FAQs

Infertility

What exactly is infertility?

Infertility is the inability to conceive a successful pregnancy. It is defined by failure to achieve pregnancy in the presence of regular menstrual cycles and regular intercourse (ie. every two to three days) over the duration of one year. There are numerous causes of infertility including male factors (40%) and female factors (40%), and the remaining 20% is both partners and idiopathic/unknown. Typically, 60% of people are able to conceive within 6 months of trying, 80% within one year, and up to 90% after two years.


You should seek assistance if:

  • You have irregular menstrual cycles, regardless of your age, and have been trying for 6-12 months.

  • You are less than 35 years, with regular menstrual cycles, and have been trying for 12 months.

  • You are 35 years or older and have been trying for 6 months.

  • You have other medical or social concerns that could significantly impact your fertility, such as genetic abnormalities, conditions such as systemic lupus erythematosus, or a history of significant uterine, tubal, or ovarian disease(s).

  • You have significant testicular, epididymal or prostatic damage or injuries.

 

If you meet any of these criteria or have any other concerns you would like addressed, you should consider making an appointment with Victory Reproductive Care for comprehensive evaluation and treatment. Click here for more information...

 

How important is age with fertility therapy?

The age of a woman receiving fertility treatment is an important factor. A woman's fertility naturally declines with age, most notably over the age of 35. Success rates are higher among younger women, but there are still options available for women over 35 to successfully conceive.

 

What can cause infertility in women?

Infertility can be caused by one or a combination of the following factors: ovulatory disorders; hormonal problems; failure to produce mature eggs; malfunction of the hypothalamus or pituitary gland; premature ovarian failure; diminished ovarian reserve; follicle problems; tubal disease; complications from abdominal diseases such as appendicitis and colitis; internal adhesions caused from previous surgeries; ectopic pregnancies; congenital defects of the reproductive system; polycystic ovarian syndrome (PCOS); endometriosis; exposure to toxins or chemicals in the environment or workplace.

 

What can cause infertility in men?

Medical causes of male-factor infertility can be caused by physiological problems with the testes (varicocele, undescended testicles, ejaculation problems such as retrograde ejaculation); anti-sperm antibodies; cancerous and benign tumors and associated treatment; hormone imbalances in the hypothalamus, thyroid, pituitary, or adrenal glands; previous sexually transmitted infections; inflammation of the prostate; sperm-duct defects such as epididymitis; chromosomal anomalies; Congenital Bilateral Absence of the Vas Deferens (CBAVD); and erectile/ejaculatory dysfunction. Men living with health conditions such as celiac disease, diabetes, and spinal cord injuries also suffer higher rates of infertility. Exposure to some industrial chemicals, anabolic steroids for body-building, radiation/x-rays, frequent use of hot-tubs, saunas, and seat-heaters can also negatively impact sperm production.

 

Does my weight impact my fertility?

Your dietary and lifestyle choices have a direct impact on your fertility. Regular exercise and maintaining a healthy weight can increase your chances of achieving a pregnancy. Significantly underweight or overweight women can struggle with fertility.

 

What lifestyle choices would increase my chances of getting pregnant?

Abstaining from alcohol, smoking, and recreational drug use will also give you a better chance of conceiving and maintaining a pregnancy through to term. All these substances negatively impact sperm count, motility, and mobility thereby decreasing fertility, while also having significantly detrimental impact on egg quality, embryo quality and implantation. Smoking cigarettes reduces chances of conception by up to 50% and dramatically increases almost all pregnancy complications including miscarriage, antepartum hemorrhage, abnormal placentation, preterm labour and delivery, premature rupture of membranes, intrauterine growth restriction, placental abruption and additional neonatal risks of morbidity and mortality. Women who consume alcohol while pregnant triple their risk of miscarriage and put their fetus at risk for birth defects. Marijuana use negatively impacts sperm quality and quantity and is also damaging to fetal neurodevelopment.

 

What are the factors that impact my success with fertility treatments?

Each patient's body is unique and treatment protocols reflect careful consideration of your specific history and medical evaluation. Successfully achieving a pregnancy through fertility treatments depends on several variables including your age and weight, your body's response to fertility medications, the age and quality of the biological specimens (eggs and sperm), the health and well-being of the reproductive system, and whether or not external contaminants such as smoking, alcohol and drugs are involved. After meeting with Dr. Victory, you will have a complete understanding of your fertility options and success rates.

 

What is Ovulation Induction?

Ovulation induction refers to the procedure whereby the female patient takes medication to improve the natural ovulatory response by increasing the number of mature eggs released during ovulation. Blood tests and ultrasounds are performed every few days for up to two weeks to monitor the growth of the follicles. Mature follicles are released by an injection of the human hormone Beta HCG that forces ovulation in over 98% of cases.

 

What is an Intrauterine Insemination (IUI)?

An Intrauterine Insemination (IUI) is a procedure whereby sperm, provided by the female patient's partner/donor, is put through a chemical wash to isolate the best of the sample. The washed sperm is then inserted directly into the uterine cavity through a catheter. This procedure bypasses the vagina and cervix thereby increasing the number of motile sperm reaching the uterus and fallopian tubes. The IUI procedure compensates for mild male factor infertility and can be quite successful with cases of unexplained infertility. An IUI is often done in conjunction with ovulation induction.

 

What is In-Vitro Fertilization (IVF)?

In-Vitro Fertilization (IVF) refers to the delicate procedure of removing mature eggs from the ovaries via a fine needle (under ultrasound guidance) and inseminating them in the laboratory with your partner's/donor's washed sperm sample. The female takes oral and injectable medication to improve the ovulatory response and release a higher number of mature eggs. Follicular monitoring and blood tests are performed regularly for the duration of the cycle, and when the eggs are mature the patient undergoes an Egg Retrieval procedure to collect the eggs. The skilled embryologist fertilizes the eggs and monitors them each day in the laboratory to assess their growth and viability. Three to five days later, a select number of embryos are transferred back into the uterus via a catheter. IVF is often done in conjunction with ovulation induction.

 

What Can I Expect At My First Infertility Appointment?

An Interview: We will take an extensive health history to document your infertility and health history. This will be a supplement to any information already provided by your primary healthcare provider. Following the interview you will meet with Dr. Victory.

Bring your partner: We thoroughly investigate both of you and encourage both parties to be present as this first visit introduces you to Dr. Victory, our team, and your potential treatment plan.

Consent signing: If you would like to share the results of your testing with your partner, you will need to sign a consent form upon arrival.

Meet our staff: We will introduce you to our skilled team.

Leave with information in-hand: You will leave with a folder summarizing your treatment plan options, instructions, and additional test requisitions.

 

 


Obstetrics

I am pregnant.  When do I see my Obstetrician?

You are typically first seen between 12 to 14 weeks, but it depends on when your family physician’s referral arrives requesting an appointment. Your appointment schedule will be as follows: once a month until 28 weeks; every two weeks between 28-36 weeks, and once a week from 36 weeks until delivery.

 

What should I do if I think I am leaking fluid or think I am in labour?

You should proceed immediately to OB triage at Windsor Regional Hospital, Metropolitan Campus.

 

How much weight should I gain in pregnancy?

What and how you eat during pregnancy will affect your child’s future health. You can protect your health and the health of your growing baby with a healthy diet. During pregnancy, you will need extra calories, protein, vitamins, and minerals. As a general guide, underweight women should gain between 28-40lbs, normal weight women should gain 25-35 lbs, overweight women should gain between 15-25 lbs and obese women should gain between 11-20 lbs.

 

What is a good resource for pregnancy and breastfeeding?

An excellent reference guide is the Pregnancy and Breastfeeding Pocket Guide: Advices on Medication and Commonly Used Products by the Mother and Child University Hospital Center, Université de Montréal.


Gynaecology

What is an ovarian cyst?

An ovarian cyst is an abnormal growth of an area within the ovary. Cysts can be solid, blood, or fluid filled, singular or multiple, benign or cancerous (malignant). The majority of ovarian cysts are simple cysts that are left over from previous menstrual cycles and did not resolve or resorb when they were supposed to. Most cysts will resolve over time. Some cysts, such as endometriosis cysts (endometriomas), dermoid cysts (teratomas), and complex cysts require surgical treatment, as they are not likely to resolve on their own and/or may pose some risk to the ovary and the patient.

 

What is a uterine fibroid?

A uterine fibroid is an abnormal growth of one of the muscle cells of the uterus, forming a firm nodule or mass in the uterus. These masses are present in up to 50% of women. They are almost always benign, but can cause problems such as bleeding, pain, pressure, miscarriage, and infertility. Fibroids can be located either in the uterine cavity, in the wall of the uterus, on the outside of the uterus, or in more unusual locations such as the cervix, or beside the uterus in rare circumstances. Currently, there are numerous treatments for fibroids, including both medical and surgical therapies aimed at either treating symptoms, shrinking the fibroids, or removing them even via minimally invasive surgeries.

 

What is Endometriosis?

Endometriosis is the presence of cells from the inner lining of the uterus (endometrium) that are located outside of the uterus in areas such as the surface of the uterus, the lining of the pelvis (peritoneum), the ovaries, fallopian tubes, the bowel, bladder and even distant locations such as the diaphragm, umbilicus and superficial scars. It is present in up to 25% of women, and more than half of patients will experience some adverse effects. Because the tissue is located incorrectly (ectopic), it causes a significant increase in inflammation. This inflammation subsequently leads to chronic pelvic pain, tenderness, nodules, sensitivity, cysts, infertility, heavier menstrual periods and pain with intercourse. Endometriosis can be minimal or severe. Depending on the symptoms and the desire for fertility, there are numerous methods of treatment including both medical and surgical approaches.

 

My periods are irregular, is this normal?

Normal periods occur with a frequency of every 21 – 35 days. If your cycle is shorter or longer than this, they may not be ovulatory, meaning no egg is being produced or released. This is particularly common when women have a condition called polycystic ovarian syndrome. Typically these women have irregular periods, and features of high male hormones (hyperandrogenism), including acne, excess facial and body hair growth (hirsutism), excess body weight, male pattern baldness, and infertility. Women with irregular periods can have significant hormonal abnormalities, including excessive estrogen levels, which can place them at risk for estrogen based cancers, including endometrial cancer.

 

I have very painful and heavy periods. Should I be concerned?

Painful periods (dysmenorrhea) are common. They are not always an indication that there is something wrong. However, some women with painful periods can have pathological conditions such as endometriosis that can cause other problems including infertility, chronic pain, and painful intercourse. There are numerous treatments for painful periods including both medical and surgical options. See your doctor to determine which option is best for you.