Genesis Fertility Clinic Blog
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January 29, 2012
Caffeine
My colleagues and I will sometimes joke that we went to university for 13+ years and now that we are in practice we get asked “can I dye my hair in pregnancy?” and we can’t answer it! We were never taught the answer! We learned about molecular mechanisms of disease, spent hours in the histology lab reviewing cell structures, sat through many lectures on metabolism and pharmacology, etc. but we were never taught the answers to many everyday questions.
One such question I get asked often is “how much caffeine is safe when trying to conceive?”
To answer that a few researchers have followed women who were trying to conceive though their attempts and early pregnancy and had them record how much caffeine (in coffee, tea, soft drinks and chocolate) they consumed. While there were some conflicting results, the bottom line is that more than 200mg of caffeine per day slightly increases the risk of miscarriage. There was no suggestion that caffeine caused infertility.
A study referenced in the NY times recently looked at how caffeine consumption effected non-pregnant women’s estrogen levels. Interestingly, caffeine was found to increase estrogen levels in white women but decrease estrogen levels in Asian women. This is probably due to genetics. The change in level, up or down, wasn’t enough to effect ovulation or fertility, that they could tell. I wonder what it means for mood and libido in the short term, and breast cancer and bone health in the long term. It will be interesting to follow this research.
Part of my job is to translate this kind of science to patients; and it’s the most fun part. Now that I have been in practice for a few years I find myself reading much less basic science research and much more of the patient-centred research. It makes the job more fun and allows me to answer the questions patients actually want answered. Rarely do I get asked about the expression of steriodogenic proteins by mouse syncytiotrophoblasts. hehe….
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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December 15, 2011Varicocele
There are lots of grey areas in reproductive medicine. Sometimes being unclear what the best treatment is makes my job interesting, and other times it makes it frustrating. One frustrating grey area is the management of varicoceles.
A varicocele is an abnormal dilatation of a vein in the scrotum that drains blood from the testicles. Varicoceles can cause pain or aching in the testicles and can effect sperm count and quality. There is little doubt that (at least large) varicoceles can impact sperm, but it is unclear whether fixing them meaningfully improves sperm counts.
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September 13, 2011NSAIDS + pregnancy = bad
If the amount of shelf space a pharmacy dedicates to a particular drug class is proportional to it’s sales, then non-steroidal anti-inflammatories (e.g. Advil, Motrin, Midol, Aleve) are big sellers. Pharmacy shelves are stocked with several different brands of these medications commonly used for pain. NSAIDS are also included in several cough and cold remedies. As North Americans over half of us have used an NSAID for pain in our lifetimes. When you are pregnant, though, you should reach for something different on your pharmacy’s shelf for pain.
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August 28, 2011Choosing who is right
I don’t know why I read Ian Brown, a Globe and Mail writer. Every time he writes about his son Walker, or how Walker’s disease relates to some topical issue, I cry. Last year when exerts from his book, The Boy in the Moon, were published by the Globe, I read, unable to hold back tears. Walker, who is now 15, has an impossibly rare genetic disorder that leaves him profoundly disabled.
This week, Mr. Brown wrote about his son in the Globe again. The article was about the new at-home fetal-DNA tests available in the USA.
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August 4, 2011Sex Position and Gender
Later today one of my dear friends is have a c-section to deliver her third child. Like her first two, this child is a boy. After having two boys, she and her husband really wanted to have a girl. She asked whether certain foods or sex positions can increase the chances of conceiving a girl.
She had read lots of different advice on the internet, based on common myths about gender selection. Sadly, none of these work.
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June 20, 2010Osteoporosis
Ok, infertility and osteoporosis aren’t intimately related, but as a “public service announcement” I thought I’d post that all women should be taking about 1,000 – 2,000 IU of vitamin D per day (depending on how much vitamin D you get in your diet and from the sun).
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June 16, 2010AMH
Fertility declines with age because egg number and quality decrease over time. This happens to all of us (unless you are a celebrity it seems! Ok, that’s a donor egg discussion I’ll leave for another entry).
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June 8, 2010How do people choose a clinic?
Driving down the strip in Las Vegas this past weekend while on vacation I heard an advertisement on the radio for a fertility clinic. My gut reaction was “ugh.” It sounded like they were announcing a mattress sale or deeply discounted used cars. It just didn’t feel right, and it made me wonder how many people choose a fertility clinic based on similar advertising.
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May 28, 2010Pregnant at 47
John Travolta’s wife is pregnant at the age of 47. I bring this up because daily since the news broke a patient who is aged 43-50 has asked me how they could get pregnant yet she can’t.
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May 9, 2010Mother's Day
Mother’s Day can be a particularly painful day if you are infertile. An American Infertility Awareness Association speaks to the difficulties the day can bring for women and some tips to make it better. Read here.
Here’s hoping the day brings joy and hope….
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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January 3, 2010Public Vs. Private Health Care
Nearly every week either a patient or someone I meet socially will ask me whether Genesis is a “private health care clinic.” The short answer is “no.”
According to Health Canada, private health care clinics in Canada are “facilities that receive no government funding: the physicians are not reimbursed by the provincial health care insurance plan and their patients must pay the full cost of the services rendered to them.”
At Genesis, we are fully within the public health care system, i.e. MSP. The catch is that not all the services we provide are covered by MSP.
I admit that the public versus private health care issue is a bit confusing as there are gray areas. The health care system in Canada is publicly funded but mostly privately delivered. Most people are treated by physicians who are in their own private practice (including your GP). This means that they are not paid a salary by the government, but they bill MSP for your medical treatment rather than charging you directly.
We are just like any other physicians or medical clinic in this regard: we see you at Genesis and bill MSP for treatments they cover. This includes your consultation with us, surgery, ultrasounds to monitor menstrual cycles, and emergency room treatment. Even your fertility tests are covered by MSP. There are a number of treatments that are not covered by MSP and these include IVF, some sperm tests and artificial/intrauterine insemination. The reason for this is that Health Canada has decided that:
… a number of services provided by hospitals and physicians are not considered medically necessary [including vitro fertilization and artificial/intrauterine insemination] and, thus, are not insured under provincial and territorial health insurance legislation. Uninsured physician services for which patients may be charged differ from province to province.
At the moment, Quebec is the only province that plans to covers IVF (likely starting in the spring 2010). However, there has been some promising progress in Ontario as a report released in August 2009 by the The Ontario Expert Panel on Infertility and Adoption proposed that Ontario health care should fund up to three treatment cycles and one session of counseling. The report argues that health care costs would be reduced by funding and regulating IVF. Currently, these recommendations are being reviewed by Ontario healthcare (OHIP), and if they were adopted that would put pressure on other provinces to follow suit.
At Genesis, we have been long-time advocates for IVF to be funded by public health care, and Dr. Albert Yuzpe sits on a national board that is lobbying the government.
We are committed to promoting reproductive health and advancing fertility treatments. In addition to caring for our patients at Genesis, we work at VGH and BC Women’s providing gynecology services and teaching medical students and residents.
And while it doesn’t help you if you are trying to conceive with IVF or other uncovered treatments now, we do hope that our efforts are going have an impact on the delivery of fertility treatment in the future.
Because the decision to fund or not to fund fertility treatments is largely political, public pressure on both your MLA and on the BC’s health minister Kevin Falcon may help bring about change. If you want to express your views on the need for public funding for fertility treatments like IVF, you can e-mail Kevin Falcon at Kevin.falcon.mla@leg.bc.ca
Dr. Beth Taylor
Reproductive Endocrinology & Infertility