A miscarriage occurs when a woman loses her pregnancy before the 20th week. Also called spontaneous abortion, it occurs in most cases during the first trimester (before 14 weeks). It is important to know that the rate of miscarriage increases with the age of the mother or the person providing the eggs. Since it often happens at the very beginning of the pregnancy, it may go unnoticed. However, there are signs that may indicate a miscarriage and should be investigated during any pregnancy. These include bleeding or painful cramps.
Miscarriage: Management
Management depends on the age of the pregnancy at the time of conclusion. It may include a period of observation, medication or a curettage. But it is important to remember that a miscarriage is not only physical but also psychological. It is important to have a support network and sometimes it may even be necessary to consult a psychologist.
How can a fertility specialist intervene in case of miscarriage?
When a woman experiences a miscarriage, it is important that she be accompanied on a moral and psychological level as well as on a medical level. Indeed, a miscarriage can have an impact on the health of the woman as well as on the outcome of future pregnancies. Hence the importance of being accompanied by a health professional who is comfortable and knowledgeable on the subject.
For example, experts recommend that women who have had two or more miscarriages meet with a fertility doctor. Many family doctors or gynecologists can also help. If possible, consulting a fertility specialist is a good idea.
Many women who experience pregnancy loss go on to have healthy pregnancies, but the loss may indicate a fertility problem. This problem needs to be recognized and evaluated if the pregnancy plan is to be pursued.
A fertility specialist will meet with you and propose a personalized treatment plan. He or she will evaluate the potential causes according to your history, such as :
Abnormal shape of the uterus (malformation, myomas, etc);
Genetic abnormalities;
Hormonal disorders;
Infection;
Immunological factors;
Since the majority of miscarriages are due to a chromosomal abnormality of the embryo, the discussion may also include the evaluation of the relevance of a genetic analysis of the embryo before a possible implantation.
Embryos analyzed in this way and considered normal will offer a higher pregnancy rate and limit the risk of genetic abnormality in the embryo, and consequently of miscarriage. Abnormal embryos will generally not be used since they often result in a negative pregnancy test or miscarriage.
Note that all of these risks are directly related to several factors, mainly the woman’s age. Thus, the options may vary depending on your personal circumstances.
Follow-up and advice from doctors
If you have suffered repeated miscarriages, we invite you to make an appointment with a fertility specialist who will be able to help you find the cause of the miscarriage and accompany you.
Ontario patients: We have big news!
On July 19, some refreshing changes are coming to our Newmarket and Vaughan locations.
Newmarket location change
Our Newmarket clinic is moving to a new address July 19th 2021. Freshly renovated with plenty of convenient parking. We look forward to welcoming you to this brand-new location.
Appointments will be at our new address as of July 19th:
1111 Davis Drive East, Unit 39
Newmarket, Ontario L3Y 9E5
T: 905.967.0852 / F: 905.967.0512
New name, new look: Vaughan and Newmarket clinics
Starting on July 19, great patient care will have a brand-new name! The Procrea Fertility clinics in Newmarket and Vaughan clinics will be renamed as Generation Fertility.
Since 2011, our Newmarket and Vaughan teams have been recognized for their caring expertise, innovation and healthy outcomes. We’ve also been growing with the addition of new team members, recently welcoming two new fertility specialists Drs. Hartman and Lai. The new Generation Fertility name and look reflect the energy and expertise of our team. And, while our name is changing, you can expect the excellent patient care and clinical team you’ve come to know.
We’re honored to be your clinic of choice, to help you achieve your dream of family.
The Vaughan clinic is not relocating and will remain at its current address:
955 Major Mackenzie Drive West, Suite 400
Vaughan, ON L6A 4P9
T: 289.357.0100 / F: 289.357.0101
What if I have eggs, sperm or embryos stored at the clinic?
Your storage arrangements are not changing. Rest assured, your samples will not be affected and will remain safely stored in their current location, carefully monitored by our expert staff. Should you have any questions you may email us at billing@generationfertility.ca
What if I have additional questions?
Or team would be happy to communicate with you. Should you have any additional concerns feel free to call us or email us at info@generationfertility.ca
Information on the COVID-19 Vaccine!
Ontario COVID-19 Vaccine Information:
For those considering the COVID-19 vaccination, our current advice is to follow the recommendations from Public Health.
As of April 23, 2021 pregnant people have been added to the “highest risk” category and can book a COVID -19 vaccine through the provincial website: : https://covid-19.ontario.ca/book-vaccine/ . A doctor’s note is not required.
In making a decision about whether to get vaccinated, each individual should weigh the risk vs. benefit for themselves.
All of the current data suggests that all vaccines that are currently available are considered very safe.
It is likely that the risks associated with COVID-19 infection are significantly greater than any potential risk associated with the vaccines.
For this reason, the benefit of vaccination for most individuals far exceeds the risk.
If you are not pregnant yet, it is likely that the benefit of getting vaccinated far outweighs any risk and we recommend that you get vaccinated if you have the chance.
These vaccines were not specifically studied in pregnant or breastfeeding individuals and for that reason we cannot comment on the specific risks in this population. We also are learning more every day about the risks of COVID-19 infection in pregnancy and breastfeeding. Although we cannot say anything with certainty, it is very likely that the benefit of vaccination will outweigh the risk in this population as well.
The current recommendation is that there is no need to delay pregnancy after vaccination and that the second dose can be received at the usual scheduled time even in pregnancy.
Prior to vaccination, all of the vaccination centers offer information about the vaccines and screen individuals for contraindications to vaccination. If you have an allergy to one of the components of the vaccine or if you have had a previous adverse reaction to vaccination, please discuss this with the vaccination center.
If you are interested in reading more about the COVID-19 vaccination, please see the following information from SOGC, Ministry of Health and CFAS
If you do decide to have the vaccine check with your nurse in timing of any procedure that may be coming up for you, as you may have some symptoms from the vaccine and may not pass the COVID screening of the clinic.
Information on the COVID-19 vaccine
For those considering the COVID-19 vaccination, our current advice is to follow the recommendations from Public Health.
In making a decision about whether to get vaccinated, each individual should weigh the risk vs. benefit for themselves.
All of the current data suggests that both vaccines that are currently available are considered very safe. It is likely that the risks associated with COVID-19 infection are significantly greater than any potential risk associated with the vaccines.
For this reason, the benefit of vaccination for most individuals far exceeds the risk.
There was an update on January 7th that Ontario will allow (encourage) pregnant or breastfeeding people to be vaccinated against COVID-19 according to new recommendations from Ontario Society of Obstetrics and Gynaecology (OSOG) and the Ontario Medical Association Section on Obstetrics and Gynaecology (OMG-OG).
As both vaccines currently available in Ontario, which are mRNA based are “not hypothesized to be a risk to breastfeeding infant” and should be offered. If you are not pregnant yet, it is likely that the benefit of getting vaccinated far outweighs any risk and we recommend that you get vaccinated if you have the chance. Prior to vaccination, all of the vaccination centers offer information about the vaccines and screen individuals for contraindications to vaccination.
If you have an allergy to one of the components of the vaccine or if you have had a previous adverse reaction to vaccination, please discuss this with the vaccination center.If you are interested in reading more about the COVID-19 vaccination, please see the following statement from the Society of Obstetricians and Gynecologists of Canada
Announcement: Changes at the Procrea Fertility Montreal location
Procrea Fertility Montreal and clinique ovo have merged clinics. Patient care in the Montreal area for both Procrea Fertility and clinique ovo has been combined under one roof at clinique ovo. Clinique ovo is located at 8000 Decarie Boulevard and is approximately 4 kms from the former Procrea Fertility Montreal location.
Excellence in patient care is our priority. We will continue to ensure that all our patients have access to the best technologies and resources for optimal care. For more information, please refer to our Frequently Asked Questions.
Patients will be treated by a new medical and clinical team who will make sure the transfer of care goes smoothly. They have access to the best possible care from the renowned ovo clinic team.
What should I do if I wish to declare my Day 1 for treatment?
Please contact clinique ovo to schedule or confirm your appointment at 514-798-2000 ext. 149 or at procreaj1@cliniqueovo.com.
What should I do to book a prenatal appointment?
You can reach a clinique ovo receptionist at 514-798-2000, option 1, option 2, or prenatal@cliniqueovo.com to schedule your prenatal appointment.
What if I was on the Procrea Montreal waiting list for a consultation?
Clinique ovo will contact patients on the waitlist to schedule an appointment
How does this merger affect the Procrea Fertility Gatineau clinic?
Procrea Fertility Gatineau patients will continue to have their appointments at 444 Boulevard de l’Hôpital, Suite 310, Gatineau, Quebec, J8T 7X6. The phone number is 819-778-5572. The procedures and treatments that were offered at the Procrea Fertility Montreal clinic will now take place at clinique ovo, located at 8000 Decarie Boulevard in Montreal.
How does this merger affect the Procrea Fertility clinic in Quebec City and other branches of clinique ovo?
The Procrea Fertility clinic in Quebec City and other locations of clinique ovo are not affected by this transition. Consultations, treatments, and other patient care will continue as usual. There are no changes for patients at any of the other Procrea Fertility and clinique ovo locations. Patients who were referred by external clinics to Procrea Fertility Montreal for treatments will now be redirected to clinique ovo, located at 8000 Decarie Boulevard, Montreal, Quebec, H4P 2S4.
Fertility Preservation: Your Frequently Asked Questions
At Procrea Fertility, preserving your fertility is one of our priorities. Egg freezing is an excellent option for women who need or want to delay pregnancy. In the interest of transparency, we wish to provide you with all the necessary answers that will allow you to make clear decisions regarding the preservation of your fertility. Here are the most frequently asked questions we have been able to collect on this subject.
The egg freezing process
Do I need a referral from a Health care provider to access the services of a fertility clinic?
A referral is required to access services and care related to fertility treatment or preservation. However, some clinics such as Procrea Fertility grant direct access to fertility specialists without prior consultation with a family doctor or an obstetrician-gynecologist (OB/GYN), in the case of a woman waiting for cancer.
However, it is also advisable to speak with your family doctor about your concerns about infertility before making an appointment with a specialist.
Is it possible to do fertility tests without having to freeze the eggs?
Absolutely! A gynecologist specializing in reproductive medicine is trained to diagnose and treat fertility problems. A fertility specialist will be able to refer you to various tests and treatments to treat the conditions that may affect your fertility. Visit our webite’s pages When to consult a fertility specialist and Fertility Assessment to learn more!
What is the egg freezing process?
Here are the different steps of our egg freezing program:
Ovarian reserve test, ultrasound and laboratory tests to look for various hormones and the presence of STIs
Consultation with a specialist to establish treatment
Controlled ovarian hyperstimulation
Egg retrieval
Egg freezing
How many times does the process need to be done?
This depends on several factors, including the number of frozen eggs and the age at the time of the puncture. The success rate for those who decide to freeze their eggs before the age of 35 can reach up to 95% in cases of 24 or more eggs, while the same rate is up to 50% if freezing is done after the age of 35. It should also be taken into account that freezing your eggs does not guarantee a child.
Is the process painful and/or does it cause side effects?
The egg retrieval procedure itself is not painful. After the procedure, the woman may feel a little pain, a little tired, and recovery may take between 24 and 48 hours to feel normal again. From a side effect point of view, bloating may be felt due to the ovaries becoming larger.
The costs involved in egg freezing
What are the costs associated with egg freezing?
On average it would cost about 5.000$ for an egg retrieval. In addition, there are storage fees (approximately $300/year) that will be paid later on in the process when it’s decided that it’s time to fertilize and transfer the eggs. ICSI (intracytoplasmic sperm injection), and FET (frozen embryo transfer). RAMQ covers the procedure for cancer cases and storage for the first 5 years and Procrea Fertility offers this service free of charge for patients undergoing cancer treatment.
Is fertility preservation covered by the RAMQ/health insurance?
Oocyte freezing is currently not covered by the RAMQ. Currently, infertile Quebecers are entitled to a tax credit ranging from 20% to 80% of the cost of treatment, depending on salary. However, coverage for fertility treatments may vary from one province to another in Canada.
The Ontario government covers the cost of an IVF cycle. Procrea Fertility clinics in Ontario have been officially approved by the Ontario Ministry of Health to provide fertility treatments funded by Medicare.
On November 11, 2020, the Quebec government introduced the long-awaited bill to reinstate free access to certain AHR treatments. Eligible couples will have free access to an in vitro fertilization cycle depending on criteria set forth when this bill is officially passed*.
*Please note this bill has not yet passed.
Egg quality
How is egg quality evaluated?
There is no formal test to determine egg quality. However, quality is directly linked with age. This factor affects the rate of eggs that contain genetic abnormalities and which may increase naturally with age. Freezing the eggs preserves their quality, so we recommend that they be frozen before the age of 35 in order to increase the chances of pregnancy afterwards.
Why does egg quality decrease with age?
Generally, egg quality is related to its age and we begin to see a decline around 37-38 years old.The decline continues until the age of 45, when the natural fertility rate per month is approximately 1%. The success rate in IVF is higher (35% to 40%) in women under 35 years of age, and decreases to approximately 5% in women 42 years of age and older. This is due to the natural ovarian reserve, which decreases with age.
Will a baby born with a frozen egg be as healthy as another?
In 2012, the American Society for Reproductive Medicine (ASRM) reported that no increase in chromosomal abnormalities, birth defects, and developmental deficits were reported in offspring born from cryopreserved oocytes compared to conventional IVF/ICSI pregnancies and the general population. The evidence indicates that oocyte vitrification and warming should no longer be considered experimental.
In fact, more recently in 2020, the European Society of Human Reproduction and Embryology (ESHRE) internationally recognized egg freezing as an acceptable option to offer to women.
How long can eggs be frozen?
The standard storage period for eggs is about 10 years. The period may be extended for circumstances involving women at risk of premature infertility due to medical treatments such as chemotherapy.
Finally, how do I make an appointment with a fertility specialist?
You can make an appointment in one of our clinics by phone call or via our contact form. Inquire about your first visit with us!
We hope to have answered your questions as well as possible. If any doubts persist, do not hesitate to contact us. We will answer as soon as possible!
For more information on other topics, please visit our blog which discusses fertility and related treatments for women, men, and couples in the LGBT2Q+ community.
Prenatal and Fertility Ultrasounds: Everything You Should Know
During the fertility diagnosis, many tests are prescribed to investigate the causes of your potential infertility. The fertility ultrasound allows us to exclude inconsistent factors or to confirm certain anomalies.
This is equally valid for pregnant women during high-risk pregnancies thanks to prenatal ultrasounds.
Fertility Ultrasound
The fertility ultrasound consists of introducing a small probe in the woman’s vagina. This technique allows a very precise visualization of the ovaries and the uterus. This test, completely painless, is done with an empty bladder and at the beginning of the menstrual cycle.
This type of ultrasound allows the fertility specialist to visualize potential anomalies, even the smallest ones. Benign tumours (fibroids) or growth of the endometrium (polyps) are detectable; The size and appearance of the ovaries are also checked.
Pelvic ultrasound
This medical imaging method detects certain abnormalities in the human body that may be the cause of infertility.
For women, the examination provides precise observation of the uterus, ovaries, kidneys and bladder. Several abnormalities can be analyzed:
Pelvic pain
Vaginal bleeding
Deformities of the uterus
The presence of cysts
The examination takes place at the beginning of the cycle. The ultrasound is endovaginal, with an introduction of the probe inside the vagina. The process is completely painless.
For men, kidneys, bladder and prostate are examined for abnormalities:
The presence of abnormal masses
Irregular structures
The presence of liquid accumulation
During the process, only a conductive gel is spread on the skin of the abdomen, which facilitates the passage of ultrasound from outside the body.
Ultrasound does not produce any adverse health effects. Repeated examination is therefore safe and risk-free. The results obtained will be able to guide the subsequent fertility diagnosis.
In order to proceed with a fertility ultrasound, please contact our fertility specialists on the first day of your period. We will be able to make an appointment for you during the first 4 days of your period at the nearest clinic.
Ovulation ultrasound
The purpose of performing an ovulation ultrasound is to plan insemination or sexual intercourse to maximize the chances of pregnancy. It is an endovaginal ultrasound to evaluate the imminence of ovulation. This examination is planned according to the length of the patient’s menstrual cycle and is determined by the physician. Following the ultrasound, an injection of Ovidrel may be prescribed to induce ovulation and plan insemination.
Ultrasound for prenatal diagnosis
Unlike fertility ultrasound, ultrasound for prenatal diagnostic purposes is performed once the patient gets pregnant. It identifies genetic diseases or malformations. This examination does not involve any radiation and does not present any risk to the mother or the fetus’ health.
Dating ultrasound
The very first ultrasound scan during pregnancy checks the presence of the fetus’ different limbs and organs, especially the heart, to ensure its vitality. As its name suggests, this ultrasound also aims to date the pregnancy more accurately than the calculation based on the patient’s cycle. Miscarriage, ectopic pregnancy, as well as higher than normal nuchal translucency (generally observed in babies with Down syndrome) are problems that can be detected through this examination.
Nuchal Translucency Ultrasound
The Nuchal translucency test is generally recommended by the physician during the first trimester of pregnancy. It indicates the fetus’ size, age and health, and identifies certain birth defects. It also evaluates the risk of Down syndrome and malformations. At Procrea Fertility, nuchal translucency ultrasound is available at the Montreal and Gatineau clinics only.
Detailed fetal ultrasound
During this examination, each part of the fetus, as well as the placenta and the uterus are evaluated. During the 2nd and 3rd trimester of pregnancy, it is important to assess the growth of the fetus, monitor its development and determine its orientation. It is also possible to know the sex of the baby during this period.
These services are available at Procrea Montreal and Gatineau. We invite you to get in touch with our specialists for professional advice regarding the prenatal diagnostics you need.
3D/4D ultrasound
3D/4D ultrasound is now offered by the Procrea Fertility clinic in Gatineau. It allows you to observe the baby’s unique traits in real time with much greater clarity. The 3D ultrasound characterizes the facial features and the 4D ultrasound brings everything in motion! This technique presents no danger for either the mother or the fetus. The best time to capture the images is between the 26th and 30th week of pregnancy.
