Transcript: Fertility Matters | Jun 25, 2015

Steve sits in the studio. He's slim, clean-shaven, in his forties, with short curly brown hair. He's wearing a gray suit, lilac shirt, and blue tie. Behind him, a wall screen reads “The Agenda, with Steve Paikin.”

Steve says WOMEN AND COUPLES
DON'T HAVE CHILDREN FOR MANY
REASONS, BUT THE TREND TOWARD
PARENTHOOD LATER IN LIFE MEANS
FERTILITY IS A GROWING
CONSIDERATION.
JOINING US NOW FOR MORE ON THE
BASIC FACTS OF FERTILITY:
DOCTOR MARJORIE DIXON, CO-FOUNDER
AND MEDICAL DIRECTOR OF THE
FAMILY FIRST FERTILITY CLINIC IN
TORONTO.
DOCTOR DIXON, GOOD TO HAVE YOU BACK
HERE AT TVO.

The caption changes to “Marjorie Dixon. First Steps Fertility.”

Marjorie is in her late thirties with curly black hair in a bun. She’s wearing a floral jacket, a white top and a pearl necklace.

Marjorie says HAD I.

Steve says THE LAST TIME YOU
WERE HERE, YOU LOOKED DIFFERENT.
DO YOU REMEMBER?

Marjorie says YEAH.
I WAS WITH CHILD.

Steve says HOW MANY MONTHS?

Marjorie says I WAS THREE
MONTHS, BUT YOU COULD TELL BY MY
FACE THAT THERE WAS STUFF
COOKING, YEAH.
SO THIS TIME I AM SO NOT.
NOW SHE IS 7.

The caption changes to “Fertility Matters. The basics.”

Steve says SO YOU WERE HERE 7
YEARS AGO.
IT'S GOOD TO HAVE YOU BACK.
IT'S LONG OVERDUE AND GREAT TO
SEE YOU AGAIN.
LET ME READ THIS TO GET STARTED
HERE.

Steve reads a quote entitled “Fertility in Canada,” from Statistics Canada 2011.

He says CANADA'S FERTILITY RATE IS
LOW ...1 IN 6 COUPLES IN CANADA USE MEDICAL HELP FOR CONCEPTION. 15 PERCENT OF COUPLES IN CANADA ARE TRYING TO HAVE CHILDREN.”

Steve says LET'S BEGIN WITH
SOME OF THE BASIC FACTS AROUND
THAT.
WHAT IS, IN YOUR VIEW, OPTIMUM
FERTILITY WINDOW FOR WOMEN TO
HAVE KIDS?

Marjorie says WELL, IT'S
A GOOD QUESTION, BECAUSE
PHYSIOLOGICALLY, WE HAVEN'T
CHANGED THE EVOLUTION OF THE
OVARY.
WHAT I SAY MAY SHOCK PEOPLE.
WOMEN ARE DESIGNED TO HAVE
BABIES SOMEWHERE BETWEEN THE
AGES OF 16 AND 22.

Steve says IN TERMS OF --

Marjorie says IN TERMS OF
EGG QUALITY.
SEE HOW YOU WERE SHOCKED?

Steve says YES.

Marjorie says I'M NOT
SAYING TEENAGERS NEED TO GO HAVE
BABIES.
WHAT I AM SAYING IS IT NEEDS TO
BE REINFORCED THAT THE EVOLUTION
OF THE OVARY HASN'T CHANGED IN
THE HUMAN RACE, AND THAT
IDEALLY, THE QUALITY OF OUR EGGS
IS READY TO BE RECEPTIVE TO
SPERM AT THAT TIME.
THE AVERAGE AGE OF MENSTRUATION
IS 13, 12 OR 13 YEARS.
SO IF YOU THINK THAT WHEN
SOMEONE HAS THE ABILITY TO
OVULATE, THE CHILD WOULD HAVE
THE OPPORTUNITY TO CONCEIVE
AGAIN AT AGE 14.
WE WOULD BE GRANDPARENTS AT
ABOUT 30 YEARS OF AGE.
THAT'S EVOLUTION.

Steve says YIKES!
WHAT HAPPENS AFTER AGE 22?

Marjorie says THERE'S A
DIMINISHING IN THE QUANTITY AND
QUALITY OF OUR EGGS, BUT REALLY
THE SIGNIFICANT ATTRITION THAT
OCCURS INCREASES AFTER AGE 35.
BUT THERE ARE STUDIES THAT HAVE
SHOWN THAT BY THE AGE OF 30,
WE'VE DEPLETED OUR OVARIES OF
APPROXIMATELY 90 PERCENT OF THE EGGS.
THE GOOD ENOUGH NEWS IS THE 10 PERCENT
THAT REMAINS STILL HAS
RELATIVELY GOOD FUNCTIONING.
BY AGE 40, WE'VE DEPLETED OUR
OVARIES OF 97 PERCENT.

Steve says IF YOU GET PREGNANT
AFTER AGE 40, IT'S A MIRACLE.

Marjorie says IT'S NOT
THAT IT'S A MIRACLE.
IT IS IMPRESSIVE AND THEN THE
FEAT WILL BE NOT ONLY IN IN
BRINGING THAT PREGNANCY TO TERM
BUT THEN ALSO IN HAVING HEALTHY
BABIES, BECAUSE WE KNOW THAT THE
INTERCELLULAR ENVIRONMENT OR
THAT INSIDE THE EGG IS
DIMINISHING IN ITS ABILITY TO
COMPLETE THE SPLITTING.
WHEN SPERM AND EGGS MEET, THE
CHROMOSOMES HAVE TO DIVIDE AND
SEPARATE AND GROW INTO AN
EMBRYO, AND THE CHROMOSOMES
DON'T DO SO WELL BECAUSE OF THE
AGING MIOTIC SPINDLE.

Steve says ENGLISH, YES?

Marjorie says WHICH IS
BIOLOGY TO SAY THAT WHEN THE
CHROMOSOMES LINE UP AND DIVIDE
EVENLY, THEY TEND NOT TO DO SO
WELL AS WE GET OLDER.
THERE'S AN INCREASED RATE OF
MISCARRIAGE AS WE GET OLDER, AND
THERE'S AN INCREASED RATE OF
UNEVEN NUMBER OF CHROMOSOMES.
FOR EXAMPLE, THINGS LIKE WHAT IS
COMMONLY KNOWN AS DOWN SYNDROME
IS MORE PREVALENT AFTER AGE 35
AND ESPECIALLY AFTER AGE 40, AND
OTHER MORE COMMON CHROMOSOME
UNEVENNESS, TRISOMY 3, 13, AND
18, THOSE ARE THE TYPES OF
THINGS THAT EVENTUALLY DON'T
BRING OUT HEALTHY BABIES, AND
SOMETIMES NOT COMPATIBLE WITH
LIFE.
AND SO WOMEN OFTEN ARE SURPRISED
WHEN THEY COME TO MY OFFICE.
THE AVERAGE AGE OF MY PATIENT IS
SOMEWHERE BETWEEN 37 AND 39
YEARS OF AGE.
THERE'S BEEN A HUGE PARADIGM
SHIFT.
WOMEN USED TO HAVE THEIR FIRST
BABIES IN THEIR 20s, AND THERE
WAS MUCH LESS INFERTILITY THEN.
AND NOW THE AVERAGE AGE OF THEM
HAVING THEIR FIRST BABIES IS UP
TO 33, RIGHT?
SO GETTING OLDER.

Steve says LET'S LOOK AT THE
OTHER SIDE OF EQUATION.
THAT'S MORE WOMEN.
SO WOMEN, 16 TO 22 IDEAL.
BY 35, DEGRADED 90 PERCENT.
BY AGE 40, DEGRADED 97 PERCENT.
HOW ABOUT FOR MEN?
IDEAL AGE FOR THEM TO BE FERTILE
AND ABLE TO MAKE BABIES?

Marjorie says IT'S A
LITTLE DIFFERENT BECAUSE MEN
MAKE SUCH AN EXCESSIVE AMOUNT OF
SPERM AS OPPOSED TO WOMEN THAT
WILL RELEASE ONE EGG IN A MONTH.
SO THERE IS A DIMINISHING
ABILITY OF SPERM AS MEN GET
OLDER, BUT NOT AS MUCH AS THE
EGGS ARE CONCERNED.
SO IT'S NOT SIMILAR, BUT WHEN
YOU LOOK AT INFERTILITY, 40 PERCENT OF
INFERTILITY CAN BE ATTRIBUTED TO
MALE FACTOR.
AND THEN AS MEN AGE, THERE'S AN
INCREASED RISK OF THINGS LIKE
SCHIZOPHRENIA IN MALE OFFSPRING,
FOR EXAMPLE, AFTER AGE 45.
SO IT'S DIFFERENT.
THEY WILL MAKE LESS QUANTITIES
OF SPERM, BUT BECAUSE THERE'S
SUCH EXCESSIVE AMOUNTS OF SPERM,
IT IS MORE EASY TO OVERCOME MALE
FACTOR INFERTILITY WITH
ASSISTIVE REPRODUCTIVE
TECHNOLOGIES THAN IT IS FEMALE
FACTOR INFERTILITY.

Steve says IS IT THE SAME THAT
A MALE'S MOST POTENT -- YOU TELL
ME THE RIGHT LANGUAGE TO USE
HERE -- BUT HIGHEST POTENCY FOR
SPERM IS BETWEEN 16 AND 22?

Marjorie says THEY MAKE
THE HIGHEST QUANTITY OF SPERM AT
THAT TIME.
BUT AS I SAID, THEY CAN CONTINUE
TO MAKE MILLIONS OF SPERM.
THE AVERAGE THAT WE LOOK AT FOR
NORMAL SPERM QUANTITIES IS
20 MILLION PER MILLILITRE.
THAT'S A LOT OF SPERM.
WHEN IT TAKES ONE SPERM PER EGG.
SPERM IS NOT AS EFFICIENT AS OUR
EGGS, LET'S SAY.

Steve says WOMEN ARE MORE
EFFICIENT AT EVERYTHING.

Marjorie says I DIDN'T
SAY IT, YOU WERE.

Steve says YOU WERE IMPLYING
IT.
I JUST INFERRED IT.
WHEN YOU'RE IN THE WORLD OF
FERTILITY TREATMENT, IS THERE A
CUT-OFF BEYOND WHICH YOU WILL
SAY TO SOMEBODY, “SORRY, WE JUST
CAN'T DO THIS ANYMORE”?

Marjorie says ABSOLUTELY.

Steve says WHAT'S THE AGE
THERE?
IS IT AN AGE OR A STAGE?

Marjorie says IT DEPENDS
ON A MULTITUDE OF FACTORS, BUT
GENERALLY SPEAKING I.V.F., IN
VITRO FERTILIZATION IS NOT
APPROPRIATE FOR WOMEN BEYOND THE
AGE OF 45, AND SOME WOULD ARGUE
THE CUT-OFF AGE SHOULD BE 43,
AND THAT'S BECAUSE I.V.F. CAN
ONLY BE AS SUCCESSFUL AS THE EGG
QUALITY.
AND WE KNOW THAT THE LIKELIHOOD
OF LIVE BIRTHS OR TAKE-HOME BABY
IS AS LOW AS 1 TO 5 PERCENT
AFTER AGE 43, NO MATTER WHAT WE
DO.
SO I THINK IT'S IMPORTANT FOR
PEOPLE TO UNDERSTAND THAT WE
CALL IT ASSISTED REPRODUCTIVE
BECAUSE IT ASSISTS NATURAL REPRODUCTION

IT IS NOT IMPROVING REPRODUCTIVE TECHNOLOGIES,
IT’S NOT SUPERSEDING REPRODUCTIVE TECHNOLOGIES, IT IS
ASSISTING.

Steve says DO YOU REALLY SEND
PEOPLE HOME IF THEY'RE OVER 43?

Marjorie says YES.
NOW, THERE ARE SOME 43-YEAR-OLDS
THAT ARE GOOD CANDIDATES.
THEY ARE THE EXCEPTIONS.
THEY MAY BE FALLING IN THAT 1 TO
5 PERCENT RANGE, AND WE SELECT
THOSE OUT, AND WE CAN BRING
THOSE TO I.V.F.
WE HAVE TO LOOK AT PEOPLE'S
BASIC PARAMETERS.
WE LOOK AT A NUMBER OF THINGS.

Steve says I DON'T KNOW WHAT
ANY OF THAT MEANS BUT I ASSUME
IT'S IMPORTANT.

Marjorie says THESE ARE
IMPORTANT PARAMETERS WHEN YOU
LOOK AT THE OVARY.
YOU NEED TO TREAT A PATIENT ON A
CASE-BY-CASE BASIS, BUT YOU HAVE
TO BE COGNIZANT OF THE AGE
BECAUSE THE AGE IS THE MOST
IMPORTANT FACTOR OF A PERSON'S
ABILITY TO CONCEIVE.
IT'S AN UNFORTUNATE FACT.
I HAVE BEEN MUCH MALIGNED FOR
TURNING PEOPLE AWAY.
THEY SAY, DOCTOR, I'M YOUNG.
I EXERCISE, I TAKE CARE, I SLEEP
A LOT, I AM DOING ACUPUNCTURE
AND ALL THESE HOLISTIC
MEDICINES.
I SAY THIS IS EXCELLENT FOR YOUR
HEALTH BUT IT WILL NOT
NECESSARILY CHANGE THE QUALITY
OF YOUR EGGS.

Steve says I WANT TO GET YOUR
OPINION ON SOMETHING THAT
TRANSPIRED IN THE LAST FEW
MONTHS THAT WAS REALLY QUITE --
WELL, IT CAUGHT A LOT OF
ATTENTION.
Facebook AND GOOGLE OFFERING
TO SUBSIDIZE EGG FREEZING FOR
THEIR FEMALE EMPLOYEES.
I GUESS THE ASSUMPTION IS YOU'RE
GOING TO BE WORKING SO HARD FOR
US THAT YOU MAY MISS YOUR WINDOW
BEFORE THE AGES OF -- IN YOUR
YOUTH AND THEREFORE YOU MAY NEED
TO PUT OFF THE DECISION TO HAVE
CHILDREN TILL A POINT WHERE, YOU
KNOW, THE LOTTERY MAY NOT COME
THROUGH FOR YOU.
WHAT DO YOU THINK OF THAT?

The caption changes to “Fertility Matters. The waiting Game.”

Marjorie says WELL, I'M
AN OPTIMIST, SO I'M GOING TO SAY
THAT I THINK THAT THEY ARE
REALLY DOING THEIR HOMEWORK IN
UNDERSTANDING THE PHYSIOLOGY OF
OVARIES AND THEY ARE PUTTING
SOMETHING OUT BECAUSE THEY
APPRECIATE THEIR FEMALE
EMPLOYEES.
NOT THAT THEY WANT THEM TO BE
SERVANTS, BUT THAT THEY WANT TO
SAY, “WE UNDERSTAND THAT YOU ARE
POTENTIALLY GOING TO BE NEEDING
TO HAVE ASSISTANCE IF YOU WANT
TO HAVE CHILDREN, IF YOU'RE
DELAYING IT FOR EDUCATION.”
THERE HAS BEEN THIS PARADIGM
SHIFT.
WOMEN TAKE TIME.
THEY FIND PARTNERS THAT THEY
ACTUALLY LIKE BEFORE THEY MARRY
THEM.
THEY GO TO GET AN EDUCATION.
THEY WANT TO BE FINANCIALLY
STABLE.
SOMETIMES THEY TRAVEL.
SO THINGS ARE BEING PUT OFF.
AND ASSISTIVE REPRODUCTIVE
TECHNOLOGIES ARE ELECTIVE AND
COST MONEY.
MAYBE THE EMPLOYERS ARE SAY WE
VALUE YOU AND WE WANT TO KEEP
YOU AS OUR EMPLOYEES AND WE WILL
SUPPORT YOU IF YOU HAVE
FAMILY-BUILDING ENDEVOURS, NOT
TO SAY THAT YOU HAVE TO HAVE
BABY TO WORK FOR US, ABSOLUTELY.

Steve says THAT IS THE POSITIVE
INTERPRETATION YOU PUT ON IT.
IS THERE A MORE NEFARIOUS
INTERPRETATION?

Marjorie says THAT'S
WHAT'S BEEN PUT OUT IN THE
PRESS.
HOW DARE THEY?
WORK, WORK, WORK, AND HAVE YOUR
BABIES LATER.
THEY'RE NOT SAYING WHEN THEY CAN
ACCESS TO THOSE THERAPIES OR
TAKE MATERNITY LEAVE.
MAYBE IT IS A NOVEL, GENIAL
THOUGHT.

Steve says WHAT DOES IT COST TO
DO EGG FREEZING, IMPLANTATION
LATER?

Marjorie says IT RANGES
SOMEWHERE BETWEEN 8,000 AND UP
TO 15,000, DEPENDING ON
MEDICATIONS AND WHAT EXACTLY IS
REQUIRED AND WHAT THE INDIVIDUAL
PERSON'S OVARIAN RESERVE IS
LIKE.
WHAT IS MORE DAUNTING FOR
PEOPLE, OKAY, I HAVE TO HAVE A
PROCEDURE.
YOU'RE GOING TO STICK A NEEDLE
INTO MY VAGINA?
REALLY?
PEOPLE ARE NOT NECESSARILY
WANTING TO TAKE THE TIME OUT OF
LIFE TO DO THAT AND THEN
POTENTIAL HEALTH RISKS,
BLEEDING, INFECTION, NOT FEELING
UNWELL.

The caption changes to “Fertility Matters. Misconceptions.”

Steve says DOES ONTARIO'S HEALTH
INSURANCE PLAN PICK UP ANY OF THIS?

Marjorie says NO.

Steve says OHIP PAYS FOR NOTHING?

Marjorie says NO, BUT, OHIP IS NOW
CONSIDERING THEY HAVE PUT ASIDE
FUNDS FOR THE COVERAGE OF IVF,
SO THEY ARE LOOKING AT PUBLIC
FUNDING OF IVF FOR COUPLES,
IT IS BEING RULED OUT IN FISCAL
2015 AS WE UNDERSTAND IT,
SO THE GOVERNMENT HAS SAID
THAT WE VALUE THE WOMEN IN
ONTARIO POPULATION, AND WE THINK
THAT WE WANT TO MAKE ONTARIO
THE BEST JURISDICTION IN WHICH
TO HAVE A FAMILY, IT SEEMS THAT
THAT'S WHAT THEY'RE SAYING BY
PUTTING US ASIDE, AND THERE ARE
OTHER JURISDICTIONS IN WHICH
IVF HAS BEEN FUNDED THAT HAS
WORKED QUITE WELL, AND THE U.K.
AND AUSTRALIA, NEW ZEALAND,
BECAUSE IT CAN BE DEVASTATING
TO COUPLES, AND FEMALES WHO
STRUGGLE WITH INFERTILITY, IT
CAN BE OVERWHELMING AND
EMOTIONALLY, FINANCIALLY AND
WOMEN CONTRIBUTE TO SOCIETY
IN A POSITIVE WAY AND WE WANT
THEM TO BE AS PRODUCTIVE AS
POSSIBLE, AS HAPPY AS POSSIBLE,
AS FULFILLED AS POSSIBLE. IT'S
NOT FOR EVERYBODY. NOT EVERYBODY
WANTS TO HAVE CHILDREN, BUT FOR
THOSE WHO DO, THEY SHOULD BE
ABLE TO HAVE ACCESS TO THAT CARE

Steve says AND WHAT'S THE SUCCESS RATE?

Marjorie says IT DEPENDS ON YOUR AGE. HERE
WE GO BACK TO THE AGE. SO I
SEEM TO BE REPEATING MYSELF
BUT YOUR AGE IS VERY TIED IN
TO YOUR SUCCESS RATE PER CYCLE,
SO LESS THAN 35, YOU WILL BE THE
MOST SUCCESSFUL WITH ANY
ASSISTED REPRODUCTIVE TECHNOLOGY
AND IT CAN RANGE SOMEWHERE
BETWEEN 30 - 40 PERCENT PER CYCLE.
THEN AFTER THAT IT STARTS TO
DECREASE. AND AS I SAID, AFTER
43 IT CAN BE AS LOW AS 1 - 5 PERCENT

Steve says HOW MANY KICKS AT
THE CAT WILL YOU LET PATIENTS
TAKE?

Marjorie says IT DEPENDS
ON THE PATIENT.
GENERALLY WE DO THINGS IN CYCLES
OF THREE.
ONE TO THREE CYCLE OF THE IN
VITRO, AND THAT MEANS YOU TAKE
THE MEDICATIONS, YOUR EGGS ARE
GROWN, THEY ARE EXTRACTED,
COMBINED WITH SPERM, AND EMBRYO
TRANSFERS ENSUE, UNTIL THE
FROZEN EMBRYOS THAT CAME FROM
THAT CYCLE ARE USED.
THAT'S CONSIDERED ONE ENTIRE
CYCLE.

Steve says AT WHAT POINT DO YOU
SAY -- DO YOU CALL THEM PATIENTS
OR CLIENTS?

Marjorie says PATIENTS,
PATIENTS.

Steve says AT WHAT POINT DO YOU
SAY TO THEM THIS ISN'T ON FOR
YOU AND YOU HAVE TO GET YOUR
HEAD INTO A DIFFERENT SPACE LIKE
ADOPTION OR A LIFE WITHOUT
CHILDREN?

Marjorie says ALWAYS THE
CONVERSATION I HAVE WHEN
PATIENTS, FOR WHATEVER REASON,
DON'T LOOK LIKE THEY HAVE GOOD
PROGNOSIS.
I ALWAYS PRESENT THE OPTIONS AS,
LOOK, FERTILITY IS ELECTIVE.
YOU CAN LOOK AT DOING NOTHING.
YOU CAN LOOK AT ADOPTION.
AND THEN THERE IS EGG DONATION
POTENTIALLY.
SO OFTEN WE HAVE SISTERS OR
ACQUAINTANCES, SOMEONE WHO IS
MUCH YOUNGER THAN THE INTENDED
PARENT, FROM WHOM THEY HAVE THE
OPPORTUNITY TO GET EGGS.
I STIMULATE THAT INDIVIDUAL,
COMBINE IT WITH SPERM, AND THEY
HAVE TO HAVE INDEPENDENT LEGAL
COUNSEL, YOU CANNOT PAY SOMEONE
FOR THEIR EGGS, YOU CAN'T MEET
SOMEONE IN A COFFEE SHOP, YOU
LOOK GREAT, CAN I GIVE YOU SOME
MONEY FOR YOUR EGGS?
THAT'S NOT HOW IT WORKS.
IT HAS TO BE CAREFULLY LAID OUT.
IT'S NOT FOR EVERYONE.
THAT'S WHAT I SAY TO PATIENTS.
YOU NEED TO UNDERSTAND THERE ARE
ALL OF THESE OPTIONS BUT DOING
NOTHING IS A VERY VIABLE OPTION.

Steve says IN YOUR LINE OF
WORK, IS THAT THE WORST NEWS YOU
END UP HAVING TO DELIVER TO
PEOPLE, YOU'RE THE PERSON WHO
TELLS PEOPLE, YOU'RE NOT GOING
TO BE ABLE TO HAVE CHILDREN
NATURALLY?

Marjorie says IT'S NOT A
FUN TASK TO HAVE.
I MEAN, YOU GO INTO THIS REALM
THINKING THAT YOU'RE GOING TO BE
HELPING ALL OF THESE FAMILIES
AND THE WOMEN WHO HAVE STRUGGLED
AND MEN WHO HAVE STRUGGLED WITH
INFERTILITY AND YOU WANT TO BE
ABLE TO GIVE THEM A POSITIVE
OUTCOME.
WE DO WHAT WE CAN TO THE EXTENT
OF THE SCIENCE THAT EXISTS NOW
AND THERE ARE EXCITING AND NEW
THINGS ON THE WAY TO IMPROVE EGG
HEALTH, AND THAT'S WHAT IS
MOVING FORWARD FOR ASSISTED
REPRODUCTIVE TECHNOLOGY.
THAT WILL BE THE NEXT CHAPTER.
TO THIS TIME, WHEN WE TELL
PEOPLE THERE ARE NO OTHER
OPTIONS, IT'S AN AWFUL THING TO
DO.
NOBODY WANTS TO BE THERE.
AND PATIENTS DON'T COME TO SEE
US BECAUSE THEY WANT TO SEE US,
THEY COME TO SEE US BECAUSE THEY
MUST.
AND AS MUCH AS WE ARE
EMPATHETIC, I THINK THAT THE LAY
PRESS HAS KIND OF GIVEN US
THIS -- GIVEN PEOPLE THE
IMPRESSION THAT WE CAN FIX ANY
OVARIAN DEFICIENCY, AND WE'RE
GETTING TO THE POINT WHERE WE
HAVE MORE THINGS AVAILABLE TO US
TO THAT END, BUT UNFORTUNATELY
WE HAVEN'T CHANGED THE EVOLUTION
OF THE OVARY YET.

THERE ARE STILL SOME
APPOINTMENTS THAT ARE GOING TO
END IN TEARS.

Marjorie says YEAH, AND THAT'S WHY IN MY
OFFICE, WE HAVE A WHOLE COHORT
OF OTHER PEOPLE, WE HAVE SOCIAL
WORKERS AT FIRST STEPS, WE HAVE
MIND BODY PROGRAMS, WE HAVE A
SUPPORT GROUP THAT WE OFFER TO
OUR PATIENTS, COMPLIMENTARY.
AND NOT EVEN TO JUST OUR
PATIENTS, BUT TO PATIENTS FROM
OTHER CLINICS WHO WANT TO COME.
SO WE KNOW HOW IMPORTANT IT IS
FOR OUR PATIENTS TO FEEL
SURROUNDED AND IN A GOOD
ENVIRONMENT TO MAXIMIZE THEIR
ABILITY TO CONCEIVE AT A TIME
WHERE IT'S KINDA STRESSFUL AND
NOT FUN TO HAVE TO DO IT IN SUCH
A CONTRIVED FASHION.

Steve says GOTCHA.

Marjorie continues BUT IT'S WHERE A LOT OF
COUPLES ARE SITTING RIGHT NOW,
ONE IN 6 COUPLES. 15 PERCENT OF THE
PEOPLE TRYING TO HAVE CHILDREN
ARE HAVING DIFFICULTY. SO
WE'RE TRYING TO DELIVER THAT
CARE IN THE BEST, MOST
EMPATHETIC, EVEN THOUGH
SOMETIMES UNFORTUNATE BAD NEWS.
BUT IN A KIND WAY.

Steve says AND WE THANK YOU FOR COMING
IN TO TVO AND MAKING US BETTER
INFORMED ALL ABOUT IT.

Marjorie says IT'S MY PLEASURE.

The caption changes to “Fertility Matters. theagenda.tvo.org.”

Watch: Fertility Matters