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Fertility Facts

How much Folic Acid should I take, and for how long?

Folic acid supplementation has been shown to reduce the incidence of neural tube and other birth defects. A woman who is trying to get pregnant should take a multivitamin containing 1.0mg of folic acid per day. Ideally, folic acid should be started 3 months prior to conception and continued during the first trimester. For some women, a higher daily dose of folic acid is recommended. For more information, please speak to your physician.

When am I most fertile?

The egg is able to be fertilized by sperm from 12 to 24 hours after ovulation. Sperm can survive in a woman's reproductive tract for several days. Taking these facts into consideration, a woman is fertile from about 6 days before to 1 day after ovulation. Timing of ovulation, and therefore, your most fertile days will depend on your individual cycle length. For more information, please speak to your physician.

What can I do to maximize my fertility?

Patients with infertility can take control of several lifestyle factors to improve their chances of conception: maintenance of normal weight through a healthy diet and regular exercise, avoidance of smoking and recreational drug use, reduction of coffee consumption to 1 or 2 cups (8 oz) per day and drinking no more that 2 ounces of alcohol once or twice per week can help your fertility.

How does smoking affect fertility?

Cigarette smoking is strongly associated with infertility and increased chances of poor reproductive outcome. Cigarette smoking is also associated with reductions in the effectiveness of fertility treatments. Evidence shows that smoking cessation prior to IVF will improve the chance of success. For more information, please see the  Patient's Fact Sheet on Smoking and Infertility or speak to your physician.

How does weight affect fertility?

It is known that excess weight is associated with reduced fertility and an increased risk of complications in pregnancy. Being extremely underweight may also result in disturbances of ovulation. Maintaining a normal body mass index (BMI) may help improve fertility and your chances of a healthy pregnancy. Weight loss should be achieved through a healthy diet and regular exercise. For more information, please see the  Patient's Fact Sheet on Weight and Fertility or speak to your physician.

Does stress cause infertility?

Although difficulty conceiving can be very stressful, there is little evidence that stress actually causes infertility. In rare cases, high levels of stress may cause disturbances of ovulation in women and impaired sperm production in men. In general, stress reduction will improve your sense of well-being and may help you cope with the difficulties of infertility. Suggestions for stress reduction include: talking openly with your partner, exercising regularly, using stress reduction techniques such as meditation or yoga, avoiding excessive intake of caffeine or other stimulants and finding a source of emotional support. An appointment with our reproductive psychologist may also be helpful.

What are the causes of infertility?

There are several causes of infertility. In general, male factors include abnormalities in sperm number, movement or shape and difficulties of erection and ejaculation. Female factors include disturbances of regular ovulation, damaged or blocked fallopian tubes, endometriosis and problems with the uterine lining. Although aging is a natural process, the reduction in fertility associated with advancing female age is a complicating factor for many women. In 10-15% of cases, no cause for infertility is found.

How do I know if I have infertility?

It is not always possible to know if you will have difficulty conceiving. However, if you are concerned about your fertility, you should see your doctor. For women under 40 years of age who are not yet pregnant after trying for a year, an infertility investigation is warranted. For women 40 years of age and over, investigation is recommended after six months of trying.

What is recurrent pregnancy loss?

It is the loss of two or three consecutive pregnancies in the first or early second trimester. The causes are varied; however, over 50% of couples with recurrent pregnancy loss will not have an identifiable cause following testing. For more information, please see the  Patient's Fact Sheet on Recurrent Pregnancy Loss or speak to your physician.

Can I freeze my eggs?

Egg and ovarian tissue freezing are considered experimental and are currently not offered at the Ottawa Fertility Centre.

Appointments

How do I arrange an appointment?

Appointments for initial consultation are generally by referral only. Please see Arrange an Appointment for further details, or call us at (613) 686-3378 extension 7. (Toll free: 1-855-596-6755)

How long will it take before I can see a fertility specialist?

Generally, you will be given an appointment at the Ottawa Fertility Centre within 3 to 4 weeks of receipt of a referral letter from your doctor.

I live far from Ottawa. Are there any special arrangements I should make before my initial consultation?

Yes. Contact us well in advance of your appointment date. It may be possible to arrange for a telephone consultation, or for most or all of your testing to be done within a single visit to Ottawa. Please refer to Out of Town Patients for more information.

Will I have to pay for my initial consultation?

Appointments for Ontario residents with a valid OHIP card are usually insured as long as they are accompanied by a request for consultation from your doctor. Out-of-province patients and those without a valid OHIP card will be billed for their visit at the current Ontario Medical Association (OMA) rate. For further details, please refer to Arrange an Appointment.

Do you treat single and/or gay/lesbian women at the OFC?

Yes. One of the available treatment options is insemination with donor sperm.

I am in my 40's. Is it too late for IVF?

Unfortunately, the success of fertility treatments decreases with increasing age of the woman. After age 42 years, the success of IVF using a woman's own eggs is low. In these circumstances, the best chance of achieving a pregnancy is to use donor eggs for IVF.

Treatments

What should I know about the Assisted Human Reproduction Act?

On March 29, 2004, the Assisted Human Reproduction (AHR) Act was passed. The AHR act provides regulation and oversight into fertility treatments such as in vitro fertilization and related research. The Act was created to help protect the health and safety, human rights and dignity of Canadians.

Section 8 of the AHR act came into force on December 1, 2007, and requires that fertility clinics using reproductive material (eggs or sperm) for any purpose obtain written consent for such use from the individual providing the material (referred to as the donor). This consent can only be obtained after the donor is provided certain written information.

Prior to treatment with intrauterine insemination, in vitro fertilization or frozen embryo transfer, you will be provided with a  written summary of information on Section 8, "Consent to Use" regulations (Français). You will also be required to sign additional consent forms as mandated by the AHR Act. The staff at the Ottawa Fertility Centre will ensure all documentation is completed to ensure your efficient treatment.

What are the treatments for infertility?

Fertility treatments are as varied as the individuals we seek to help. At the Ottawa Fertility Centre, we provide a comprehensive range of fertility treatment options. For more information, please see Fertility Treatments under Services.

What are the costs of treatment?

As the recommended fertility treatment will depend on your individual diagnosis, your OFC physician will discuss with you all applicable fees for services prior to initiation of any treatment. The cost of individual fertility treatments can be found under Fees. Please note that these fees do not include the cost of medications.

How common are multiple pregnancies with fertility treatment?

Unfortunately, many fertility treatments are associated with an increased risk of multiple pregnancies. The chance of multiples depends on several factors including the woman's age and the specific fertility treatment. You physician will provide you with more detailed information based upon your individual circumstances.

Why should I be concerned about twins and triplets?

While multiple pregnancies are viewed as desired outcomes by many patients, they are associated with significantly increased risks of medical complications for the mother and babies, and with unique parenting challenges when compared to singletons. We encourage patients to familiarize themselves with these potential complications and challenges. Fortunately, the risk of high order (triplet or more) multiple pregnancies can be minimized in IVF by reducing the number of embryos transferred. For more information regarding the risks of multiple pregnancy, see the  Patient's Fact Sheets on Complications of Multiple Gestation and  Challenges of Parenting Multiples or speak to your physician.

Is it safe to take herbal products along with my fertility medications?

Many herbal medications have powerful biological effects and some may actually inhibit fertility. We suggest you refrain from using any herbal medications during your fertility treatments.

Ovarian Stimulation and Insemination

What are the side effects of ovarian stimulation?

Ovarian stimulation is generally well-tolerated by women and the side effects are minimal, if present at all. Side effects include headache, bloating and mild pelvic pressure or discomfort. For more information, please speak to your physician.

How long does the insemination take?

Inseminations are performed in the morning. The procedure itself requires less than a minute to perform. Generally, you will rest for several minutes afterwards, before leaving the clinic. Following insemination, normal activities may be resumed.

Is the insemination painful?

IUI is generally painless, similar to having a PAP test. Occasionally, minor cramping and some spotting may occur throughout the day.

Is donor sperm safe?

While absolute safety cannot be guaranteed, the screening of sperm donors is strictly regulated by Health Canada to maximize your safety.

In Vitro Fertilization

How do I know if IVF is right for me?

Following your investigation and diagnosis, your physician will discuss potential treatment options with you, which may include IVF. If IVF is recommended, you will have an hour long visit with your physician who will provide you with all the necessary information to allow you to make an informed decision regarding treatment.

IVF sounds very complex. How will I know if I'm doing everything correctly?

Every detail of your IVF cycle will be expertly managed by the physicians and nurses at the OFC. Patients undergoing IVF will attend a group education session and a one-on-one visit with a nurse prior to treatment. During treatment, all patients will receive detailed instructions regarding the administration and timing of all medications.

How much time will IVF treatment take?

Depending on the specific treatment protocol, an IVF treatment cycle can last several weeks. The active phase of treatment, from the start of ovarian stimulation to the embryo transfer, generally last two to three weeks.

Can I exercise during IVF?

While we do encourage regular exercise and healthy living, the answer to this question must be individualized, depending on the type of exercise, your fitness level and your overall health. Please speak with your physician.

How successful is IVF?

The success rate of IVF depends on a number of factors, one of the most important being the woman's age. At the Ottawa Fertility Centre, our IVF success rates have been consistently above the Canadian average. Please see our Success Rates or speak with your physician for more information.

If my first cycle of IVF isn't successful, how many more cycles will it take?

Each patient is unique, as is each IVF treatment cycle. Therefore, it is not possible to provide a general answer to this question. At the Ottawa Fertility Centre, each unsuccessful cycle is reviewed by the entire team of physicians and the scientific director in order to generate recommendations for future fertility treatment.

How do I know if I need intracytoplasmic sperm injection (ICSI)?

The main indications for ICSI include poor sperm parameters (low number, movement or normally-shaped sperm), sperm that is surgically retrieved, and failed fertilization in a prior IVF cycle. Your OFC physician will review all recommended treatments with you, prior to the start of your treatment cycle.

Why should I freeze extra embryos after an IVF cycle?

Freezing extra embryos offers additional attempts at pregnancy from a single IVF cycle. Since these embryos have already been created, the risks, expense and inconvenience of ovarian stimulation and the egg retrieval procedure can be avoided. Also, it is often possible to perform a frozen-thawed embryo transfer in a natural cycle, that is, without any medications.

For how long can embryos be frozen?

It is currently not known how long embryos can be kept frozen before they are unable to cause a pregnancy. To date, successful pregnancies have been reported from transfer of embryos frozen for longer than ten years.

How do I find an egg donor?

At the Ottawa Fertility Centre, the egg donation program requires patients to find their own donor. It is generally recommended that the egg donor be under 35 years of age. Please speak with your physician for more details.

Can I pay a donor for her eggs?

No. In Canada, it is illegal to purchase a woman's eggs. Egg donation must be an altruistic act.