The facts about fertility

One in six Canadians will struggle with this important issue. Tracey Tong spoke to one couple about their experience, and consulted with an expert to clarify the many misconceptions about fertility.

When Kaeleigh MacDonald and her husband Jeff decided to have children, they didn’t think there would be any problems. After all, the couple, who had been married for four years, were young (26 and 27 respectively), healthy and in great shape.

After six months, they still hadn’t conceived, so MacDonald improved her diet, added folic acid, and starting using ovulation kits. When 10 months had passed without conceiving, she started to get concerned. Friends who had started trying for babies after they did were pregnant. The MacDonalds asked their doctor to refer them to a fertility specialist.

“I had to push my doctor really hard to see a fertility specialist,” says MacDonald, who is from Calgary. The doctor said MacDonald and her husband were young, and should keep trying.

There was an eight-month wait to get into a fertility clinic, where MacDonald was diagnosed with diminished ovulation reserve, meaning she had fewer eggs than an average person of the same age.

“I hadn’t been worried about eggs at all,” says MacDonald. “It wasn’t even on my radar. For that to be the problem was really devastating.”

According to statistics from the Government of Canada, one in six Canadians will experience infertility, and a new survey from Fertility Matters Canada shows that there are many misconceptions about fertility.

The general rule is for people under the age of 35 to try for one year and people over the age of 35 to try for six months before seeing a fertility specialist, says Dr. Dan Nayot, a Reproductive Endocrinology and Infertility Specialist at Toronto’s Trio Fertility. Trio Fertility sees nearly 10,000 new patients every year, with many people coming from out of town and internationally to get second opinions.

Patients should seek help earlier if they suspect something more is going on, or if they have health issues such as obesity, uncontrolled diabetes, sleep apnea or thyroid dysfunction that could affect fertility, says Nayot.

Lifestyle factors, including stress, poor sleep, poor nutrition, lack of exercise and environmental toxins like smoking and drinking also have a negative impact on fertility, he adds.

While many people end up conceiving without assistance, there are also patients who, without fertility treatment, will not conceive or have very little chance of conceiving, Nayot says.

However, one of his jobs is reassuring patients. “People can be hard on themselves,” he says. “Even the most fertile among us can’t expect to be pregnant in three, four months.” 

By the time they got their diagnosis, the MacDonalds had been trying to have a baby for two years. After unsuccessfully attempting intrauterine insemination, they moved on to in-vitro fertilization (IVF).

While the average round produces 20 to 25 eggs, MacDonald only got seven mature eggs. Four were successfully fertilized, and nine months later, their son Callan was born.

With Callan set to turn two, MacDonald – who writes the blog about struggling with infertility, and Extra!, an upcoming children book on families conceived through alternate means – and her husband recently had a surprise.

Earlier in 2017, they were planning a second embryo transfer when she had a positive pregnancy test, and a second child for the couple, this time conceived naturally, is due in May 2018.

“It was the craziest moment,” says MacDonald. “It’s hard to believe that’s even my reality because it was such a road to be pregnant with my son.”

All in, the couple spent about $11,000 on fertility treatments, but one big misconception about these treatments is the cost, says Nayot.

Even though cost can be a big barrier, the assessment is almost completely covered by OHIP. Medication is not covered, but starting in 2015, OHIP began funding IVF for patients under the age of 43 with a recommendation from by their family doctor.

The field of fertility is still fairly new, but is rapidly evolving, says Nayot, also an executive on the board of Fertility Matters Canada, which raises awareness of fertility in Canada.

The stigma of infertility is where mental health was 10 years ago, says Nayot. Increasingly, people are talking about it and recognizing it as a medical issue, which he says is great. “We want to connect people with resources and see more funding and research,” he says.

It’s obvious Nayot is passionate about his work. “It’s something where you can help somebody through a journey of highs and lows. When it works, you can change many people’s lives all at once.”

Although MacDonald acknowledges not everyone who struggles with infertility will come out with a baby, she urges would-be parents to stay strong.

“When you’re going through this, it’s hard to have faith that you’re going to get to where you’re going to get to,” she says.

“It will show you your inner mettle and what you’re made of, and you’ll develop all this empathy and hopefully, become a better person.”

Photo: © Kasia Bialasiewicz