate it.”

Besides helping people conceive, fertility providers also help them keep their reproductive options open. When should someone consider egg freezing as an option?

“Egg freezing allows people to have more choice and control over their own fertility journey. I see an increasing number of patients who consider egg freezing for a variety of reasons, including fertility preservation before cancer treatment, prior to gender affirmation treatment, or retaining independence and agency over one’s own fertility. The latter refers to some women who may choose to store their eggs while healthy and fertile in order to preserve their biological option to have a child later in life. This category is often a uniquely personal choice, which may be influenced by your life stage and circumstances, career goals, involvement of a life partner and readiness to start a family. It is such a personal decision, but it is reassuring that we can now offer more flexibility and options than were available in years past.”


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