Good news in Britain

INFERTILITY: UK moves to extend free IVF to women up to 42, same-sex couples, cancer patients

May 22, 2012

Isabel Teotonio

Embryologist Ric Ross pulls out vials of human embryos from a liquid Nitrogen storage container at the La Jolla IVF Clinic February 28, 2007 in La Jolla, California.

Sandy Huffaker/GETTY IMAGES

Advocates for infertility patients say Ontario should follow the lead of Britain, where a powerful health advisory agency recommended on Tuesday that the U.K. extend free fertility treatments to women up until the age of 42 and to same-sex couples.

In Ontario couples struggling with infertility continue to pay for costly treatments and there is no indication that the provincial government is moving toward funding in vitro fertilization (IVF).

“I think it’s fantastic what’s happening in Britain,” says Jan Silverman, a Women’s College Hospital infertility counselor who’s also a member ofConceivable Dreams, a grassroots organization representing infertile couples across Ontario.

“What makes me frustrated is that these models have come up in other areas, such as Quebec and now Britain, and yet we cannot budge the Ontario government right now.

“It is shameful that Ontario has let the needs of the infertile population go unrecognized and undealt with, causing unbelievable expense to people for wanting to have a child.”

The British health system usually pays for up to three cycles of IVF for couples who have been trying to get pregnant for at least three years. Previously, women had to be under the age of 40 to qualify. Many government-funded clinics already treat gay and lesbian couples, but the recommendations now make that explicit, though they are not binding. (The recommendations will likely be followed by many of the U.K.’s medical centres.)

The guidelines are likely to affect only a minority of patients, and it will be up to hospitals to decide whether to pay for IVF treatments. Britain’s health service is being forced to trim $31 billion USD from its budget by 2015 and many hospitals often ration who gets IVF and deny the treatment to eligible patients. One IVF cycle typically costs about $4,730 USD.

Adam Balen, chairman of the British Fertility Society, said the new draft guidelines recognized the importance of treating infertility, citing the psychological harm it can cause. “No one who stands a reasonable chance at conception should be denied the opportunity,” he said in a statement. “These (new) guidelines outline how that can be achieved.”

The draft guidelines issued Tuesday also say the government should pay for IVF in people with diseases such as HIV, or patients facing cancer treatment who want to preserve their fertility. About one in four IVF cycles results in a baby; that drops to about one in 10 for women over 40.

Elsewhere in Europe, many countries including France, Germany, Italy and Switzerland ban gay and lesbian couples from receiving IVF and often impose similar age limits for eligible women, cutting off treatment to women over 40.

In all Canadian provinces, except Quebec, IVF treatment is not covered. According to the Canadian Assisted Reproductive Technologies Registry, in 2008 – the last year for which statistics are available – 9,904 live births in Canada were the result of IVF.

The Royal Commission for New Reproductive Technology found that a quarter of a million couples in Canada are affected by infertility, which is defined an inability to conceive after 12 months.

In Ontario, because treatment is not covered by OHIP, most couples transfer multiple embryos rather than a single embryo. But multiples are 17 times more likely to be born pre-term, to require a caesarean delivery and to need expensive care at birth and throughout their lives, according to Conceivable Dreams.

In 2009, Ontario’s Expert Panel on Infertility and Adoption recommended that the province fund up to three cycles of IVF for women up to age 42, not discriminate against same-sex couples and adopt policies that reduce the number of multiple pregnancies through IVF.

The panel estimated that the savings to the healthcare system through a reduction in the number of multiple births through IVF would be between $400 million and $550 million.

“I understand that it’s a time of fiscal restraint,” says Silverman, who was part of the panel. “However, the arguments we have put forward are about cost-saving methodology not about further spending.”

During the last provincial election, advocates sought a commitment from all three political parties to provide OHIP coverage of IVF and encouraged Ontario to follow the lead of Quebec.

In August 2010, the Quebec government began funding up to three rounds of IVF treatment for couples, on the condition that only one embryo be transferred at a time. The aim is to reduce the number of multiple births, which are riskier than births of singletons.

Early results show a decrease in twins from 27 per cent to 5 per cent in the first 6 months of government funding, according to the Registry.

With files from the Associated Press

One year later....

On April 24 our little miracle turned ONE!
I can't believe a whole year has gone by and now I'm already back to work and missing every moment at home. But he is thriving at his great home daycare that is just around the corner from our house and meeting new friends. He comes home with messy hands and paint covered clothes--a great indication of a day well spent! His precious artwork gets hung up on the fridge and when I got my first "Ethan-made" mothers day card I felt a small tug of joy in my heart that I would be getting one of these every year. At the end of the day after tucking E in, I put my card up on the mantle and it made me realize just how lucky I am to be this lil man's mom. 

And then I got another small tug in my heart..full of sadness for all the ladies I've met online and through these blogs, those amazing ladies who have yet to fulfill their journey to mommyhood. I can't forget how sad the holiday of Mothers Day can be when you are still counting out cycles, measuring out meds, taking temperatures and bloodwork and peeing on sticks that never produce that silly second line you pray for. 

I keep all you ladies in my heart and still log on to follow your journeys while I can--I'm excited when I hear someone's BFP (Big Fat Postive) and heartbroken when those embies just don't stick. I can only hope that one day your miracle will come your way as well.

It is the simple things in my day--like a painted handprint card-- that make me ever so grateful for becoming a mom. Of course, like many women who struggle with infertility, I never forget our journey and already have many people asking us when we are going to have another. It's a difficult question, especially when the person asking doesn't know that Ethan was conceived through IVF. We are extremely lucky that we have nine top grade embryos sitting in the freezer so our next cycle won't be as invasive (or expensive) as our first--but I also know the success rates of frozen embryo transfers as well as the fact that while it is significantly cheaper it is still $700 a cycle (not including meds which can be up to $3000). 

For now my hands are full with my rambunctious one-year old who  everyday makes me smile.

The following pics are of a recent trip we took to our fertility clinic in London (a three hour trek from where we now live) for Ethan to meet the man behind it all. Dr. Power will forever hold a special place in my heart and not only for helping me become a mom. He is the same doctor that saved my life in 2001 and I can truly say I wouldn't be here today without him.  

It was a great moment for mommy. 

                             Ethan meeting our fertility doctor with lots of smiles and giggles.

When we started our fertility journey I snapped a picture of myself in this exact spot to document our clinic...what a great feeling to snap another pic with my lil munchkin in it!

Long overdue but here is my precious miracle--ETHAN!!

To say it was all worth it is an understatement.. my precious miracle arrived on April 24, 2011

Ethan Foster

7lbs 14 oz

21 inches

He is the happiest two month old boy and every day amazes his mommy!!

22 weeks--past the half way mark

So today I had my second OB appointment and with the results that the anatomy scan and IPS #2 test all came back normal the reality has set in that in 18 weeks I'll be a mama!!

And just to make things more interesting I'll also be a homeowner on Jan. 24--meaning we'll be moving to Innisfil on Feb 2.--nothing like a 7 month old prego moving in the middle of the winter. :) We are extremely excited that 2010 really turned out to be our year and can't wait for the new adventures in 2011.

We have already started planning for the baby's room and since we are not finding out what we are having we decided on a tree/forest themed room with white furniture --lots of owls and woodland creatures to entertain!!--I've been searching on craigslist and kijiji and Im surprised people ever pay full price for stuff when sooo many people are selling almost new items. Needless to say we'll probably end up with an amazing crib for under $200!

here's some pics of the bedding we have--can't wait to paint the room and get organized!

Blood type O may affect infertile women’s chances of pregnancy

From parentcentral.ca

November 04, 2010

Debra Black

Staff Reporter

Researchers at Yale University and Albert Einstein College of Medicine have found an association in infertile women between type O blood and a diminished ovarian reserve, or the number of eggs that can be fertilized and result in pregnancy.
The study found these women with blood type O were at double the risk of having diminished ovarian reserve than women of other blood types, said Sangita Jindal, an assistant professor in the department of Obstetrics & Gynecology and Women’s Health at the Albert Einstein College of Medicine and one of the authors of the study.
But she cautioned: “I don’t want people with Blood Type O to think they’re half as likely to get pregnant. This is only in the infertile population and it’s only an association. We don’t know what the cause is.”
The study of 536 women’s blood types, obtained from data at Yale University under the supervision of Dr. Lubna Pal and data at Albert Einstein College of Medicine, found that both blood type O and A had an association with ovarian reserve.
In the case of infertile women with blood type O, they were twice as likely to have an elevated amount of FSH – a hormone produced by the pituitary gland that is related to the production of estrogen – as well as diminished ovarian/egg reserve, Jindal said in an interview with the Star.
High levels of FSH, or follicle-stimulating hormone, are a key indicator of having a low egg count.
However, researchers found that infertile women with blood type A in the study were 50 per cent less likely to have elevated FSH and diminished reserve, said Jindal who is from Ottawa and did her Ph.D. at the University of Toronto’s Department of Medicine at the Banting and Best Department of Medical Research.
Blood type B failed to demonstrate any relationship with FSH, the study found.
Jindal, also the lab director for the IVF program at Albert Einstein College, stresses it’s too soon to come to any conclusions about what the study’s results mean when it comes to helping infertile couples, which make up about 15 per cent of the population across North America, or one in six couples.
More research must be done to understand what the association means, Jindal said.
The researchers will need to look at blood types and the actual number of eggs produced through IVF in female patients, as well as a number of other variables before they can associate a response to a blood type, she said.
Once that is better understood, doctors working with infertile couples could one day use a woman’s blood type to help determine IVF treatment, Jindal said.
“I think we’re still grappling with why ovaries age. This is another piece of information we bring to the puzzle – yet another association.
“The field is still pretty new.”
The study, which Jindal and her co-authors hope will be published in a journal next spring, was recently presented at the annual American Society for Reproductive Medicine conference in Denver, Colo.

Feeling like I won the lottery

I am almost at the 16 week mark--FOUR MONTHS pregnant and this week I realize just how lucky DH and I am. I've been following all the ladies I cycled with during IVF that resulted in pregnancy--I think there is about 8 or 9 of us---out of 30 or so...each one of us knowing how extremely lucky we were.

While I was browsing around some of the other ivf blogs I just can't belief the amount of heartache and disappointment that goes along with it. I read one woman's story after four ivfs---her cycle yet again has been cancelled due to poor response from her ovaries (even with all those injections pumping in the crazy hormone drugs)--I don't know where they find the strength to keep their chin up and look ahead to the next cycle. 

The odds are low and I knew that going in which just makes me realize just how much of a miracle my lil bean is!!

MIA but back in action

So I realized this morning that I've really put my blogging on hold and I'm not sure what happened...part of me didn't want to write my joy into words in case things took a turn for the worse. As a first time pregger and IVFer I can admit I have been pretty calm about twitches, cramps, aches and pains--I have yet to drive to the ER for confirmation that my bean is still where it should be--BUT throughout my whole first trimester it did sit in the back of my mind that things can go wrong at the most unexpected moment.
Well I am officially onto my second trimester and after an amazing u/s on Tuesday I am feeling more like this is all really happening. The baby was extremely active--so much so the technician had a very difficult time getting the neck measurement. The entire time I had a permanent smile across my face and be amazed at the baby bouncing its feet off my uterine wall (of course I won't be smiling if he/she does that all day once I can feel him/her  LOL)
My symptoms are as strong as ever with nausea (and sickness) getting worse by the weeks---I was hoping week 12 was my saviour but oh no it only gets worse with my poor DH having to witness me losing my breakfast into a bag while we make our morning drive into the city.--no stopping on the express lanes during rush hour :(
I have also just discovered I am anemic--probably from being pregnant but is a HUGE explanation as to why I've been breathless after going up the stairs and a high heart rate (130 resting!)--but no fear it is typical in pregnancy and I'll start a supplement after a second test.
One of the hardest things for me has been being under the care of my family DR. and not my fertility DR. who I trust immensely. I have told my family DR. twice now that I am an IVF patient--every time she fills my blood work form she goes to tick off NO in the IVF box. I just feel like the care isn't up to par and am counting down the days till I get to my OB at Credit Valley Hospital!!
So until Nov. 17th I'll try and stay sane!
This weekend should be a great time for us as we have so much to be thankful for and so much to look forward to. I went on a buffalo shopping trip with my sister and two close friends (all of whom are prego) and couldn't resist buying one little outfit at Carters---a first thanksgiving onezie with a turkey hat--can't wait to show it off next year at the cottage!!
Happy thanksgiving to all the mommas, mommas to be and mommas in waiting!