Frequently Asked Questions

Q10.  Do the medications used during in vitro fertilization lead to regrowth of the endometriosis?

Endometriosis growth is driven by estrogen.  Estrogen goes up during ovarian stimulation but the duration of time is too short to cause regrowth of endometriosis.  Endometriosis will likely return over time regardless of IVF treatment as long as the woman has sufficient estrogen in her body. 

Q11.  What assistance does Health Canada provide to Canadians for infertility treatment?

The Ontario Health Insurance Program provides partial funding to patients for IVF who have bilateral blocked tubes to a total of three cycles.  Ontario is the only remaining province to provide this. 

Q12.  What can be done to prevent weight gain during infertility treatment?

Obesity is known to have a negative effect on reproduction.  Both fertility and pregnancy outcomes are better when a woman is of normal weight. Weight gain during infertility treatment is not known to be a effect of the medications used during infertility treatment (clomiphene citrate, injectable gonadotropins).  Weight gain in these situations may be due to other contributing factors such as anxiety leading to compulsive eating or fear of exercising.  Some women may find some weight gain due to water retention that may be related to ovulation but this would be minor.  Prevention of weight gain is commonsense – exercise, eat in moderation, watching what you eat.

Q13.  Does weight gain affect the future baby?

It appears what obese women have a greater chance of pregnancy complications.  They have a higher risk of developing diabetes in pregnancy, blood pressure problems and having a cesarean section which in turn increases their chance of having an infection of the incision site. Both diabetes and blood pressure problems can have negative effects on the developing baby.

Q14.   What is polycystic ovarian syndrome?

PCOS is a condition that has 2 or more of the following features – irregular cycles, problems with acne or hair growth in a male pattern or elevated male hormones in the blood and ovaries that have lots of potential eggs most commonly arranged around the outside edge of the ovary.  We do not know why women develop PCOS but it does appear that the underlying problem in the condition may be how the body handles insulin.  Simply, the body has difficulty handling glucose so the insulin goes up and therefore the male hormones go up and then the menstrual cycle gets interrupted.  There is no cure.  There is some suggestion that a woman with PCOS will find her menses become more regular as she ages.

Q15.   What are fibroids?

Fibroids are an abnormal growth of the muscle cells of the uterus.  They can grow in the wall of the uterus, on the outside of the uterus and in the cavity of the uterus. They are almost never a cancer.

Q16.  How would I know if I have fibroids?

One of the easiest ways to find out if you have fibroids is to have an ultrasound done.  Ultrasound can see most fibroids and measure their size and location. Some women will have an MRI to view their fibroids. 

Q17.  What symptoms do fibroids cause?

Fibroids can cause many symptoms that are mainly in relation to their location. They may cause irregular bleeding if they are in the uterine cavity or the wall of the uterus.  They can also affect fertility by decreasing pregnancy rates and increasing miscarriage rates  but this only occurs if the fibroids are in the cavity of the uterus or very near it.  If fibroids are very large, they can also cause problems with pelvic discomfort, difficulty with urination and bowel movements.

Q18.  How can I get a referral to ISIS?

You may ask your family doctor or any other physician to make a referral. Referral forms are available on the internet website.

Q19.  Are IVF cycles are ever cancelled?

Yes.  Sometimes patients do not respond to the stimulation medications as expected.  They produce too few eggs or eggs that are not growing together.  These women may benefit from stopping the cycle and starting again with a different protocol and/or a higher dose of medications at the start. At ISIS, in order to maximize your opportunity for pregnancy, cancellation of an IVF cycle may be discussed when less than 4 or 5 eggs are growing together. 

Q20.   Can I take herbal supplements during infertility treatment?

Most herbal supplements are considered safe but because there is often minimal to no research on them studying how they influence outcome of infertility treatment, your physician is likely to recommend stopping all herbal supplements during infertility treatment.

Q21.  What about our sex life during treatment?

Continuing with your sex life is important during treatment.  There may be times when your physician recommends not having sex or using condoms if you do in order to prevent pregnancy.  This is most commonly when having a test in which a pregnancy could be negatively affected (HSG, sonohysterogram).  When women are undergoing IVF treatment, they may find intercourse uncomfortable when the ovaries are getting large during the stimulation.  When it is approaching time for an insemination or production of sperm to be used in IVF, you will be advised to abstain from intercourse for 48 hours or more. 

Q22.  During monitoring when taking ovulation induction medications, when do the ultrasounds occur?

The timing of the ultrasounds occur on day 3 of the cycle and then again starting close to ovulation (most commonly on day 10).  After day 10, you may be advised to have an ultrasound every day or every other day depending on your response and your normal cycle response.  You will have an ultrasound until you ovulate and then may do one more to determine how many eggs ovulated.  Monitoring ultrasounds occur in the morning at ISIS.

Q23.   When is therapeutic donor insemination desired?

TDI (therapeutic donor insemination) may be a option for treatment in the following situations:

• When the sperm count is very low or sperm motility is very poor and fertilization of the egg would not be optimal
• When a patient cannot afford to do IVF with ICSI
• Single women
• Same sex couples
• When sperm cannot be obtained from the man’s testicle or if it is, it is not even able to be used for ICSI

Q24.  What is ICSI?

ICSI is known as Intracytoplasmic Sperm Injection.  It is a procedure when a single live sperm is trapped in a glass needle and injected straight into the egg.  You need to do IVF in order to do ICSI.

Q25.  How do I know I am ovulating?

The majority of women with regular menstrual cycles coming every 26-35 days are ovulating regularly at least 96% of the time.  It is when cycles are outside of this range that ovulation may not be occurring in a predictable manner. Some women with polycystic ovarian syndrome can have regular bleeding episodes but not be ovulating regularly.

Q26.  What is the ISIS refund policy for IVF cycles?

During the stimulation cycle, we would like to see at least 8-10 follicles. If there are less than 5 follicles, the cycle will likely be cancelled. You will be responsible for all drugs dispensed. You will also be responsible for all the bloods and ultrasounds up to that point except for the baseline ultrasound and bloods. This cost will be approximately $100/day for ultrasound and blood work.

Cycle Conversion to IUI – During the stimulation cycle, if it is recommended that your cycle be converted to an IUI cycle, you are responsible for all the drugs dispensed and IUI fees. Your procedure fee will be credited for a future cycle or refunded.

Q28.  What lifestyle behaviours are associated with infertility?

Smoking is known to affect both sperm and eggs in terms of their quality and therefore ability to fertilize.  It is known that women who smoke undergo menopause on average 2 years earlier than non-smokers.  Success of IVF is also significantly affected.  Excessive alcohol consumption is also known to decrease fertility.  Though difficult to measure, stress affects the reproductive tract in a negative way.  Large amounts of caffeine consumed on a daily basis also decreases fertility.

Q29.   Can I exercise during treatment?

Moderate exercise is beneficial to the health and to reduce stress.  You may be advised to limit the types of exercise during treatment by your doctor.  It is not advisable to take up excessive exercise for the first time during treatment.

Q30.  Do I need to rest after an embryo transfer?

Studies have shown the lying down after an embryo transfer does not impact the chance of a pregnancy establishing itself.  You will be recommended to take it easy for the remainder of the day after your embryo transfer but you do not need to take the day off work.

Q31.   Is an IVF egg retrieval painful?

All patients at ISIS are given appropriate amounts of pain medication during the egg retrieval.  Some women are more sensitive to pain that others and some ovaries are more sensitive also.  If you have pain during the procedure, tell the nurse and additional pain management will be administered. 

Q32.  What if my husband or partner cannot produce a sperm sample on the day that it is required for treatment?

If there is sufficient concern that sperm will not be produced as a fresh sample on the day of IVF and/or ICSI or when it is needed for an insemination, it is possible to arrange for freezing of a sample prior to the procedure. 

Q33.  My husband travels a lot and may not be available to provide his sperm on the day of my insemination or treatment.  What can we do?

It is possible to arrange for freezing of a sample prior to the procedure.  Speak to your doctor regarding this.

Q34.  How old is too old to do IVF?

Success of pregnancy with IVF is very dependent upon the age of the woman and her eggs.  Studies show that success of IVF is significantly reduced after the age of 43.


Q35.  Does ISIS treat same-sex couples (lesbians, gay men)?

Yes.