Medical Articles
Printer-friendly versionA follow up on IVF children - Spring 2009
A health report on 16,280 children born between 1982 and 2001, and their mothers.
Canada’s new AHR Law prohibits paid sperm donations, sets stringent standards and regulates reimbursement. Will donors still come forward?
A report on the decline of men's reproductive health.
Artificial Gametes: A Future Route for Reproduction or an Unreality
Several scientific papers have shown that both eggs and sperm (known as gametes) can be created by artificial means...
Chemical Exposures and Human Fertility
Chemical Exposures and Human Fertility
CHEMICAL EXPOSURES AND INFERTILITY - Fall 2008
The prevalence of human infertility is thought by many to be increasing. There is also a perception held by many Canadians that their health has been adversely affected by exposure to environmental contaminants. However, the impact of exposure to environmental contaminants on the reproductive capacity of Canadians is poorly understood. Moreover, while there is a general perception that the prevalence of infertility has increased in recent years, several studies conducted in the United States and Canada have been unable to show an increase in infertility rates. Although the literature does not support the conclusion that infertility rates are increasing across the overall population, this does not mean that environmental contaminants are not involved as underlying causal factors in the infertility of some couples. We do know that both naturally occurring chemicals and chemical contaminants present in our environment can disrupt reproductive function in wildlife and experimental animals. However, applying generalized results obtained from animal studies to humans is difficult, and reports in the media are often sensationalized and misleading. Furthermore, it is difficult to obtain access to credible, unbiased and authoritative information. The objective of this article is to provide a brief overview of the extensive information pertaining to the association between exposure to environmental chemicals including dietary factors and impaired human fertility.
Cross-Border Repductive Care - Winter 2010
While most couples do not expect to be infertile, once diagnosed, they are usually treated within their own country. Some couples, however, will look for treatment beyond their country’s borders. People travel to another country for treatment, a practice frequently referred to as “fertility tourism” or “cross- border reproductive care”...
Current Issues & Treatment Strategies for Male Infertility - Summer 2007
While various cultural and social norms have led the public to assume that fertility is primarily a “female issue”, the reality is that only about a third of fertility problems in couples are due to pure female-factor, while another third is due to pure male-factor and another third a combination of both male- and female-factors. Thus male-factor infertility is found in over half of all cases of couples experiencing infertility.
Disorders of Ejaculation Affecting Sexual Function and Fertility - Fall 2007
Ejaculatory disorders, while not receiving the same media exposure as problems with erectile function, are by far the most common sexual problems in men. Almost half of men over 50 years of age notice some degree of ejaculatory disturbance, and of these men 60% are significantly bothered by these symptoms. Others suffer from lifelong problems including 30—40% of men with premature ejaculation. On the other end of the spectrum, as many as 4% of men suffer from significant problems with delayed ejaculation. These estimates are derived from studies of large populations and we know that a number of disease processes and medications can result in much higher rates of ejaculatory disturbance in certain groups at higher risk. Ejaculatory disturbances can affect both sexual functioning and fertility.
Donor Insemination: The Needs of the Couple - Winter 2010
As a social worker and family therapist, I have been working with couples using donor insemination (DI) to build their families for over 15 years. I have counselled couples before, during and after treatment, and together with Ken Daniels from New Zealand, conducted educational seminars. Though I live and work in Germany, where both the culture and legislation regarding DI is different from Canada, many of the issues I explore and raise with couples and families are likely to be very similar. This first of two articles will focus on the needs of couples. It will be followed by an article on the needs of children in the next edition of this magazine.
Everything you ever wanted to know about donor sperm, but were afraid to ask
Nutrition is an important piece of the Infertility puzzle
Embryology: The Role of the Embryologist
Today, the science of human embryology has evolved significantly. Louise Brown was conceived from a natural cycle of IVF and was transferred to her mother’s uterus as a Day 2 embryo. Advances in the last 25 yrs have drastically changed the methods of embryo culture, sperm recovery, egg retrieval and embryo transfer, and have significantly increased the rates at which an infertility patient goes home with a baby. In this article I will discuss some of these advances and how they have changed this wonderful field of ours. I will briefly give an overview of the IVF cycle, ICSI and embryo selection.
The inner lining of the uterus is called the endometrium, a layer of cells that gradually thickens every month, until it is shed in response to the hormonal changes of a woman's menstrual period. If these endometrial cells grow anywhere else outside the uterine cavity, then it is called endometriosis.
Erectile Dysfunction and Infertility - Fall 2005
Erectile Dysfunction and Infertility
Essential Fatty Acids and Fertility - Spring 2005
Fat makes us fat, right? Not necessarily so. Too much fat makes us fat, and too much of the wrong type of fat in our diet makes us ill. But these days, in our effort to avoid "bad" fats for heart health and (let’s admit it) slimmer waistlines, we have once again gone to extremes: low fat and no fat. Current research strongly supports a new view: not enough good fat in our diet is making us ill. The truth is, we need a healthy balance of the different types of fats to achieve good health and fertility...
Evaluating the Infertile Male
Female Infertility and the Thyroid - Fall 2006
What is the Link between the Thyroid and Fertility?
Fertility and Thyroid Function - Fall 2006
The Naturopathic View
Fertility Preservation In Children & Young Adults Undergoing Cancer Treatment
First Frozen Egg Baby Born in Canada - Fall 2005
MONTREAL, May 30, 2005 – The McGill University Health Center (MUHC) in Montreal is pleased to announce the first successful birth in Canada resulting from frozen eggs. A team led by Professor Seang Lin Tan, Chair of the Department of Obstetrics and Gynec-ology at McGill University and Director of the McGill Reproductive Centre at the MUHC in Montreal confirmed the birth of a healthy baby boy, weighing 3740 grams on April 29.
Forty is the Thirty, right? - Fall 2008
It’s a sign of our times: fit, healthy, fabulous-looking women in their forties and even in their fifties. And some of them are pushing baby strollers. How do they do it? The baby part, I mean.
What's it all about?
ICSI - Intracytoplasmic Sperm Injection
Breakthrough in the Treatment of male infertility
ICSI for Male Factor Infertility - Fall 2008
The injection of sperm directly into an egg under the microscopy is a procedure that started in the early 1990s to help patients with severe male factor infertility achieve a pregnancy. The procedure is usually referred to as ICSI, which stands for intracytoplasmic sperm injection. Here, the cytoplasm refers to the substance inside the human egg that surrounds the nucleus and it is surrounded by the cell membrane and the ‘shell’ (zona pellucida) of the egg. The procedure is done under a special microscope and involves drawing up a sperm into a fine glass needle, inserting the needle through the shell and the cell membrane of the egg into its cytoplasm and leaving the sperm in the egg while withdrawing the needle. In the hands of a skilled embryologist, the chance of the egg being damaged by ICSI is very low and the fertilization rate is usually around 70-80% on average.
In Vitro Fertilization: The Natural Way - Fall 2005
In Vitro Fertilization - The Natural Way
Infertility and Celiac Disease - Winter 2008
Infertility may be one of the reproductive complications of undiagnosed celiac disease, which can affect both women and men. An estimated 13%-15% of Americans of reproductive age are infertile. Ovulatory dysfunction accounts for 20% of female infertility, while tubal and pelvic abnormalities account for a further 20%. Male factor infertility accounts for 30%, combined factors account for 5% and the remaining 15% are classified as “unexplained infertility.” Some studies suggest that undiagnosed celiac disease may be a factor within this group.
Infertility and The Environment - Winter 2006
Infertility and The Environment
Infertility Treatment for Non-Traditional Families - Spring 2007
During this festive season, many thoughts turn to recognized cultural and religious traditions which dominate the written and broadcast media at this time of year. These traditions are also often associated with family – which traditionally consists of a man, married to a woman, and their children. The father is the provider and the mother stays at home to raise their normally conceived biological children.
Infertility Treatment in Atlantic Canada - Winter 2004
Assisted reproduction is currently available at three centers in the Atlantic Provinces. The Conceptia Clinic in Moncton, New Brunswick; Fertility Services with the St. John’s Healthcare Corporation, Newfoundland; and the Atlantic Assisted Reproductive Therapies in Halifax, Nova Scotia. These clinics are able to provide a broad range of fertility treatments.
Assisted Reproductive Technology Is Not The Only Treatment
Mature Motherhood - Winter 2005
Do reproductive technologies need a cut-off age? Two experts take a stand pro: older parenthood raises serious ethical concerns
Mind Matters: Same Sex Couples - Winter 2006
Mind Matters: Same Sex Couples
The forgotten constituents
Oocyte cryopreservation - Spring 2006
A new opportunity for women
Polycystic Ovary Syndrome - Spring 2005
What is PCOS?
Possible Causes of Endometriosis - Summer 2005
The Naturopathic View
Pre-Implantation Genetic Diagnosis
Choosing to Have a Healthy Child
Pre-implantation Genetic Diagnosis
Now Available to all Canadians
Predicting Ovulation - Summer 2006
In the past few years, a variety of luteinizing hormones (LH) urinary ovulation predictor test kits for home use have become available. There are a number of methods for predicting ovulation such as basal body temperature (BBT) charts, cervical mucus changes, Estradiol levels, salivary and vaginal electrical resistance tests and ultrasound measurements of follicular size.
Preimplantation genetic diagnosis “in a nutshell”
PGD allows couples to have their embryos screened during their ART cycle for known familial genetic disorders and other abnormalities. Embryos, free of disorders are transferred to the uterus while affected embryos are not. Depending on the disorder, patient counseling, and informed consent, an affected embryo may sometimes be considered for transfer if no “normal embryos’” are identified.
What is Premature Ovarian Failure (POF)?
Recurrent Miscarriage - Summer 2008
A Common Problem with an Uncommon Solution
Regulating the Transfer of Multiple Embryos
Regulating the Transfer of Multiple Embryos
Sexually Transmitted Diseases and Infertility - Fall 2008
Sexually-transmitted diseases (STDs) are one of the commonest reasons worldwide for seeing a doctor. A recent estimate is that 1.5% of people under the age of 25 years are treated for chlamydia infection each year1. Overall, it is estimated that over 15 million new cases of STDs are diagnosed each year in the United States, resulting in a huge potential burden to any type of health care system. Particular problems stemming from lesser STDs include facilitation of HIV infection, later development of some anal and cervical cancers, complications during and after pregnancy, and male and female infertility.
Single Embryo Transfer in IVF Helping Patients to make Informed Decisons - Fall 2007
In Vitro Fertilization (IVF) treatment has offered patients the chance to have a family where natural conception is not possible. At the same time, concerns have been raised about the increased risk of multiple pregnancy associated with this technology. The main reason for this is the usual practice of transferring more than one embryo at a time to the woman’s uterus. However, as medical knowledge and techniques have improved, the number of embryos transferred to the uterus during IVF treatment has gradually decreased. For example, twenty years ago it was not unusual to transfer up to five embryos during a treatment cycle. Now the transfer of two embryos, for women under the age of 35, is common practice in Canada.
Smoking and fertility - Spring 2005
Cigarette Smoke Dramatically Reduces IVF Success
The Aging Male and Infertility
The Aging Male and Infertility
The Naturopathic View: Uterine Fibroids and Fertility - Summer 2006
Uterine fibroids are benign tumour growths, made up of smooth muscle tissue, that are found in about 25 percent of women by the age of 40. They are the most common reason for major surgery. It is thought that the growth of fibroids is stimulated by estrogen. This is supported by the fact that uterine fibroids tend to appear during the reproductive years, and may have a period of rapid growth during pregnancy, when estrogen levels are increasing.
The Place of IntraUterine Insemination (IUI) in Infertility - Summer 2007
Traditionally, intrauterine insemination with or without ovulation induction has been the first line of treatment for couples suffering from infertility.
Jim Meriano, BSc, RT, MSc Lab Director, LifeQuest Centre for Reproductive Medicine
The Significance of Sperm Morphology
In our clinical practice, we constantly receive semen analysis reports from laboratories in our province showing a low percentage of normal sperm morphology, together with annotated comments on the potential causes. In the absence of other relevant information, many of these patients could be misclassified, and this, in turn, could lead to unnecessary anxiety among infertile couples and inappropriate utilization of health care resources...
Towards Single Embryo Transfer: An Embryologist's Perspective - Fall 2006
An embryologist's perspective
Treatment of Polycystic Ovarian Syndrome - Summer 2008
PCOS or PolyCystic Ovarian Syndrome is the most common cause of menstrual irregularity and affects 5-10% of reproductive age women.
Umbilical Cord Blood & Tissue Banking - Fall 2007
When a baby is born the umbilical cord is cut, and the baby enters the world physically separated from its mom. Within minutes, the structures which kept the baby attached to its mom, the placenta and umbilical cord, separate from the uterus and are delivered as the so-called ‘afterbirth’. These structures that were so vital for the pregnancy are no longer useful to the baby or mom, and become waste material. Millions of these are disposed of as waste each year although recent scientific advancements have shown how these structures can be put to use in the fight against disease.
Hidden Cause of Infertility
Worldwide, much is made of obesity and the significant health problems associated with it. Weight excess and obesity are related to a multitude of health consequences, including diabetes, heart disease, stroke, osteoathritis, and reproductive dysfunction - most commonly manifested as irregular menstruation and infertility. However, being underweight also has significant consequences both to general and also reproductive health. Worldwide, low body weight and malnutrition are obviously a significant cause of death, but even in Canada, chronic underweight state and anorexia are also associated with osteoporosis and bone fracture as well as irregular or absent menstruation and infertility. Being either over- or under-weight is also associated with poorer obstetric and infant outcomes. This article will discuss what is normal, how weight affects reproductive function, how maternal weight affects pregnancy and the newborn, and ways to avoid some of these risks.
The story of fertility treatment in western Canada
Why Do So Few Couples Seek Infertility Treatment? - Fall 2007
We know that parenthood is one of the most desired goals in adulthood, and that most people have life plans that include children. However, since surprisingly few seek medical advice for fertility problems, one of our research goals was to understand this inconsistency.