Over the years IVF success rates have gotten better and better.  We can stimulate the ovaries to produce multiple eggs fairly well (if there are eggs to stimulate), we usually can extract 80-90% of the eggs that grow, and our lab is very good at fertilizing eggs and creating embryos.  We can even test embryos now (PGT-A) to get a sense of an embryo’s chromosomal health.  Even with all these advancements, IVF pregnancy rates are still not 100%.

 

Glee - the TV show about high school kids from about 10 years ago. I remember liking the show and thinking it was about music and high school angst. I started watching it this week with my 12 year old daughter.  Turns out, Glee, when seen through a mother’s eyes, is about sex and how to get pregnant and drink alcohol in high school.  We’ve had to stop watching it because I was fast-forwarding 80% of the show to get past the inappropriate parts.  I guess we’ll go back to Peppa Pig reruns.

 

At the end of medical school we promise to abide by the Hippocratic Oath.  In the oath we declare, among other things to "...abstain from all intentional wrong-doing and harm."  Then we complete a residency and eventually get a license to practice medicine from the College of Physicians in our province.  The College of Physicians asks us to keep the highest ethical standards possible in patient care. The College is then meant to police physicians, ensure patient's are not being harmed by the actions of physicians.

 

One of the more awkward conversations to have with patients is about weight.  There aren’t many overweight or obese woman who haven’t tried to lose weight, wish they could lose weight or feel terrible about their weight.  In my experience, most women do not want to talk about their weight - it hurts.

 

I just spent a wonderful week showing my dearest friend around the Maritimes. Born in New Brunswick and raised in Nova Scotia, I still consider the Maritimes “home” even though I have lived in BC longer than I have in the east.  One day we drove from PEI, to New Brunswick and to Nova Scotia.  While the eastern provinces are small in comparison to western Canadian provinces, that day of driving was still about 6 hours.  Lots of time to chat, listen to podcasts and belt out 80s music (to the chagrin of our children in the backseat).

 

Some patients are hesitant to pursue fertility treatment out of a fear that hormone treatment might harm their health.  This is a fair concern, after all, we are putting women's ovaries and endocrine system through abnormal pressure.  Is that harmful?

 

IVF has been performed since 1978 and hormone manipulation to promote fertility since the 1960s.  We've been studying women who have undergone fertility treatment in many ways, over many studies, over many years.   I follow these studies closely so:

 

One thing that drives me bonkers is smelling marijuana in public.  I don't much like the smell and you can never figure out who is smoking it so you can't avoid it.  Tobacco smokers are really obvious - they are usually in pairs, standing outside a government building or a bar. You smell the smoke and see the cigarette.  For some reason, marijuana isn't like that.  The smell is dense and icky and you can't figure out where it is coming from, well, at least I can't.

 

I don't read fiction very often.  I read scientific journals, non-fiction works, autobiographies and the like.  I'm not much for the un-real.  I've never been invited to join a book club and would certainly decline the invitation unless it was for non-fiction works (or there was good food or wine, in which case I would fake it).

 

In reproductive medicine we face ethical dilemmas regularly.  Nearly every week we navigate questions about treating when the chance of success might be futile, when the treatment might pose risk that exceeds the benefit, when patients ask for care that is outside of societal norms, and more.

Are we going to hell in a handbag? My mother thought so, mostly because I had terrible manners, poor posture and listened to music that was too loud.

My parents made me suspicious of insurance. They weren't necessarily optimistic people, but they just felt they could handle bad outcomes themselves and didn't trust that insurance help with be forth coming in the event of a disaster.

Happy 2019! Looking back at my blogs, it seems the most popular ones are the simplest. The ones where I attempt to explain the every day questions of infertility.

"Will I love the child?" "Will I be able to bond with them?" I get asked this a lot by women considering using an egg donor. These questions are heart-breaking. I often get a lump in my throat when I'm asked these questions because I know the place they are coming from.

There are few things as terrifying as bleeding in pregnancy. Even a spot, or a pink tinge on the

Should I do PGT-A? I get asked this every day. About 1 in 4 of the patients I see need to