Transcript: Infertility | Mar 12, 2001

The opening sequence shows a wooden table with a small-lit candle as
Several words fly by: Nutrition, medicine, prevention, treatment,
health. Fast clips show different sets of hands performing
activities on the table such as pulling petals from a daisy, drawing
a big red heart, tuning a violin, flipping through the pages of a
book, cooking, and pouring a glass of red wine. In animation, the
Title appears inside the shape of a house: “More to life.”

Maureen Taylor sits in a studio with yellow walls and a small TV set
in the background, which reads “More to life.”

Maureen is in her late thirties, with wavy brown hair in a bob.
She's wearing a pink jacket over a black turtleneck.

Maureen says HELLO AND
WELCOME TO “MORE TO LIFE'S.”
I'M MAUREEN TAYLOR.
LATER NONE THE SHOW, WE'LL
HAVE SOME GREAT CRAFTS TO
KEEP EVERYBODY BUSY DURING
MARCH BREAK, BUT FIRST,
COUPLES THAT HAVE TROUBLE
CONCEIVING FIND THEMSELVES
ON AN EMOTIONAL ROLLER
COASTER OF HOPE AND
DISAPPOINTMENT, BUT MEDICAL
SCIENCE IS IMPROVING THE
CHANCES OF A SUCCESSFUL
CONCEPTION.
IN 1999, 26 PERCENT OF CANADIAN
WOMEN WHO UNDERWENT IN VITRO
FERTILIZATION BECAME
PREGNANT.
STILL, INFERTILITY TREATMENT
IS CONSIDERED MORE OF A
FRILL THAN A MEDICAL
ILLNESSNESS AND COUPLES CAN
FORK OUT THOUSANDS OF
DOLLARS BEFORE THEY FIND
THEMSELVES PATIENTS.
OUR GUEST, Dr. WILLIAM VIRO,
MEDICAL DIRECTOR OF THE
MARKHAM FERTILITY CENTRE,

Dr. Virro says is in his forties and has grey hair and is clean-shaven. He wears
a brown suit, white shirt and green and pink shaded tie.

Maureen says HE'LL BE ABLE TO ANSWER YOUR
QUESTIONS ABOUT WHEN TO SEEK
ANDEP THE TREATMENTS THAT
ARE AVAILABLE.
WHAT WOULD YOU LIKE TO KNOW
ABOUT INFERTILITY?

A caption appears showing two phone numbers and then changes to show the e-mail
address.

Maureen says IN TORONTO CALL: IN TORONTO DIAL 416-484-2727.LONG DISTANCE WE HAVE
A TOLL FREE LINE AT 1-888-411-1234. AND YOU CAN ALSO e-mail YOUR QUESTION TO
moretolife@tvo.org
AND Dr. Virro, WELCOME BACK.

Dr. Virro says THANK YOU.

Maureen says THE LATEST NEWS I UNDERSTAND
IN INFERTILITY IS SOMETHING
CALLED SPERM DNA TESTING.
WHAT'S THAT?

Dr. Virro says CAN I AVOID THAT QUESTION
FOR ONE SEC?

Maureen says SURE.

Dr. Virro says I NOTICED YOU READ OFF
26 PERCENT OF CANADIAN -- THAT'S
THE 1999 CANADIAN STATISTICS.

Maureen says STATISTICS YEA.

Dr. Virro says JUST AN INTERESTING POINT
ABOUT THE 26 PERCENT, I WAS LOOKING
AT THE NUMBERS BEFORE I CAME
HERE THIS MORNING, AND 50 --
ALMOST 55 PERCENT OF OUR IVFs DONE
IN 1999 WERE WOMEN OVER THE
AGE OF 35.
SO THOSE NUMBERS WOULD BE A
LOT BETTER IF WE WERE
WORKING ON YOUNGER WOMEN.

Maureen says AND ALL OF THAT
IS TO SAY GETTING YOUNGER?

Dr. Virro says YEAH, I MEAN IDEALLY, I
REALIZE THERE'S LIFESTYLES
TO DEAL WITH AND JOBS AND
MONEY, BUT THERE'S NO
QUESTION PREGNANCY RATES ARE
BETTER AS A WOMAN IS
YOUNGER.

Maureen says THERE'S A
PROTECTION FACTOR, TOO,
AGAINST BREAST CANCER --

Dr. Virro says ABSOLUTELY, AND ALL THOSE THINGS AND YOU DON'T
HAVE TO TAKE AS MANY
FERTILITY DRUGS AND YOU PUT
THE WHOLE PACKAGE TOGETHER,
I'D LIKE TO SEE -- I LOVE
SEEING 30-YEAR-OLD WOMEN --
NOT THAT I DON'T WANT TO SEE
WOMEN WITH PROBLEMS BUT I'D
RATHER SEE A 30-YEAR-OLD
THAN A 40 YEAR OLD.

Maureen says INTERESTING.
GREAT.
BACK TO SPERM DNA TESTING.

Dr. Virro says YEAH, THIS IS THE WORLD
ACCORDING TO Dr. Virro AS OF
TODAY.
IT'S VERY NEW.
WE'RE VERY EXCITED ABOUT IT
AT OUR CENTRE.
WHAT IT IS NOW, WE ARE AT
THE -- WE'RE AT THE POINT
NOW WHERE WE LOOK AT A SPERM
SAMPLE, WE'RE WAY BEYOND
LOOKING AT A SPERM COUNT AND
THE MOTILITY AND THE SHAPE.
I MEAN, FIVE YEARS AGO OR
WHATEVER, WE LOOKED AT A
COUNT AND IT GIVES US
INFORMATION BUT LOOKING AT A
SPERM SAMPLE DOESN'T TELL US
WHETHER THAT SPERM CAN
FERTILIZE AN EGG OR NOT.
WE CAN'T DETERMINE WHETHER
FERTILIZATION OCCURS -- IVF
IS THE BEST WAY TO LEARN
THAT BUT THE NEW TEST, WE
CALL IT THE SPERM CROMATIN
ASSAY IS WHERE WE TAKE THE
SPERMLOOK AT THE DNA
PACKAGE INSIDE THE SPERM.
AND IF YOU THINK ABOUT IT,
THE SPERM JUST ACTS AS A VEHICLE TO
TAKE THE DNA FROM THE
HUSBAND TO THE EGG WHICH
ACTS AS A VEHICLE TO GET THE
WOMAN'S DNA PACKAGE -- WE
NEED THE TWO PACKAGES TO
MAKE OUR CHILDREN.

Maureen says RIGH.

The caption appears it reads “Dr. Michael Virro. Infertility Expert.”

Dr. Virro says THIS TEST WILL LOOK AT THE
PERCENTAGE OF FRAGMENTATION
OF THE DNA PACKAGE AND WHAT
WE'RE FINDING IS IF MORE
THAN 30 PERCENT OF THE DNA IS
FRAGMENTED, WE'RE NOT
GETTING ANY PREGNANCIES,
WHEREAS IF THE FRAGMENTATION
RATE IS VERY LOW, WE'RE
GETTING LOTS OF PREGNANCIES.
AND SORT OF A SIDE BEAT,
AGAIN THIS IS VERY EARLY AND
I DON'T WANT EVERYBODY TO
THINK THIS IS THE END ALL
AND BE ALL, BUT WE'RE
FINDING THAT IF THERE'S A
HIGH FRAGMENTATION RATE, THE
PREGNANCIES THAT WE ARE
GETTING, WHICH THEORETICALLY
WE SHOULDN'T BE GETTING ANY,
THEY'RE ENDING UP IN VERY
EARLY MISCARRIAGES.
IT'S VERY EARLY.
WE ARE STILL EVALUATING THIS
ALMOST ON A DAY BY DAY BASIS
IN OUR CENTRE.
WE HAVE ABOUT 200 TO 250
RESULTS IN NOW.
SO THAT'S HOW NEW IT IS BUT
I DO KNOW THE GOOD DNA
PACKAGES WE'RE GETTING THE
PREGNANCIES AND THE BAD DNA
PACKAGES WE'RE NOT SO WHAT
THIS CAN DO FOR COUPLES,
WHAT I'M FINDING, THE
GREATEST POTENTIAL, IF WE
CAN DO THIS TEST BEFORE
EMBARKING ON IVF OR WHATEVER
TREATMENT OPTION, IF WE KNOW
IT'S BAD, WE CAN COUNSEL
THEM AND SAY LISTEN, WE'VE
GOT A POTENTIAL -- AT THIS
POINT, I'M CALLING IT A
POTENTIAL PROBLEM WITH
FERTILITY.

The caption changes to “Today's Topic Infertility.”

Dr. Virro says AND SAY AROUND WE BE
SPENDING ALL THIS MONEY FOR
AN IVF CYCLE, KNOWING WE
MIGHT NOT GET VERY GOOD
EMBRYOS BECAUSE THIS DNA
PROBLEM AND AT LEAST THEY'RE
GOING INTO IT -- THEIR EYES
ARE MORE OPEN, WHEREAS IF WE
KNOW IT'S REALLY GOOD, WE
HAVE ALL THE CONFIDENCE, OR
I HAVE ALL THE CONFIDENCE IN
THE WORLD THAT AT LEAST THE
MALE FACTOR PART IS OKAY OF
THE TWO PARTS THAT ARE
NECESSARY.

Maureen says AND THE
FRAGMENTATION YOU GET IN ONE
SAMPLE IS GOING TO BE THE
SAME IN ANOTHER SAMPLE.
IT'S ALWAYS GOING TO LOOK
LIKE THAT?

Dr. Virro says WELL THEORETICALLY BUT IT
CAN CHANGE AND THIS IS WHAT
WE'RE SORT OF LEARNING.
IF A MAN HAS AN ILLNESS -- I
MEAN THERE HAVE BEEN SOME
CASE REPORTS OF DOCUMENTED
VIRUS, INFLUENZA VIRUS,
GETTING A SPERM DNA ONE
MONTH BEING SUCH AND SUCH A
LEVEL AND THEN THREE MONTHS
LATER WENT ILLNESS IS OVER
IT'S REVERTED BACK TO
NORMAL.
SO YOU HAVE TO TAKE INTO
HISTORY THE PAST THREE
MONTHS OF THE MAN'S LIFESTYLE.
I MEAN, DRUG ABUSE, SMOKING,
ALCOHOL -- THE WORST DNA
SAMPLE WE'VE SEEN IN OUR
CENTRE WAS A MAN THAT WORKED
IN A CHEMICAL FACTORY HIS
WHOLE LIFE, WAS EXPOSED TO
CHLORINE AND BROMINE AND ALL
THESE FUMES AND HE WAS 85PERCENT
FRAGMENTED.
THEY HAD A 12, 13-YEAR
HISTORY OF INFERTILITY.
AFTER WE PIECED ALL THE
PUZZLE TOGETHER, WE THOUGHT
THIS WAS PROBABLY THE MOST
LIKELY CAUSE, AND HE HAD A
VERY NORMAL-LOOKING SPERM
COUNT.
AND THEY SWITCHED TO A DONOR
AND GOT A BABY THE VERY
FIRST CYCLE.

Maureen says WOW!
SO IN RETROSPECT, THAT WAS A
CASE WHERE HER FERTILITY WAS
NOT IN QUESTION AT ALL.
BUT DID IT TAKE YOU THAT
LONG TO FIGURE THAT OUT?

Dr. Virro says WELL, THEY TRIED -- THEY
HAD TRIED A FEW CYCLES AT
OUR CENTRE WITH NEGATIVE
RESULTS AND WE WERE SORT OF
SCRATCHING OUR HEADINGS WHY.
THEY THOUGHT IT LOOKED FINE,
THE COUNT WAS OKAY, JUST
WEREN'T GETTING THESE GOOD
EMBRYOS.
ONCE WE DISCOVERED THESE
TESTS WE RETROSPECTIVELY
TESTED HIS DNA AND WOW,
IT WAS REALLY BAD.
AND SO AGAIN, YOU HAVE TO
PUT EVERYBODY'S CLINICAL
PICTURE TOGETHER.
THESE TWO PEOPLE HAVE BEEN
TRYING THEIR WHOLE LIFE AND
THEY WERE AT THE POINT,
THEY'D FINALLY GOTTEN
POSSIBLY AN ANSWER AND WERE
VERY COMFORTABLE SWITCHING
TO A SPERM DONOR.
SO YOU KNOW, THEY'RE A
COUPLE -- IT'S MORE
DIFFICULT, I THINK, IF
YOU'VE GOT SOMEBODY WITH ONE
YEAR OF INFERTILITY, IF YOU
DO THE TEST AND FIND OUT
IT'S BAD, DO I FEEL
COMFORTABLE TELLING THAT
COUPLE WELL, THIS IS THE
PROBLEM FOR SURE?
THAT'S -- WE'RE FINDING THAT
MORE DIFFICULT.

Maureen says DID YOU PIONEER
THIS RESEARCH?

Dr. Virro says NO, DONALD DAVIDSON IS
THE ONE THAT'S DONE MOST OF
THE WORK IN THE U.S., I MET
HIM AT A CONFERENCE AND WHAT
HE SAID MADE A LOT OF SENSE
AND WE'VE JUST FOLLOWED IT
UP.

Maureen says COOL.
AND WHAT ROLE TO BLASTOCYSTS
PLAY THIS PROCESS?
WHAT IS A BLASTOCYST?

Dr. Virro says WELL THE TWO THINGS I
THINK IN MY OPINION
INTERVENE VERY NICELY.
WE HAVE AT OUR CENTRE BEEN
DOING BLASTOCYST CULTURES
FOR ALMOST THREE YEARS NOW
AND WE'RE ALMOST DOING THAT
IN 100 PERCENT OF OUR CASES.
SO WE'RE TALKING ABOUT IVF
NOW, DOING AN EGG RETRIEVAL.
UP UNTIL THREE YEARS AGO, WE
WERE DOING EMBRYO TRANSFERS
THREE DAYS AFTER THE EGG
RETRIEVAL.
SO ONE DAY AFTER AN EGG
RETRIEVAL AN EMBRYO SHOULD
BE TWO CELL, 48 HOURS AFTER
IT SHOULD BE FOUR AND THREE
DAYS IT SHOULD BE EIGHT.
WE'VE NOW JUST PUSHED IT TO
FIVE DAYS, WAITING TWO MORE
DAYS, AND A BLASTOCYST IS
SIMPLY AN EMBRYO, ANY EMBRYO
MORE THAN 60 CELLS IN
DIVISION SO THEY'LL GO FROM
EIGHT CELLS ON THREE DAYS TO
MORE THAN 60 TWO DAYS LATER.
AND AT OUR CLINIC, ONLY
ABOUT ONE-THIRD OF THE
EMBRYOS ARE MAKING IT TO THE
BLASTOCYST STAGE.
SO IF SOMEBODY STARTS OFF
WITH TEN EMBRYOS, WE'RE ONLY
GETTING ON AVERAGE THREE
BLASTOCYSTS.
WE'RE LOSING SIX OR SEVEN IN
THE PROCESS, THEY JUST STOP
DIVIDING AT EIGHT, TEN, OR
TWELVE CELLS OR STOP DYING
OFF SO IT ALLOWS US TO PICK
AND CHOOSE YOUR BEST
EMBRYOS.
SO FIRST OF ALL, I THINK THE
FIRST IVF A COUPLE GOES
THROUGH, THEY SHOULD DO A
BLASTOCYST CULTURE, BECAUSE
NUMBER ONE IT ALLOWS US TO
SEE WITH OUR OWN EYES
WHETHER OR NOT THAT COUPLE
CAN MAKE A BLASTOCYST.
BECAUSE IF ALL OF YOUR
EMBRYOS DIE AT EIGHT OR TEN
CELLS, YOU'RE NOT GOING TO
GET PREGNANT WITH THAT GROUP
OF EMBRYOS.
SO IF YOU PUT THEM IN ON DAY
THREE WHEN THEY'RE EIGHT
CELLS, A LOT OF THOSE MAY
JUST STOP DIVIDING.
AND SO HOW MANY TESTS IN THE
PAST WERE WE GETTING
NEGATIVE WHERE THE EMBRYOS
STOPPED DIVIDING?
WE JUST COULDN'T SEE THAT
BECAUSE WE'D PUT THEM BACK
INTO THE WOMAN.

Maureen says IT SEEMS LIKE
ALL THIS TECHNOLOGY WHAT
IT'S ALLOWING TO YOU DO IS
BE MORE SPECIFIC ABOUT WHICH
SPERM AND EGG ARE GOING TO
CREATE A VIABLE PREGNANCY.
IS THAT RIGHT?

Dr. Virro says ABSOLUTELY.
SO IT ALLOWS US TO PICK AND
CHOOSE THE ONES THAT GET
THERE AND THE ONLY WAY YOU
CAN MAKE A BLASTOCYST --
AGAIN I'M LOOKING AT THIS
SIMPLISTICLY, BUT YOU HAVE
TO HAVE A GOOD QUALITY
SCOMPEG YOU HAVE TO HAVE A
GOOD QUALITY SPERM TO GET A
GOOD QUALITY EMBRYO OR BLAST
BLASTOCYST.
THERE'S ONLY TWO REASON YS
YOU CAN'T GET TO THAT POINT,
IS IF THERE'S A PROBLEM WITH
THE SPERM OR A PROBLEM WITH
THE EGG.
SO WHAT WE ORIGINALLY
DISCOVERED IS THAT -- OR
WHAT WE ORIGINALLY DID, WE
TOOK ABOUT 50 OF OUR COUPLES
THAT HAD GONE THROUGH IVF
THAT DID NOT MAKE
BLASTOCYSTS OR HAD VERY POOR
QUALITY BLASTOCYSTS AND
WE'RE TRYING TO THINK WHAT'S
GOING ON HERE?
WE'VE GOT WHAT WE THINK ARE
RELATIVELY GOOD LOOK EGGS,
GOOD-LOOKING SPERM BUT WE'RE
GETTING LOUSY-LOOKING
EMBRYOS.
SO THIS IS WHERE THE DNA
PACKAGE COMES IN.
WE THEN -- WE STARTED OFF,
RETROSPECTIVELY LOOKED AT
THOSE 50 COUPLES THAT HAD
THOSE POOR EMBRYOS AND LO
AND BEHOLD ABOUT 65 PERCENT
OF THEM HAD THIS BAD DNA
PACKAGE.

Maureen says IN THE SPERM.

Dr. Virro says IN THE SPERM.
SO RIGHT AWAY WE SAID WELL,
MAYBE THERE'S A PROBLEM WITH
THE SPERM RELATING TO THE
BAD QUALITY EMBRYOS.
AND THEN WE STARTED GOING,
PROSPECTIVELY LOOKING AT IT
AND NOW WE'RE AT THE POINT
WHERE IF WE SEE A GOOD SPERM
DNA PACKAGE WITH THIS DNA
TEST, WE CAN ALMOST PREDICT
THOSE COUPLES ARE GOING TO
GET GOOD QUALITY BLASTOCYSTS
IF THE EGG QUALITY'S OKAY.
SO THE TWO FIT IN VERY
NICELY, GIVING US MORE
ANSWERS.
I MEAN, IF YOU GET A LOUSY
BLASTOCYST YOU'RE PROBABLY
NOT GOING TO GET A PREGNANCY,
BUT AT LEAST WE CAN COUNCIL
THE -- COUNSEL THE COUPLE,
SAYING “WE THINK THIS IS A
SPERM PROBLEM, AND THIS IS
PROBABLY THE REASON YOU'RE
NOT GETTING PREGNANT.”

Maureen says ARE YOU OPEN TO
A DONORER IN?

Dr. Virro says THEY MAY IS HE SAY NO,
WE'VE GOT AN ANSWER, WE QUIT
BUT IT'S GIVING THESE
COUPLES INSIGHT WHAT TO DO
NEXT.

Maureen says ALL RIGHT, ONCE
YOU HAVE THE BLASTOCYSTS
WHAT IS YOUR GENERAL RULE OF
THUMB AS TO HOW MANY
IMPLANTED EGGS --

Dr. Virro says TWO.

Maureen says YOU'LL ONLY DO
TWO?
GOOD FOR YOU?

Dr. Virro says AND NOW 30 COUPLES WHERE
WE'VE JUST PUT IN ONE,
THAT'S HOW MUCH CONFIDENCE
WE HAVE WITH THESE
BLASTOCYST, WE'RE OBVIOUSLY
NOT GETTING ANY MORE THAN A
TWIN PREG NANCY.
WE HAVE ONE SET OF TRIPLETTS
NOW, BUT THAT WAS NOT AN IVF
PREGNANCY SO WE JUST DON'T
GET THESE MULTIPLE
PREGNANCIES WE USED TO SEE.

Maureen says WE'LL TALK MORE
ABOUT WHY THAT'S IMPORTANT
BUT WE'RE TALKING ABOUT
INFERTILITY TREATMENTS WITH
Dr. WILLIAM VIRO, HE'S MEDICAL DIRECTOR OF THE MARKHAM FERTILITY CENTRE
IF YOU HAVE A QUESTION ABOUT ALL OF THEM--
IT'S REALLY FASCINATING, THE
MALE INFERTILITY ASPECT AS
WELL AS IVF AND SOME OF THE
FERTILITY DRUGS YOU MAY HAVE
CONCERNS ABOUT, GIVE US A
CALL IN TORONTO IN TORONTO 416-484-2727.LONG DISTANCE CALL 1-888-411-1234 AND
YOU CAN ALSO e-mail YOUR QUESTION TO moretolife@tvo.org.

Maureen says AND GLORIA IS IN
TORONTO.
HI GLORIA.

Gloria says HI.

Maureen says HI, WELCOME.

Gloria says YES, I WOULD LIKE
TO KNOW, BECAUSE I AM AN EGG
DONOR FOR MY AUNT, I WANT TO
KNOW IF I WILL BE AT THE
RISK OF NOT GETTING PREGNANT
AFTER THE EGG RETREAVEAL.
THIS PROCEDURE WILL NOT
EFFECT MY FUTURE PLANS OF
GETTING PREGNANT MYSELF.

Dr. Virro says WELL FIRST OF ALL MY
HAT'S OFF TO YOU FOR BEING
AN EGG DONOR.
WE HAVE A BIG SHORTAGE OF
EGG DONORS IN TORONTO AND
I'M GLAD TO SEE THAT YOU'RE
DOING THAT I WOULD NOT HAVE
INTERCOURSE FOR PROBABLY
FOUR DAYS AFTER YOUR EGG
RETRIEVAL JUST IN CASE
THERE'S A FEW EGGS LEFT
BEHIND, AND IN RESPECT TO
YOUR FUTURE FERTILITY, NO
HIGHER PROBLEMS OR RISKS, AS
LONG AS THE EGG RETRIEVAL
GOES FINE WITHOUT A PROBLEM
SO VERY SAFE PROCEDURE.
I'D WAIT PROBABLY THREE,
FOUR DAYS AND THEN YOU
SHOULD BE FINE.

Maureen says IT'S -- IS THIS
VERY COMMON THAT FAMILY
MEMBERS DONATE EGGS TO OTHER
FAMILY MEMBERS?

Dr. Virro says I DON'T KNOW IF IT'S
COMMON, IT'S IDEAL.
IT'S JUST MOST COUPLES DON'T
HAVE A YOUNGER SISTER OR A
SISTER THAT'S WILLING TO DO
THAT OR YOUNG ENOUGH OR
WANTS TO DO THAT.
IT'S A VERY EMOTIONAL
DECISION, EGG DONORS AND
SPERM DON'T NERS, BUT THAT'S
IDEAL, IF YOU HAD A YOUNGER
SISTER TO DO IT.

Maureen says SHE'LL ACTUALLY
BE THOUGH TECHNICALLY THIS
CHILD'S BIOLOGICAL AUNT AND
MOTHER.
COOL.

Dr. Virro says VERY COOL.

Maureen says THANKS GLORIA FOR YOUR
QUESTION.
CINDY IS IN TORONTO.

Cindy says HI.

Maureen says HI.
AND YOUR QUESTION?

Cindy says YES, I WAS TREATED AT A
FERTILITY CENTRE BECAUSE I
WAS YEARS WITHOUT A
PREGNANCY, I DON'T KNOW
WHETHER OUR TIMING WAS OFF,
BUT WHEN I REACHED THE AGE
OF 40 I THOUGHT WELL, I
BETTER SEE WHAT I CAN DO
HERE.”
SO I WAS TREATED WITH A
DONOR AND TREATED WITH
CLOMID AS WELL.
THERE WAS JUST ONE PILL PER
DAY, AND AT THE AGE OF 40 I
WAS VERY GRATEFUL, I JUST
GOT PREGNANT WITH THE FIRST
CYCLE, HOWEVER WHEN I WAS ON
CLOMID I FELT LIKE A VERY
SWELLING IN THE LOWER
STOMACH AND A LOT OF
CRAMPING, AND I JUST, I WAS
JUST WONDERING WHAT THAT
COULD POSSIBLY HAVE BEEN,
EVEN AFTER THE INSEMINATION,
I JUST FELT LIKE A LOT OF
CRAMPING.

Maureen says HMM.

Dr. Virro says I THINK THAT'S A NORMAL
SIDE EFFECT FROM THE CLOMID.
WHEN WE ARE PATIENTS ON
HIGHER DOSAGE OF FERTILITY
DRUGS THAN THE CLOMID,
THEY'LL GET A SENSATION OF
BLOATING, ABDOMINAL
DISCOMFORT.
IT DEPENDS ON HOW MANY EGGS
YOU HAVE, DEPENDS ON THE
RESPONSE WHICH IS VERY -- IT
VARIES FROM INDIVIDUAL TO
INDIVIDUAL.
BUT CERTAINLY THE SENSATIONS
YOU'RE DESCRIBING I THINK
ARE VERY NORMAL FROM TAKING
A FERTILITY DRUG.

Maureen says HAS CLOMID --
IT'S BEEN AROUND FOR HOW
MANY YEARS NOW?

Dr. Virro says OH, 40?
35 OR 40.

Maureen says AND THE EARLY
CONCERNS WERE WOULD THERE BE
ANY HEALTH RISKS FOR THE
CHILDREN.
HAVE WE SEENING?

Dr. Virro says NO.
AND WE HAVEN'T SEEN ANY
HEALTH RISKS TO ANY THE
CHILDREN OF ANY THE
FERTILITY DRUGS SO FAR.
THAT'S NOT A CARTE BLANCHE
TO SAY JUST USE THESE DRUGS
WITH RECKLESS ABANDON.
WITH CLOMID, COUPLES SHOULD
NOT TAKE MORE THAN SIX
CYCLES, IF IT DOESN'T WORK
YOU MOVE ONTO A DIFFERENT
DRUG.
I DON'T THINK WE SHOULD USE
STRONGER DRUGS WITH
LIMITLESS CYCLES.
YOU KNOW, HAVE GUIDELINES,
SIX, NINE CYCLES MAXIMUM OF
THESE DRUGS AND WE SHOULD BE
ABLE TO GET A PREGNANCY
WITHIN THAT NUMBER OF
CYCLES.
NO STUDIES SHOW THAT THERE'S
AN INCREASED RISK OF CANCER,
BUT I DON'T THINK WE SHOULD
JUST GO CRAZY WITH THEM,
EITHER.

Maureen says BACK TO THE
MULTIPLE BIRTHS THING.
IT'S NOT JUST IVF THAT PUTS
YOU AT RISK FOR MULTIPLE
BIRTHS, DEPENDING ON HOW
MANY EGGS ARE IMPLANTED BUT
THE FERTILITY DRUG, DO AS
WELL.

Dr. Virro says THAT'S WHY WE'RE GETTING
THESE HIGHER MULTIPLE
PREGNANCIES NOW, JUST
PUTTING DRUGS ON -- PATIENT
ON DRUG, WE DON'T HAVE
CONTROL OVER HOME EGGS WILL
FERTILIZE AND HOW MNY WILL IMPLANT --

Maureen says WHEN YOU READ
ABOUT SOMEONE GIVING BIRTH
TO SEVEN CHILDREN THAT WAS
PROBABLY A FERTILITY DRUG
ISSUE.

Dr. Virro says IT BETTER BE.
IF SOMEONE'S PUTTING IN
SEVEN EMBREYOS I THINK
THAT'S IRRESPONSIBLE.

Maureen says THANKS VERY MUCH,
CINDY, ALEXANDRA IS IN
TORONTO.
HI ALEXANDRA.

Alexandra says HELLO, HOW ARE
YOU?

Maureen says GOOD THANKS.

Alexandra says GOOD.
MY QUESTION IS WITH RESPECT
TO MY SISTER.
SHE'S GOING THROUGH THE IVF
PROGRAMME AS WELL RIGHT NOW
AT PRESENT.
THERE'S BEEN A CONCERN.
SHE'S HAD THREE TRIALS,
WHERE THEY'VE RETREIVED AND
IMPLANTED I GUESS THE
EMBRYOS INTO HER AND SHE'S
BEEN UNSUCCESSFUL.
NOW WHAT OUR CONCERN WAS,
WHAT ARE THE LONG-TERM
EFFECTS OF SOME OF THE HORMONES THEY PLACE YOU ON IN
THE INITIAL STAGES AND
BEFORE IMPLANTING THESE
FETUSES?

Dr. Virro says AGAIN, I THINK THE SAME.
I THINK THREE CYCLES IS VERY
SAFE.
I DON'T THINK THERE'S ANY
LONG-TERM RISKS TO HER A BIG
STUDY TWO YEARS AGO, MAYBE A
YEAR AND A HALF, THE
LANCETTE, I THINK THEY
LOOKED AT 20 WOMEN WHO TOOK
FERTILITY DRUGS, NO HIGHER
INCIDENTS OF BREAST CANCER
OR OVARIAN CANCER WITH THESE
DRUGS AND IT WAS A VERY GOOD STUDY.AGAIN
WE DON'T IGNORE THAT AND
JUST TREAT THESE WOMEN WITH
WRECKLESS ABANDON BUT NOW
THE DRUGS ARE VERY SAFE.

Maureen says ARE THEY THE
SAME SORT OF THINGS?
CLOMID IS IT A HORMONE
DRUG?

Dr. Virro says YEAH, IT'S DIFFERENT THAN
THE INJECTIONS BUT THEY'RE
STILL CLASSIFIED AS FERTILITY DRUGS.

Maureen says OKAY.

Dr. Virro says EVEN THOUGH OTHERS ARE
STRONGER WE DON'T IGNORE
CLOMID WE COUNT IT AS A CYCLE OF FERTILITY DRUGS.

Maureen says AND BASICALLY
THEY MAKE THE WOMAN PRODUCE
MORE EGGS MORE RAPIDLY?

Dr. Virro says YEAH, THEY DON'T MAKE
MORE EGGS BUT WE CERTAINLY
STIMULATE MORE EGGS THAT
PARTICULAR CYCLE.
IT MAKES THE ESTROGEN
HORMONE GO HIGHER IN A WOMAN
THAT MONTH.
BREAST CANCER CAN BE AN
ESTROGEN DEPENDENT CANCER SO
THEORETICALLY IT MAKES SENSE
IF WE'RE PUSHING ESTROGEN
LEVELS HIGHER EACH MONTH WE
MIGHT BE INCREASING THE
CHANCE OF CANCER DOWN THE
ROAD.
DOESN'T SEEM TO BE THE POINT
BUT I THINK WE HAVE TO BE VERT
CAUTIOUS AND USE THEM
WISELY.

Maureen says THE FACT THAT HER
SISTER'S GONE THROUGH
THREE CYCLES UNSUCCESSFULLY,
AT WHAT POINT WOULD YOU SAY
TO HER I DON'T THINK THIS IS
WORKING?
OR WOULD YOU LOOK AT THE
SPERM IN THIS SITUATION?

Dr. Virro says OH, ABSOLUTELY.
I'D LOOK AT THE SPERM.
I DON'T THINK YOU CAN JUST
SAY WE'VE DONE THREE CYCLES
AND CALL IT QUITS.
WE NEED TO KNOW HOW OLD THE
COUPLE, IS HAVE THEY HAD A
BLASTOCYST TRIAL.
THERE ARE A LOT OF THINGS
YOU'VE GOT TO TRY TO PIECE
TOGETHER.
AGAIN, THIS IS WHERE, IN MY
OPINION, THIS BLASTOCYST
BUSINESS IS VERY IMPORTANT.
BECAUSE IF THIS COUPLE IS
MAKING GOOD QUALITY
BLASTOCYSTS EVERY TIME, IF
YOU DID -- I MEAN, IDEALLY
THE SPERM DNA TEST AND FOUND
OUT THAT WAS NORMAL, IF HER
UTERUS IS OKAY, HYSTEROGRAM THEN WE HAVE TO START QUESTIONING WHY AREN'T THESE
EMBRYOS
IMPLANTING?
MAYBE THERE'S AN
IMPLANTATION PROBLEM.
IN SOME WAYS YOU CAN TRY TO
APPROACH THE IMPLANTATION
FACTOR.
WE'RE STILL FAIRLY IGNORANT
ABOUT IMPLANTATION BUT THERE
ARE THINGS YOU CAN DO TO
HELP EMBRYOS IMPLANT.
THE ULTIMATE SOLUTION FOR AN IMPLANTAION PROBLEM IS
POSSIBLY GETTING A SURROGATE
MOTHER TO CARRY EMBRYOS IF
YOU'RE NOT ABLE TO DO THAT
THAT'S SORT OF THE ULTIMATE
WAY OUT THERE BUT THAT'S
THERE.
BUT IF YOU'RE NOT MAKING
GOOD QUALITY BLASTOCYSTS,
THE EMBRYOS ARE BREAKING
DOWN, MAYBE YOU'VE GOT TO
LOOK AT THE EGG QUALITY OR
THE SPERM QUALITY.
MAYBE THAT'S WHY YOU'RE NOT
GETTING GOOD QUALITY -- FOR
ME TO SAY JUST THREE CYCLES,
IT'S TIME TO CALL IT QUITS,
IT MIGHT BE TIME TO CALL IT
QUITS, BUT YOU NEED MORE
INFORMATION ON THAT
PARTICULAR CASE.

Maureen says AND AT WHAT
POINT DO YOU CALL IT A
SUCCESSFUL PREGNANCY IN YOUR
CLINIC?

Dr. Virro says WHEN SHE'S SITTING IN
FRONT OF ME IN THIS
POST-PARTUM VISIT WITH THAT
BABY.

Maureen says SAID LIVE BIRTH
IS WHAT YOU GO WITH.

Dr. Virro says YEAH, THAT'S THE IDEA.

Maureen says BECAUSE THE 26 PERCENT
WHO UNDERWENT BECOMING
PREGNANT.

Dr. Virro says THAT WAS I BELIEVE
POSITIVE HEARTBEAT.
THE PREGNANCY RATE I BELIEVE,
31.SOMETHING WAS THE
POSITIVE PREGNANCY RATE IN
1989 --

Maureen says THE 26 YOU
BELIEVE MIGHT BE LIVE BIRTH
RATE?

Dr. Virro says YEAH, THE IMPLANTATION RATE I BELIEVE.

Maureen says THESE GOOD
QUESTIONS TO ASK WHEN YOU GO
INTO A CLINIC THOUGH, AREN'T
THEY.

Dr. Virro says YEA, ABSOLUTELY.

Maureen says ALRIGHT THANK YOU,
ALEXANDRE
JANE IS IN TORONTO.
HELLO JANE.

Dr. Virro says HI.
MY QUESTION IS I'VE GONE
THROUGH ALL THE FERTILITY
SURGERY, HYSTERSOSCOPY, EVERYTHING
FERTILITY TESTS AND THEY
DIDN'T FIND ANYTHING WRONG.
IT'S BEEN YEARS OF TRYING,
FOUR, FIVE YEARS AND I'M
WONDERING WHAT THE POSSIBLE
CAUSE COULD BE.

Dr. Virro says HAVE YOU DONE AN IVF
CYCLE YET?

Jane says NO, HAVEN'T GONE THROUGH
THAT YET.

Dr. Virro says IF YOU'RE FOUR OR FIVE
YEARS OF INFERTILITY AND
YOU'RE BEING TOLD EVERYTHING
IS NORMAL, I WOULD RECOMMEND
DOING AN IVF CYCLE, ONLY
BECAUSE IT TAKES IT TO
ANOTHER LEVEL.
YOU CAN LOOK AT THE EGG
QUALITY, YOU CAN LOOK AT THE
SPERM QUALITY ISSUES, DOES
YOUR HUSBAND FERTILIZES?
IF YOU WANT TO DO THE SPERM
DNA TEST IT TAKES YOU TO A
DIFFERENT LEVEL.
MAYBE YOUR HUSBAND'S SPERM
JUST CAN'T FERTILIZE AN EGG.

Maureen says AND THERE'S IN
WAY TO KNOW THAT UNLESS YOU
DO THIS --

Dr. Virro says THERE'S A TEST YOU CAN DO,
BUT I THINK THE IDEAL TEST
IS AN IVF CYCLE.
I MEAN, WE WANT TO KNOW IF
YOUR HUSBAND'S SPERM CAN
FERTILIZE YOUR EGG AND THE
BEST WAY TO DETERMINE THAT
IS THROUGH IVF.
AND IF HE DOESN'T, I MEAN,
YOU CAN OVERCOME THAT
PROBLEM JUST BY DOING IXY,
JUST WHERE YOU INJECT THE
ONE SPERM IN.
THAT'S THE BEST SORT OF
GROUP TO FALL IN JUST THE
PURE MALE FACTOR AND
THAT IS CORRECTABLE.
BUT THAT'S IN ANSWER TO THE
QUESTION I WOULD TAKE IT
THAT'S THE NEXT LEVEL YOU'VE
GOT TO TAKE IT.

Maureen says LET ME GO BACK
TO JANE.
HAVE YOU GUYS DISCUSSED
WHETHER YOU'D GO THROUGH IVF
OR NOT?

Jane says IT WOULD DEPEND HOW MUCH
IT COSTS.
WHAT IS THE COST FOR A CYCLE
OF IVF?
I DON'T KNOW IF IT'S COVERED
UNDER MY INSURANCE?

Dr. Virro says IF YOUR TUBES ARE OPEN
IT'S NOT COVERED THROUGH
OHIP ONTARIO.
I WOULD HAVE TO GUESS MOST
CENTRES IN TORONTO, ONTARIO,
5,000 DOLLARS, YOU KNOW, 4,500 DOLLARS TO
6,500 DOLLARS FOR AN IVF CYCLE.

Maureen says WOULD THAT
INCLUDE ICHSZ WOULD THAT INCLUDE THE DNA TEST?

Dr. Virro says NO, I THINK YOU GOT TO CHECK FROM CLINIC TO CLINIC. AT OUR CENTRE
WE CHARGE SEPARATELY FOR THE
ICHSY AND THE DNA TEST, IT'S
A SMALL CHARGE BUT WE HAVE
TO SEND IT TO THE STATES TO
DO THAT BUT JUST CHECK WITH
THE CLINIC YOU'RE GOING TO
GO TO.

Maureen says DO MANY PEOPLE'S
PRIVATE HEALTH INSURANCE
THROUGH THEIR EMPLOYER COVER
THIS?

Dr. Virro says WE'VE HAD A FEW CYCLES
WHERE THE COUPLE'S INSURANCE
PLAN HAS COVERED THEIR IVF
THAT IS VERY RARE SO FAR,
WE'RE DISCOVERING.
A LOT OF COUPLES HAVE HAVING
TROUBLE WITH GETTING THEIR
DRUG PLAN, INSURANCE PROGRAM
TO COVER THEIR DRUGS.
SOME COUPLES DON'T EVEN HAVE
DRUG COVERAGE.
AND THE DRUGS FOR AN IVF
CYCLE RUN 2,000 DOLLARS, TO 2,500 DOLLARS.
SO IDEALLY IF YOU'VE GOT A
DRUG PLAN YOU'LL AT LEAST
GET YOUR DRUGS COVERED FOR
AN IVF CYCLE.

Maureen says DO YOU WANT TO
MAKE ANY POLITICAL
STATEMENTS HERE ABOUT
WHETHER THIS OUGHT TO BE
COVERED?

Dr. Virro says I THINK ALL DRUG PLANS
SHOULD COVER SIX CYCLES OF
FERTILITY DRUGS.
YOU KNOW, AND I'M NOT OUT TO
GET THE INSURANCE AGENCIES
OR THE COMPANIES, BUT YOU
KNOW, SOME COMPANIES FIND
OUT THAT IF Mr. AND
Mrs. SMITH HAVE AN
INFERTILITY PROBLEM, WELL,
THEY KNOW HOW EXPENSIVE
FERTILITY DRUGS, AND YOU
KNOW, WE'VE GOT A LITTLE
EXCLUSION FACTOR IN OUR
POLICY THAT EXCLUDES
FERTILITY DRUGS.
I LOVE THESE POLICIES THAT
WILL PAY FOR THE CHEAP
THINGS BUT IF SOMETHING
EXPENSIVE COMES ALONG THEY
WON'T DO THAT.
SO SURE, THE POLITICAL
STATEMENT WOULD BE WE SHOULD
PAY FOR SOME CYCLES OF DRUGS
IF YOU'VE GOT A DRUG PLAN.
AND I THINK WE SHOULD BE
PAYING FOR SOME IVF CYCLES
FROM OUR -- I DON'T THINK
THAT'S EVER GOING TO HAPPEN,
BECAUSE WE'VE GOT NO MONEY
IN OUR HEALTHCARE SYSTEM
PERIOD.
THAT'S A WHOLE DEBATE,
WHETHER OR NOT -- I MEAN,
SOME PEOPLE IN ONTARIO, IN
CANADA THINK THAT
INFERTILITY IS NOT A MEDICAL
PROBLEM.

Maureen says YEAH.
AT LEAST IN ONTARIO WE DO
PAY IF YOUR TUBES ARE
BLOCKED, CORRECT?

Dr. Virro says AND ISN'T THAT A
BEAUTIFUL THING TO SAY, EH?

Maureen says YEAH, EXACTLY.
BUT WE DO -- SOME PROVINCES
STILL DON'T EVEN PAY FOR
THAT WHY DID THE ONTARIO
GOVERNMENT COME UP WITH THAT
AS --

Dr. Virro says WELL, I THINK YEARS AGO
THEY SAID IF A WOMAN GOT HER
FALLOPIAN TUBES BLOCK FROM A
VENEREAL DISEASE THAT WE
WOULD PAY FOR IVF.
DON'T ASK ME WHAT KIND OF
RATIONALE WENT BEHIND THAT
STATEMENT, BUT I MEAN NOW,
I'D SAY MAYBE PROBABLY
ONE-FIFTH, 20 PERCENT TO 25PERCENT OF
WOMEN IF EVEN THAT ARE DOING
IVF FOR BLOCKED FALLOPIAN
TUBES.
IT'S MALE FACTOR,
UNEXPLAINED, ENDOMETRIOSIS
SO MANY OTHERS
CONDITIONS WE'RE DOING IVF
FOR BUT IT'S NOT COVERED.

Maureen says THANK YOU, JANE.
GOOD LUCK.
LORI IS IN SUDBURY.
HI LORI.

Lori says HI THERE.
HOW ARE YOU?

Maureen says GOOD, THANKS.

Lori says UM, I WAS JUST
WONDERING, I WENT THROUGH
THE FIRST CYCLE OF IVF AND
IT DIDN'T WORK, AND MY OVARIES HYPERSTIMULATED.
IS THAT A FACTOR --

Dr. Virro says DOES THAT WHAT AFTER?

Lori says MY PHONE'S
BEEPING, I HAD SOMEBODY ON
MY OTHER LINE, SORRY.

Maureen says YOU ASKED IS
THAT A FACTOR?

Lori says YEAH, LIKE THE --
MY OVARIES HYPERSTIMULATED.
IS THAT WHY IT DIDN'T WORK
THE FIRST TIME?

Dr. Virro Says THAT'S A GOOD QUESTION.
UM, PROBABLY THE GLOBAL
ANSWER TO THAT WOULD BE NO.
I THINK THAT DEPENDS WHO YOU
TALK TO AND WHICH
OPINIONS -- YOU KNOW, I
THINK WE HAVE A VARIANCE IN
OPINIONS, DIFFERENT
SPECIALISTS MAY HAVE AN
OPINION ON THIS.
AT OUR CENTRE WE DON'T LIKE
TO PUSH THE HORMONE LEVELS
VERY HIGH.
HYPERSTIMULATION,
CLASSICALLY FOR THOSE WHO
DON'T KNOW IS WHERE YOU GET A VERY
HIGH ESTRIGEN LEVEL WITH
LOTS OF SMALL FOLLICLES AND
THE COMBINATION OF LOTS OF
SMALL FOLLICLES AND A
HIGH ESTROGEN LEVEL CAN
CAUSE A VERY POTENTIALLY
SERIOUS CONDITION CALLED
OVARIAN HYPERSTIMULATION AND
SO WE TRY IT AVOID THAT AND
THE WAY IS BY DOING DAILY
BLOOD TESTS AND ULTRA SOUNDS
ON COUPLES TO PREVENT THAT
WERE HAPPENING.
SOME WOMEN JUST -- IF IT'S
YOUR FIRST CYCLE, WILL
RESPOND MUCH MORE QUICKLY TO
THE FERTILITY DRUGS THAN WE
ANTICIPATED AND SOMETIMES WE
CAN'T ANTICIPATE THAT.
AND YOU HAVE TO SORT OF GO
THROUGH THAT.
BUT WE AT OUR CENTRE LIKE TO
KEEP THE LEVELS AT A
RELATIVELY LOW LEVEL, SAFE
LEVEL.
WE DON'T TRY TO GO FOR 15,
20, 30 EGGS.
WE TRY TO GET AROUND 10 OR
11.
WE VERY RARELY GET
HYPERSTIMULATION CASES AT
OUR CENTRE BUT WOMEN WITH
POLYCYSTIC OVARIES, THEY'RE
SORT OF THE GROUP OF WOMEN
THAT STANDS OUT AS TO THE
WOMEN THAT ARE GOING TO GET
THIS HYPERSTIPULATION
SYNDROME.

Maureen says OH.

Dr. Virro says AND SOMETIME IT'S VERY
DIFFICULT TO STIMULATE A
WOMAN WITH POLYCYSTIC
OVARIES.
SOMETIMES YOU JUST CAN'T GET
AROUND IT.
NOW YOU CAN GET AROUND IT BY
FREEZING ALL THE EMBRYOS AND
NOT DO AN EMBRYO TRANSFER,
YOU CAN CANCEL A CYCLE -- WE
WANT TO TRY TO DO AS MANY
THINGS AS WE CAN AS TO AVOID
THE HYPERSTIMULATION.

Maureen says NOW WHEN SHE SAYS
HER FIRST ROUND DIDN'T WORK,
DOES SHE MEAN THEY DIDN'T
GET A PREGNANCY?

Dr. Virro says I AM ASSUMING THAT'S WHAT
THAT MEANT.
WHETHER SHE'S GOT FROZEN
EMBRYOS -- IF YOU'VE GOT
FROZEN EMBRYOS, YOU
CERTAINLY WON'T GET
HYPERSTIMULATION WITH A
NATURAL CYCLE OR A FROZEN
TRANSFER SO IF YOU'VE GOT
FROZEN, GOD WILLING YOU DO,
I WOULD USE THOSE NEXT AND
IF IT DOESN'T WORK AND IF
YOU NEED TO DO ANOTHER IVF
CYCLE, CERTAINLY LOOK AT THE
FIRST CYCLE AND TRY IT MAKE
ADJUSTMENTS TO PREVENT THE
HYPERSTIMULATION THE SECOND
TIME AROUND.

Maureen says SPEAKING OF
FROZEN EMBRYOS, I WAS
READING IN THE PAPER TODAY
THAT IN THE STATES THEY'RE
ALLOWING COUPLES WHO HAVE
GOT FROZEN UNWANTED
LEFTOVER EMBRYOS TO GIVE
THEM UP FOR ADOPTION TO
OTHER COUPLES.
DO YOU HAVE PEOPLE WITH A
LOT OF LEFTOVER EMBRYOS
IN YOUR CLINIC?

Dr. Virro says WE’RE NOT FREEZING AS
MANY NOW AS WE WERE THREE
YEARS AGO BECAUSE OF THE
BLASTOCYST CULTURING, SO
THEY'RE NOT GETTING AS MANY
BLASTOCYSTS SO NOT GETTING
AS MANY EMBRYOS TO FREEZE.
MOST COUPLES AT THIS POINT
THAT IF THEY HAVE SOME
FROZEN EMBRYOS ARE
OPTING TO KEEP THEM.
EVERY YEAR WE SEND A LETTER
OUT SAYING THAT YOU'VE GOT
TWO EMBRYOS FROZEN AT OUR
CENTRE WHAT DO YOU WANT TO
US DO WITH THEM?
KEEP THEM FROZEN FOR ANOTHER
YEAR OR DESTROY THEM OR GIVE
THEM UP FOR ADOPTION?
VERY RARELY -- SO FAR, VERY
RARELY ARE COUPLES GIVING
THEM UP.
I THINK THEY WANT TO WAIT UNTIL
THEIR KIDS GET OLDER OR WHAT
HAVE YOU --

Maureen says JUST IN CASE.

Dr. Virro says YEAH, SORT OF LIKE A
LITTLE BIT OF AN INSURANCE
POLICY, NOT SAYING YOU'VE
GOT TWO IN THE FREEZER MEANS
YOU'RE GOING TO GET KIDS BUT
THEY FEEL BETTER THAT THEY HAVE SOME EMBRYOS FROZEN --
BUT I THINK WE'VE DONE THREE
AT OUR CENTRE WHERE WE'VE
GIVEN UP AND
TWO HAVE GOTTEN PREGNANT.
AGAIN THE COUPLES THAT ARE USUALLY GIVING
THEM UP USUALLY HAVE
CHILDREN, THEY'RE PROBABLY
GOOD QUALITY EMBRYOS BUT SO
FAR AT OUR CENTRE IT'S VERY
RARE.

Maureen says HOW LONG DO THEY
STAY FROZEN?

Dr. Virro says THE LONGEST WE'VE HAD AT
OUR CENTRE BETWEEN
PREGNANCIES WITH A FROZEN
AND FRESH WAS EIGHT YEARS.
THAT'S SORT OF PUSHING IT.
EIGHT, NINE.
IDEALLY THE LEAST NUMBER OF
YEARS IN BETWEEN IS PROBABLY THE BEST.

Maureen says DIDN'T CELINE
DION FREEZE AN EMBRYO.

Dr. Virro says I HOPE SHE HAD SOME
FROZEN, YEAH.

Maureen says AND SHE'S GOT A
BROTHER OR SISTER TOO ALL READY
TO GO.
OKAY, SHARON IS IN OAKVILLE.
HI SHARON?

Sharon says HI.

Maureen says HI.

Sharon says MY HUSBAND AND I
WENT THROUGH APPROXIMATELY
FIVE YEARS OF INFERTILITY
TREATMENTS.
I HAVE ENDOMETRIOSIS AND ONE OF THE FIRST THINGS
THEY DID WAS THE LASER
SURGERY TO COMBAT THAT. WE
DID ALL OF THE STEPS IN
BETWEEN UP TO TWO CYCLES OF
IVF AND UNFORTUNATELY WE
DIDN'T HAVE ANY SUCCESS WITH
ANY OF THOSE THINGS.
AFTER THE SECOND CYCLE OF
IVF WE HAD A RARE
OPPORTUNITY TO ADOPT, WHICH
WE DID, AND WHEN OUR
DAUGHTER WAS SIX MONTHS OLD,
I BECAME PREGNANT WITHOUT
ANY INTERVENTION WHAT SO EVER,
COMPLETELY TOOK US BY
SURPRISE, HAPPILY, OF COURSE,
AND SO NOW MY SON IS ELEVEN
MONTHS OLD AND, YOU KNOW,
WE'RE WONDERING HOW
CONCERNED DO WE HAVE TO BE
ABOUT BEING PREGNANT AGAIN?
BECAUSE NO ONE HAS BEEN ABLE
TO EXPLAIN IT TO US.
SO WE JUST DON'T KNOW IF IT
WAS A FLUKE OR WAS IT
SOMETHING THAT WE WERE
ALWAYS ABLE TO DO BUT MAYBE
SOME ENVIRONMENTAL FACTORS
KEPT IT FROM HAPPENING.

Maureen says WELL, IF IT WAS
A FLUKE, I KNOW A LOT OF
PEOPLE WHO HAD THE SAME
FLUKE.
THERE MUST BE A NAME FOR
THIS MEDICALLY NOW.

Dr. Virro says I THINK A FLUKE IS JUST
AS GOOD AS ANYTHING.
I'M ASSUMING IF YOU WENT
THROUGH IVF THEY HAD EMBRYOS
SO THEY JUST DIDN'T IMPLANT SO
AN ANSWER TO YOUR QUESTION,
I WOULD PROBABLY USE
CONTRACEPTION, UNLESS YOU
DON'T MIND HAVING ANOTHER
CHILD.

Maureen says I THINK SHE'S
SAYING THEY'RE GOING TO WANT
ANOTHER CHILD.
DO YOU THINK THEY SHOULD EXPECT TO HAVE
FERTILITY PROBLEMS ZEN.

Dr. Virro says I DON'T THINK YOU CAN SAY
THAT JUST BECAUSE YOU'VE HAD
A CHILD, I DON'T THINK THAT
PUTS YOU MORE FERTILE.
IN A CERTAIN GROUP OF WOMEN
IT DOES IN SOME IT DOESN'T
BUT I DON'T THINK WE CAN
MAKE A CARDINAL RULE THAT
I'VE HAD A CHILD, I DON'T
HAVE A FERTILITY PROBLEM.
I THINK THAT'S WRONG TO SAY
THAT.
INTERESTING, THERE'S A NEW
STUDY THAT'S GOING TO BE
STARTED, I THINK IT'S GOING TO
BE BASED OUT OF OTTAWA WHERE
THEY'RE TRAYING TO LOOK AT
COUPLES THAT WILL DO NOTHING
OVER A PERIOD OF YEARS,
COMPARED TO A GROUP OF WOMEN
THAT ARE GOING TO GO THROUGH
IVF AND SEE THE DIFFERENCE
IN THE PREGNANCY RATES.
I THINK THEORETICALLY THAT'S
A GREAT STUDY.
NOW YOU'RE TALKING TO A
PERSON THAT DOES
INFERTILITY.
YOU KNOW, THAT'S MY LIFE
LINE.
AND FORTUNATELY WE'RE VERY
SUCCESSFUL AT OUR CLINIC, SO
WE'VE GOT A VERY GOOD
PREGNANCY RATE.
I HAVE HARD TIME SAYING TO
SOMEBODY WELL, WE'VE DONE
YOUR INVESTIGATION, WE'VE
FOUND NOTHING WRONG, JUST GO
HOME AND DO NOTHING WHEN I KNOW
I CAN GIVE THEM X-PERCENTAGE
OF A PREGNANCY RATE DOING A
PROCEDURE.
I THINK WE HAVE TO GIVE
THESE COUPLES THE OPTIONS.
DO YOU WANT TO TRY -- WE DO
THAT WITH EVERYTHING.
DO YOU WANT TO GO AHEAD AND
TRY WITH THE DRUGS OR GO TO
IVF OR WHATEVER?
AND IN THIS CASE, IT -- I
SORT OF KNEW WHEN SHE
STARTED THE STORY, WE'RE
GOING TO HAVE A PREGNANCY IN
HERE SOMEWHERE.
WHICH IS GREAT.

Maureen says AFTER AN
ADOPTION, WITHIN THE FIRST
FEW MONTHS -- DON'T YOU
THINK IT HAS SOMETHING TO DO
WITH HER HORMONES?
THE MOTHERING INSTINCT?

Dr. Virro says I CAN'T SAY THAT.
I'D LOVE TO SAY YES BUT --

Maureen says SOMEONE SHOULD
STUDY THIS MAYBE I WILL.
CONGRATULATIONS ANYWAY.

Dr. Virro says ABSOLUTELY!

Maureen says AND I HOPE IT
ALL WORKS OUT IF YOU WANT
ANOTHER ONE.
WE ARE TALK INFERTILITY
TREATMENT THIS IS AFTERNOON
WITH Dr. MICHAEL VIRRO, HE IS THE
MEDICAL DIRECTOR OF THE
MARKHAM INFERTILITY CENTRE.
IF YOU HAVE A QUESTION ABOUT
HOW TO GET PREGNANT, GIVE US
A CALL. IN TORONTO (416) 484-2727 AND LONG DISTANCE IT’S FREE ITS 1-888-411-1234
OR EMAILS US AT MORETOLIVE@TVO.ORG

Maureen says WE HAVE AN
E-MAIL QUESTION FOR MONIQUE.
ANY ADVICE TO WOMEN WHO ARE
THINKING OF BEING SURROGATE
MOTHERS?
AND IS THERE ANY POSSIBLE
COMPLICATION FOR THAT WOMAN
IF SHE TRIES TO HAVE MORE
CHILDREN IN THE FUTURE?”

Dr. Virro says A SURROGATE, THE BIGGEST
RISK IS OBVIOUSLY THE
PREGNANCY ITSELF.
IF YOU'RE A LOW RISK
PREGNANCY TO START OFF WITH
I MEAN, YOU'VE GOT TO GO
THROUGH LABOUR AND DELIVERY.
I DON'T KNOW IF I'D WISH
THAT ON ANYBODY BUT ASIDE
FROM THE NORMAL RISK OF A
NORMAL PREGNANCY, NO, THERE
SHOULDN'T BE ANY INCREASED
RISKS AT ALL, DOWN THE ROAD.

Maureen says AND WHAT'S
INVOLVED IN THIS IN CANADA?
IS THERE A LOT OF LEGAL
PAPERWORK OR IS IT A MATTER
OF JUST AN ADOPTION AFTER
THE SNAKT.

Dr. Virro says IT'S AN ADOPTION
PROCEDURE IN CANADA.
SO ON THE BIRTH CERTIFICATE
WILL BE THE FATHER.
SO THE BIOLOGICAL FATHER.
BUT THE WOMAN THAT GIVES TO
THE CHILD HER NAME WILL BE
ON THE BIRTH CERTIFICATE SO
IF Mr. AND Mrs. SMITH, IF WE
USE THEIR EMBRYO TO GET
PREGNANTNANT, ON THE BIRTH
CERTIFICATE WILL BE
Mr. SMITH BUT SURROGATE
MOTHER'S NAME SO THAT COUPLE
THEN HAS TO GO THROUGH AN
ADOPTION PROCESS TO GET THE
BIRTH CERTIFICATE CHANGED SO
THAT THEIR NAMES ARE -- HAS
THE LEGAL PARENTS OF THE --
BIOLOGICAL PARENTS OF THE
CHILD.

Maureen says HOW MANY OF
THOSE WOULD YOU RUN INTO IN
A-YEAR?

Dr. Virro says NOT VERY MANY AT ALL.
IT'S NOT A COMMON PROBLEM.
A LOT OF COUPLES I DON'T
THINK ARE COMFORTABLE WITH
DOING IT.
IT IS SORT OF THE ULTIMATE
LAST-DITCH SOLUTION.
BUT I DON'T WANT TO GET INTO
A WHOLE POLITICAL THINKING,
BUT THIS NEW ROCK -- FALLING
ROCKS, GOING TO PUSH THESE
PROCEDURES, IN ONE OF THEM I
THINK THEY WANT TO TRY TO
STOP THE SURROGACY, I CAN'T
JUMP INTO HIS HEAD SPACE.
I KNOW CANADA DOESN'T LIKE
THE ELEMENT OF FINANCIAL
COMPENSATION FOR ANYTHING.
SO THEY DON'T WANT TO BE
PAYING SPERM DONORS, THEY DON'T WANT TO BE PAYING
EGG DONORS, THEY DON'T WANT
TO BE PAYING SURROGATES AND
IN THE IDEAL WORLD, I THINK
THAT'S GREAT.
UNFORTUNATELY WE HAVE TO PAY
TAXES SO IN AN IDEAL WORLD
WE WOULDN'T HAVE TAXES.
SO I THINK WE SHOULD ALLOW
SURROGACY TO CONTINUE, WE
SHOULD ALLOW EGG DONATION,
SPERM DONATION TO CONTINUE.
LET'S MAKE SOME GUIDELINES.
I'M REALLY WORRIED ABOUT
THESE GUYS COMING IN AND
JUST TAKING THE HAMMER AND
SAYING “I DON'T THINK THIS
IS RIGHT AND JUST STOPPING
IT.”
THERE ARE WOMEN BORN WITHOUT
UTERUSES, THAT'S NOT THEIR
FAULT AND THEY SHOULD BE
ALLOWED TO HAVE A CHILD AND
ALL WE'VE GOT IS SOME GUY UP
IN OTTAWA SAYING “WELL, WE
DON'T AGREE WITH THAT,” BUT
THEY'VE NEVER WALKED IN HER
SHOES AND THEY'RE MAKE
OPINIONS ON WHAT TO DO.

Maureen says BUT REASONABLE
GUIDELINES YOU WOULD
WELCOME.
RIGHT NOW, EVERYTHING WAS
SUPPOSED TO BE OPERATING
UNDER --

Dr. Virro says BUT WHO'S MAKING THE
REASONABLE GUIDELINES.WELL THAT'S IT.

Maureen says PRESUMABLY THEY'RE
TALKING TO PEOPLE LIKE YOU
THOUGH.

Dr. Virro says THEY’RE TALKING TO US BUT
THEY'RE NOT LISTENING TO US
VERY MUCH.
I HONESTLY -- OR I HAVE
CONVICTION THAT I DON'T
THINK THEY'RE LISTENING TO
THE SPECIALISTS VERY MUCH.

Maureen says BUT LET ME MAKE
ONE LAST POINT MUCH THE
ISSUE WE'RE TALKING ABOUT
BEFORE, THE MULTIPLE BIRTHS,
SHOULDN'T THERE BE A LAW
FROM IMPLANTING SAY MORE
THAN THREE?

Dr. Virro says THE PROBLEM WITH MAKING A
LAW IS YOU'VE GOT A LAW AND
YOU CAN'T GO BACKWARDS.
I MEAN WE'VE TRANSFERRED
FIVE OR SIX EMBRYOS AT OUR
CENTRE.
NOT VERY OFTEN RECENTLY, BUT
THAT'S ONE OF THOSE THINGS I
THINK YOU HAVE TO LOOK AT
INDIVIDUALLY WITH EACH CASE,
AND IF YOU'VE GOT A COUPLE
THAT'S HAD FOUR OR FIVE
FAILURES, AND WE'RE LOOKING
AT MAYBE ONE OR TWO GOOD
QUALITY BLASTOCYSTS OR EMBRYOS, WHATEVER YOU'RE
DEALING WITH AND THE OTHERS
ARE VERY, VERY POOR IN
QUALITY AND THE OTHERS ARE
PROBABLY NOT GOING TO
SURVIVE FREEZING, THE
LIKELIHOOD OF THEM GETTING
PREGNANT AND SO WE TRANSFER
FIVE OR SICKS, I THINK WE
SHOULD HAVE THAT LEEWAY.
THAT'S NOT SAYING I'M GOING
TRANSFER FIVE EXCELLENT
QUALITY BLASTOCYSTS BUT AS
SOON AS YOU HAVE A LAW YOU
CAN ONLY TRANSFER TWO, THEN
IF YOU'VE GOT A SITUATION
LIKE THAT YOU CAN ONLY
TRANSFER TWO POOR EMBRYOS.
THESE LAWS, ONCE THEY'RE
LAWS, THEY'RE LAWS.
AND YOU CAN'T GO BACK.
AND IF THEY MAKE A LAW TO
BAN SURROGACY OR EGG
DONATION YOU CAN'T NEXT YEAR
SAY WELL, NOW THAT WE'VE
RECONSIDERED AND WE WANT TO
CHANGE OUR OPTIONS WE'VE GOT
THIS LAW.

Maureen says OKAY FAIR ENOUGH,
LET'S GO TO LUCY.

Lucy says HI Dr. VIRRO AND
THANKS FOR TAKING MY CALL.
I HAVE FOUR AND A HALF YEAR
OLD DAUGHTER AND I'VE HEARD
THAT THERE'S A COMMON
PROBLEM CALLED SECOND
PREGNANCY INFERTILITY.
I'VE BEEN TRYING TO HAVE
ANOTHER ONE FOR OVER TWO AND
A HALF YEARS.
JUST HAD A LAPAROSCOPY THIS
WEEK, AND MY QUESTIONS ARE I
WANT -- WELL, I OBVIOUSLY
WANT TO HAVE ANOTHER ONE,
THEY TOLD ME I HAD MILD
ENDOMETRIOSIS AND INFLAMED
TUBES.
AND BECAUSE THE TUBES WERE
INFLAMED, I BELIEVE THAT
THEY WANT TO STOP MY CYCLE
FOR THREE MONTHS AND TRY
SOMETHING, WHICH I'M NOT
CLEAR ON WHAT THAT IS, BUT
WOULD THAT BE WISE TO DO?
ARE THERE ANY SIDE EFFECTS
WITH STOPPING THE PERIOD?
I'M AFRAID THAT I WON'T GET
MY CYCLE AGAIN AFTER THAT
AND HOW SOON AFTER COULD I
TRY?

Dr. Virro says IT SOUNDS LIKE THEY'RE
TRYING TO STOP YOUR PERIODS
AND TREAT THE ENDOMETRIOSIS
BOTH WITH A MEDICATION WHICH
SORT OF PUTS YOU IN AN
ARTIFICIAL MENOPAUSE.
YOU WILL GET YOUR PERIOD
AGAIN UNLESS YOU'RE GOING
NATURALLY GO INTO MENOPAUSE
EARLY, SO I WOULDN'T -- I
HAVEN'T SEEN IT THAT YOU'RE
INTO THE GOING TO RESUME
YOUR PERIODS.
I THINK YOU'VE GOT TO GO
WITH WHAT THEY'VE TOLD YOU.
IF THEY WANT TO SUPPRESS
YOUR ENDOMETRIOSIS FOR THREE
MONTHS WITH THIS TREATMENT,
I WOULD DO IT.
YOU WILL GET YOUR PERIODS
AGAIN IT MAY TAKE TWO TO
THREE MONTHS AFTER THE
TREATMENT, BUT IF THAT'S THE
WAY THEY'RE TRYING TO GO, IT
SOUNDS LIKE VERY GOOD PLAN.

Maureen says IS THAT COMMON?
A SECOND PREGNANCY --

Dr. Virro says YEAH.
AGAIN, WE SORT OF TOUCHED ON
THAT EARLIER, JUST BECAUSE
YOU'VE HAD A CHILD DOESN'T
MEAN EVERYTHING IS HUNKY
DORRY.
I THINK THAT'S MORE THE
COMMON RULE BUT WE CERTAINLY
SEE COUPLES THAT HAVE A
CHILD THAT ARE HAVING A VERY
DIFFICULT TIME GETTING A
SECOND ONE.

Maureen says NOW SHE WAS
SAYING IT'S BEEN TWO AND A
HALF YEARS THEY'VE BEEN
TRYING AND SHE'S FINALLY
GOING FOR SOME ADVICE.
HOW LONG DO YOU ADVISE
COUPLES TO WAIT BEFORE
THEY --

Dr. Virro says ONE YEAR.
I THINK THAT'S THE STANDARD,
AND I THINK THAT'S A VERY
GOOD STANDARD.
I THINK TOO MANY TIMES
COUPLES ARE TOLD WELL,
YOU'RE YOUNG, JUST RELAX, GO
HAVE A VACATION.
THERE'S USUALLY A PROBLEM IF
YOU KNOW, WITHIN A YEAR.
AGAIN, THE LONGER YOU WAIT,
THE LONGER YOU MAY BE
PUTTING OFF SOMETHING THAT
YOU'RE MISSING.
IT COULD BE A VERY SIMPLE
PROBLEM TO CORRECT SO THAT
YEAR, I THINK IS IDEAL.

Maureen says OKAY.
ALL RIGHT, GOOD LUCK.
THANK YOU FOR THE CALL.
SUE IS IN TORONTO.
HI SUE.

Sue says HI.
MY QUESTION IS -- ACTUALLY I
GOT PREGNANT THROUGH A SPERM
WASH FOR FIRST TIME.
NOW I TRY FOR SECOND TIME
AND I COULDN'T.
AND I ASK MY DOCTOR TO DO
THROUGH IVF BUT BECAUSE MY
AGE IS 45, SHE SAID IT'S NOT
A GOOD IDEA TO DO.
MY QUESTION IS WHAT SHOULD I
DO?

Dr. Virro says WELL, 45 IS EXTREMELY
TOUGH ANYWHERE ON THE PLANET,
AND I DON'T WANT TO BE A BAD,
NASTY GUY, BUT YOUR CHANCES
WITH ANY PROCEDURE ARE LESS
THAN 1 PERCENT.
AGAIN, I DON'T KNOW IF
YOU'RE LISTENING AT THE TOP
OF THE SHOW, AGE IS OUR
BIGGEST HURDLE THAT WE HAVE
TO OVERCOME, AND PREGNANCY
RATES AT THE AGE OF 45 ARE
DISMAL.

Maureen says BUT THEN YOU
KNOW, YOU LOOK AT HOLLYWOOD
AND SUSAN SARANDON, I DON'T
KNOW HOW OLD SHE WAS, BUT
LOTS OF ACTRESSES ARE HAVING
BABIES AT THAT AGE.

Dr. Virro says YOU KNOW, BUT IF THEY'RE
45, THEY'RE PROBABLY USING
AN EGG DONOR.

Maureen says DO YOU THINK SO?

Dr. Virro says ABSOLUTELY!
I MEAN, IT'S -- I MEAN,
NOBODY'S GOING TO ADVERTISE
THAT, BUT --

Maureen says SO THAT'S AN
OPTION FOR HER.

Dr. Virro says OH, AN EGG DONOR'S AN
ABSOLUTE OPTION.
IT GIVES YOU BY FOR YOUR --
FAR YOUR BEST OPTION.
BUT I DON'T KNOW IF THAT'S
AN OPTION FOR HER OR IF
SHE'S COMFORTABLE WITH THAT
OR HER HUSBAND, BUT USING
HER OWN EGGS HER CHANCES ARE
VERY, VERY SLIM SO THE
ADVICE SHE WAS GIVEN IS VERY
ACCURATE.

Maureen says SHE WAS
MENTIONING SPERM WASH?
WHAT'S THAT?

Dr. Virro says THAT'S WHERE WE JUST
PREPARE THE SPERM IN A WAY
WHERE WE CAN DO AN INTRA
UTERINE INSEMINATION SO WE
CAN TAKE A LITTLE CATHETER,
GO THROUGH THE CERVIX AND
PUT THE SPERM UP INSIDE THE
UTERUS, BYPASSING THE
CERVICAL MUCAS IN THE CERVIX AND IN ORDER TO PUT FRESH SPERM INTO THE UTERUS IT
HAS TO BE PREPARED
WITH THE SPERM WASHING PROCEDURE.
TAKES OUT THE DEAD ONES, THE
ABNORMAL SHAPED ONES,
REMOVES THE PROSTA GLANDS FROM THE SPERM, THEY PUT IN CALCIUM AND SUGAR AND
LITTLE PROCEDURES THAT
MAKE THEM BETTER FOR THE
ENVIRONMENT OF THE UTERUS.

Maureen says IF SHE DID WANT
AN EGG DONATED WOULD THERE
BE A WAITING LIST INVOLVED
IN THAT? YOU WERE SAYING THEY WERE IN VERY SHORT SUPPLY.

Dr. Virro says IF SHE'S GOT A YOUNGER
SISTER OR SOMEBODY THAT
WANTS TO DO THAT, THEN SHE
HAS NO WAIT.
WE'VE VERY DIFFICULT TIME
KEEPING UP WITH OUR PATIENTS
AT OUR CLINIC, BECAUSE OF
THE SHORTAGAGE.

- SHORTAGE.
NOW THIS CHANGES, BUT IF I
WERE TO GO TO THE “GLOBE and
MAIL” OR THE STAR OR THE SUN,
I DON'T THINK I COULD PUT AN
AD IN THE PAPER SAYING I
WOULD LIKE A DONOR TO COME
IN AND FINANCIALLY
COMPENSATE THEM.
IT GETS AROUND, YOU KNOW,
WHY ARE WE FINANCIALLY
COMPENSATING THEM?
THERE'S IN LAW THAT SAYS I
CAN'T DO THAT, BUT I DON'T
THINK THEY LIKE THAT.
I MEAN, IDEALLY, WE'LL HAVE
A BUNCH OF WOMEN COME INTO
THE CLINIC AND SAY, YOU KNOW,
I'M 28; I'VE GOT THREE KIDS
AND I WANT TO BE AN EGG
DONOR.
BECAUSE TO ME THAT'S THE
IDEAL EGG DONOR.
WE HAVEN'T TOUCHED ON THAT
BUT AGAIN, MY OPINION, IF
YOU WANT TO BE AN EGG DONOR,
YOU'VE GOT TWO OR THREE
CHILDREN, RELATIVELY YOUNG
IN AGE, WE'VE GOT LIVING
PROOF THEY'VE GOT TWO OR
THREE KIDS, YOUR EGGS WERE
OKAY, WHEREAS IF WE USE A
28-YEAR-OLD, NEVER HAD
CHILDREN BEFORE, WE DON'T
KNOW WHAT KIND OF EGG
QUALITY SHE'S GOING TO HAVE FOR ALL WE KNOW SHE'S GOING TO HAVE AN INFERTILITY
PROBLEM.
SO IDEALLY YOU WANT TO HAVE
A WOMEN THAT'S HAD CHILDREN
BEFORE.
AGAIN IN A PERFECT WORLD
WE'D HAVE DONORS COMING IN,
VOLUNTEERING THAT SERVICE.
IT'S A LOT OF WORK TO BE AN
EGG DONOR.
THEY'VE GOT TO GO ON
FERTILITY DRUG, INJECTIONS
FOR FOUR WEEKS, THREE AND A
HALF WEEKS.
THEY'VE GOT BLOOD TEST,
DAILY BLOOD TESTS EVERY
MORNING.
THERE'S SOME DISCOMFORT WITH
THE RETRIEVAL AND THERE ARE
THEORETICAL RISKS WITH THE
RETRIEVAL.
A SPERM DONOR COMES IN, DOES
HIS THING AND THERE'S NO
RISK.

Maureen says YEAH, YOU DON'T
HAVE ANY TROUBLE WITH THAT,
EH?
THERE'S LOTS OF SPERM DONORS.
OF COURSE THE MORE WE
HAVE -- WHAT DO YOU CALL
THEM?
ADULTS NOW LOOKING FOR THEIR
BIOLOGICAL FATHER WHO DONNATED HIS SPERM, I THINK
THAT'S GOING TO HAVE AN
EFFECT ON MEN'S WILLINGNESS
TO DONATE SPERM.

Dr. Virro says YEAH, THAT'S A VERY -- I
DON'T THINK WE HAVE THE
ANSWERS TO THAT.
I HAD A CONVERSATION MAYBE A
YEAR AGO WITH A MAN THAT HE
KNEW HE WAS A SPERM -- A
RESULT OF A SPERM DONOR.
HE WAS A GROWN MAN, IT WAS
OBVIOUSLY MANY YEARS AGO,
AND HE WAS VERY INTENT ON
FINDING OUT WHO HIS
BIOLOGICAL PARENTS WERE.
AND WE HAD A LOT OF
DISAGREEMENTS AND DISCUSSION
ABOUT IT.
IT WAS A VERY GOOD
DISCUSSION, BUT THE PROBLEM
IS WITH -- AND I DON'T THINK
WE HAVE AN ANSWER TO THIS,
BUT MEN OR WOMEN, I DON'T
THINK, WANT TO BE EGG OR
SPERM DONORS WITH THE
KNOWLEDGE THAT THIS CHILD
WILL COME -- OR THE
OFFSPRING WILL COME BACK 15
YEARS FROM NOW AND WANT TO
FIND OUT WHO THEIR PARENTS
ARE.
SO THEY'RE DOING IT UNDER
THE AUSPICES OF BEING
ANONYMOUS.

Maureen says YEAH, AS A GIFT
TO SOMEBODY ELSE.

Dr. Virro says AS A GIFT.
AND THE PERSON DONATING IS
VERY CONCERNED ABOUT BEING
TRACKED AND FOLLOWED BACK,
AND THE COUPLE RECEIVING IS
VERY CONCERNED ABOUT THE
DONOR FINDING OUT.

Maureen says FINDING THEM.

Dr. Virro says SO THEY WANT IT TO BE
ANONYMOUS BOTH WAYS.
WHETHER OR NOT WE SHOULD
TELL THESE CHILDREN?
I DON'T THINK WE HAVE THE
ANSWER TO THAT AND I DON'T
THINK I CAN BLATANTLY SAY WE
NEED TO TELL THEM.
I'M MORE ON THE -- RIGHT NOW,
I THINK WE SHOULD NOT.
I COULD BE TOTALLY WRONG
WITH THAT BUT I DON'T THINK
WE NEED A LOT MORE PROOF
DOWN THE ROAD IN FOLLOWING
THESE PREGNANCIES AND
FOLLOWING THESE CHILDREN.
AGAIN, AS YOU SAID, I THINK
THERE'S A DIFFERENCE BETWEEN
AN ADOPTED CHILD -- I WOULD
HAVE TO THINK AN ADOPTED
CHILD HAS SOME INNER DESIRE
TO FIND OUT WHY -- WHAT WERE
THE CIRCUMSTANCES WHY THEY
WERE GIVEN UP FOR ADOPTION.
WHEREAS IF YOU LOOK AT THE
EGG OR SPERM DONOR ISSUE,
HOW YOU PRESENT IT TO THE
CHILD, IF YOU SAY THIS IS
THE ONLY WAY MOMMY OR DADDY
COULD HAVE HAD A CHILD,
SOMEBODY WAS KIND ENOUGH TO
DONATE FOR YOU TO BE HERE, I
THINK THAT'S A TOTALLY
DIFFERENT SET OF
CIRCUMSTANCES.

Maureen says I WOULD AGREE
WITH THAT.
ALL RIGHT, ETHICAL CANADA
CONUNDRUMS.
I'M SURE THERE NEEDS TO BE A
LOT MORE DISCUSSION.
TRACY'S IN LONDON.
HI TRACY?

Tracy says HI.

Maureen says HI, AND YOUR
QUESTION FOR Dr. VIRRO.

Tracy says MY QUESTION IS
THIS: MY HUSBAND AND I HAVE
BEEN GOING THROUGH
INFERTILITY TREATMENTS AND
IT WAS RECENTLY DISCOVERED
HE HAD AN EXTREMELY LOW
SPERM COUNT AND MOTILITY AND
ICHSY WAS GIVE AN OPTION FOR
US AND WE WERE JUST
WONDERING, EVEN THOUGH THEY
CAN'T FIND A REASON
NEUROLOGICALLY WHY HIS SPERM
COUNT IS SO POOR, IF WE DO
DECIDE TO GO THROUGH WITH
ICHSY WILL MAKING A LITTLE
TEAR IN THE EGG CAUSE US ANY
PROBLEMS LATER ON OR WILL WE
HAVE ANY INCREASED CHANCES
OF DEFECTS OR ANYTHING ELSE
THAT COULD STAND IN THE WAY
OF HAVING A NORMAL, HEALTHY
CHILD?

Dr. Virro says NO.
THE ONLY POSSIBILITY WITH AN
ICHSY CHILD OF AN ABNORMALITY WITH THE
CHILD IS POSSIBLY PASSING ON
A CHROMOSOMEAL DEFECT WHICH
MOST LIKELY YOUR HUSBAND
HAS.
SO BY DOING THE ICHSY
PROCEDURE, WE'RE NOT
CREATING CHROMOSONAL
PROBLEMS, WE ARE POTENTIALLY
PASSING ON THE SAME
CHROMOSONAL PROBLEM FROM THE
HUSBAND SO IF HE HAS A VERY
LOW SPERM COUNT, YOU MAY TO
WANT GET CHROMOSOME TESTING
WITH HIM.
AND WHAT THEY'RE LOOKING FOR
IS A LITTLE WHAT WE CALL A
MICRO DELETIONS ON THE Y
CHROMOSOME.
IF IT'S THERE, IF YOUR
HUSBAND'S THERE IF HE'S GOT
THE DEFECT, IT'S OBVIOUSLY
NOT A LETHAL CONDITION BUT IF HE
HAS IT AND YOU HAVE A MALE
CHILD, YOUR SON MAY HAVE
THAT EXACT SAME DEFECT.
WHAT DOES THAT MEAN TO YOUR
CHILD?
NOTHING, HE'LL GROW UP
HEALTHY BUT HE MAY HAVE TO
DO ICHSY FOR HIS CHILD DOWN
THE ROAD.
BUT I AM TOTALLY CONVINCED
THAT ICHSY IS NOT CAUSING
ANY INCREASED ABNORMALITIES
WITH THESE CHILDREN.
PIERCING THE EGG -- ONCE A
WHILE YOU'LL LOSE AN EGG
FROM THE INJECTION PROCESS
BUT THEN YOU DON'T GET AN
EMBRYO, YOU JUST LOSE THE
EGG.
IF THAT'S YOUR ONLY OPTION
AND HE'S GOT A NORMAL
CHROMOSOME PROBLEM OR EVEN
IF HE DOES HAVE A MICRO
DELETIONS, MOST COUPLES
STILL SAY IF THAT'S THE ONLY
PROBLEM THAT'S GOING TO
HAPPEN LET'S GO AHEAD AND DO
IT.

Maureen says ICHSY JUST DOES
MECHANICALLY WHAT NATURE
DOES NATURALLY I GUESS?

Dr. Virro says YES.

Maureen says IT'S KIND OF
NEAT TO SEE UNDER THE
MICROSCOPE.
ALL RIGHT, GOOD LUCK.
THANK YOU, TRACY.
LET ME GET IN DEBBIE'S E-MAIL.
“I'M ALMOST 36 YEARS OLD AND
I'VE BEEN INFERTILITY
PATIENT FOR SEVEN YEARS.
I'M CURRENTLY PREPARING FOR
A FROZEN EMBRYO THIRD TIME
TRANSFER OF TWO BLASTOCYSTS
ALONG WITH ASSISTED
HATCHING.
I'VE NEVER HAD A PREGNANCY
AND WAS WONDERING WHAT ARE
THE CHANCES OF SUCCESS WITH
AN ASSISTED HATCHING OR IS
THERE ANY OTHER PROCEDURE,
I.E. GIFT THAT WE SHOULD
CONSIDER.
WE'RE IN THE UNEXPLAINED
CATEGORY.

Dr. Virro says NOBODY IS DOING, TO MY
KNOWLEDGE, ASSISTED HATCHING
ON BLASTOCYSTS.
ASSISTED HATCHING IS WHERE
YOU TAKE THE SHELL OF THE
EMBRYO AND MAKE A HOLE IN
IT.
YOU CAN EITHER DO IT WITH A
LASER OR ACID.
YOU CAN ACTUALLY RUB IT WITH
A NEEDLE.
I THINK MOST CENTRES ARE
USING THE ACID OR THE LASER.
SO IT'S ALMOST LIKE A
CHICKEN BREAKING OUT OF THE
EGG.
WE THINK THE SHELLS OF SOME
EMBRYO ARE VERY HARD SO
THE EMBRYO CANNOT BREAK
THROUGH THE SHELL TO ALLOW
IN IMPLANTATION SO BY DOING ASSISTED HATCHING YOU MAKE A LITTLE
A NICK IN THE HOLE, TO ALLOW THE EMBRYO TO
ESCAPE.
SO THEORETICALLY IF YOU’RE WORKING ON THE IMPLEMANTATION PROBLEM I WOULD
CERTAINLY
TRY
ASSISTED HATCHING.
IF YOU ALREADY HAVE
BLASTOCYSTS I DON'T KNOW IF
ANYBODY'S DOING HATCHING ON
BLASTOCYSTS IN ONTARIO.
I GUESS THERE MAY BE.
NOT TO MY KNOWLEDGE.
SO IF YOU'RE GOING TO DO ASSISTED
HATCHING IT'S USUALLY DONE
ON THE THIRD DAY WHEN YOU
HAVE AN EIGHT-CELL EMBRYO IN
RESPECT TO THE GIFT QUESTION,
I THINK IT DEPENDS ON YOUR
FERTILIZATION RATE WITH IVF,
IF YOU’RE TUBES ARE BEAUTIFUL
AT LAPAROSCOPY, A GIFT IS
CERTAINLY AN OPTION.

Maureen says GIFT IS A DONNATED?

Dr. Virro says NO A GIFT IS A GAMETE INTRAFALLOPIAN TRANSFER. YOU HAVE TO HAVE A
LAPAROSCOPY BASICALLY TAKE
UNFERTILIZED EGGS, MIX THEM
WITH A SPERM AND TRANSFER
TWO OR THREE EGGS INTO THE
FALOPIAN TUBE.
THEY HAVE TO FERTILIZE ON
THEIR OWN AND IF THEY DO,
THEY ROLL DOWN THE TUBE AND
IMPLANT.
IT'S SUPPOSEDLY MORE NATURAL
THAN IVF BUT YOU ARE
SELECTING THE GOOD EGG,
PUTTING THEM TOGETHER WITH
THE SPERM AND LETTING NATURE
SORT OF TAKE ITS CASE FROM
THAT.
IT'S INVASIVE BECAUSE YOU
HAVE TO HAVE A LAPAROSCOPY.
BUT POSSIBLY A VERY GOOD
OPTION.

Maureen says COULD THIS WOMAN
GET PREGNANT AFTER ALL SHE'S
BEEN THROUGH?
WHAT ARE HER CHANCES?
SHE'S NEVER HAD A PREGNANCY.

Dr. Virro says YOU CAN'T -- I DON'T
WANT TO AVOID THE QUESTION
BUT YOU CAN'T JUST PUT A
BLANKET STATEMENT ANSWER TO
THE QUESTION.

Maureen says BUT THERE MUST
BE SOME PEOPLE OFF TO BREAK
THE NEWS TO --

Dr. Virro says ABSOLUTELY.
SOME PEOPLE YOU HAVE TO SAY
IT'S OVER, I DON'T KNOW WHAT
ELSE TO DO AND Its TIME TO
QUIT OR MOVE ON.

Maureen says AND THAT'S HARD
TO SAY AND ACCEPT.
BUT --

Dr. Virro says YEAH, IT'S A LITTLE BIT
ODD.
SOME COUPLES, IF THEY TRY A
CYCLE AT ONE CLINIC, FOR
WHATEVER REASON, WILL GO TO
ANOTHER CLINIC THE SECOND
TIME.
SO THERE'S A LITTLE BIT OF
CLINIC HOPPING, MAYBE FROM
SOME COUPLES, SO THAT'S
FRUSTRATING ON OUR PART.
I MEAN, IF THEY'RE
DISSATISFIED WITH OUR
SERVICE, THAT'S ONE ISSUE,
BUT I THINK IF A COUPLE LIKES THE
CLINIC WHERE THEY'RE WORKING
AT, I THINK THEY NEED TO
TALK WITH THE DOCTOR AND SAY
OKAY, THIS IS WHAT WE DID
LAST TIME, DIDN'T WORK
WHAT'S OUR NEXT STEP.
AND I WANT JUST LIKE TO TRY
SOMETHING DIFFERENT EACH
TIME WE GO THROUGH
SOMETHING.
THERE ARE DIFFERENT OPTIONS
YOU HAVE.
BUT AGAIN, DEPENDING ON THE
CASE, DEPENDING ON THE
COUPLE THERE IS A POINT
WHERE YOU HAVE TO SAY, AND
THAT MAY BE YOU NEED AN EGG
DONOR, YOU MAY NEED A SPERM
DONOR OR IT MAY BE TIME TO
QUIT.

Maureen says OR THINK ABOUT
ADOPTION.

Dr. Virro says OR A SURROGATE OR ADOPT
BUT WE HAVE TO TELL THESE
COUPLES AT THIS POINT.

Maureen says WE'RE ALL OUT OF
TIME BUT IT WAS FASCINATING.
THANKS, COME BACK AND WE'LL
DO IT AGAIN.

Dr. Virro says OKAY.

Maureen says DR. MICHAEL VIRRO IS THE MEDICAL DIRECTOR OF THE MARKHAM FERTILITY
CENTRE YOU CAN CALL HIS CLINIC AT 905-472-7128. AND FOR MORE INFORMATION CONTACT
THE INFERTILITY NETWORK AT AREA CODE 416-691-3611 OR VISIT THEIR WEBSITE AT
WWW.INFERTILITYNETWORK.ORG.”

The panel appears under the title “Markham Fertility Centre.” It reads “905-
472-7128. The panel changes to “Infertility Network.” It reads “416-691-3611.
Www.infertilitynetwork.org.”

The table appears with stacking blocks and “More to Life” symbol appears.
(Theme music)

Maureen says THERE'S MORE TO
GARBAGE HERE ON “MORE TO
LIFE.”
I KNOW YOU'RE ALL GOOD
RECYCLERS.
YOU PUT YOUR CANS AND
PLASTIC CONTAINERS IN THE
BLUE BOX EVERY WEEK, BUT
DID YOU EVER THINK THERE MIGHT
BE OTHER THINGS THAT
YOU COULD DO WITH ALL THAT
STUFF?
ALL THIS WEEK ON “MORE TO
LIFE” PATTY SMITH, A.K.A.
THE GARBAGE QUEEN AND HER
COMPATRIOT, MIKE STOLL OF
THE GARBAGE PALACE IN
TORONTO WILL DEMONSTRATE A
WIDE VARIETY OF CRAFTS THAT
YOU CAN MAKE WITH THE KIDS
ALL FROM ITEM TEAMS FROM THE
RECYCLING BINS OR GARBAGE
CAN.

Garbage is spelled out in bright block letters with a background that shows a
fast clip of several types of items such as tin cans, candles, frames with doll
heads, vinyl records, and finally a sign that reads “Garbage Palace.”

Patti is in her fifties and has short pixie cut brown hair. She wears glasses,
and a blue long sleeved shirt.

Myke is in his forties and has a brown goatee and brown hair. He wears a red
long sleeved shirt.

Patti says HELLO, I'M PATY, THE
GARBAGE QUEEN.
WELCOME TO THE GARBAGE
PALACE.
AND HERE COMES MY PARTNER IN
GARBAGE, MIKE.

Myke says HI; WE'RE GOING TO SHOW
YOU WHAT WE DO WITH GARBAGE.

A caption appears and it reads “Myke Stoel and Patti Smyth. 'THE GARBAGE
PALACE'.”

Myke and Patti stand at a table and Myke holds a Tropicana carton and Patti a
blue plastic water jug.

Patti says TODAY MIKE AND I ARE
GOING TO MAKE JUGHEAD MASKS
AND BIRDFEEDERS.

Myke says WHAT DO WE NEED TODAY FOR
THE JUGHEAD MASK, PATTI?

Patti says YOU NEED A JUG.
YOU CAN USE A WATER JUG OR A
FLEECY JUG, A MARKER,
AN EXACTO KNIFE AND A PAIR
OF SCISSORS.

Myke says THIS IS REALLY SHARP,
RIGHT?

Patti cuts into the bottom half of the water jug with the exacto knife.

Patti says YUP.
VERY SHARP.
SO YOU JUST DO A SMALL CUT TO
GET IT GOING YOU'RE
GOING CUT OFF THE BOTTOM.
SO FOR THIS PART YOU COULD
GET AN ADULT TO DO THIS.
IT'S QUITE TOUGH.
YOU'RE CUTTING OFF THE
BOTTOM OF THE JUG.
AND THIS PART, YOU CAN REUSE
IT.
YOU CAN USE IT FOR PAINT OR
GLUE OR PUTTING YOUR BUTTONS
AND STUFF IN.

Myke says OKAY WHAT'S THE NEXT
STEP?

Patti says NEXT STEP, YOU CUT, YOU
DECIDE WHAT KIND OF A
PATTERN.
YOU COULD DO A SQUIGGLEY
PATTERN OR WE HAVE SOME
EXAMPLES HERE.
JUST HAIR ON THE TOP.
AND SO FOR THAT YOU CAN USE

- SCISSORS TO CUT
STRIPS.

Myke says DO YOU NEED TO DRAW THIS
OUT OR CAN YOU -- DO YOU CUT
IT FREEHAND.

Patti draws squiggly lines on the jug and then uses the scissors to cut.

Patti says YOU CAN DO IT FREEHAND OR YOU
COULD DRAW IT OUT WITH A PERMANENT MARKER IT WORKS BEST.
SO IF YOU WERE TO CUT IT OUT TO DRAW IT ON YOU CAN DRAW YOUR LITTLE PATTERN THAT
YOU WANTED.
AND THEN CUT ALONG THE LINE.
SO ACTUALLY THE KIDS COULD
DO ALL THE DRAWING AND THEN
THE ADULTS COULD DO ALL THE
CUTTING OUT.
AND THEN YOU JUST FOLLOW THE
LINES AS BEST YOU CAN.

Myke says SO I GUESS WITH REALLY
YOUNG KIDS THE KIDS COULD
JUST DRAW THIS OUT AND THEN
THE PARENTS COULD CUT IT OUT
FOR THEM, RIGHT?
OKAY, RIGHT.
Patti draws eyes on the jug where the handle is located. Then she shows the jug
to the camera which appears to be a mask with the spout of the jug as the mouth
and the eyes had drawn on either side of the handle of the jug.

Patti says UNTIL YOU GO ALL THE WAY
AROUND THE JUG, AND THEN
DECIDE WHAT KIND OF A MASK
YOU WANTED.
IF YOU WANTED A HAPPY MASK
OR A SAD MASK.
AND THEN YOU COULD DESIGN
THE EYES.
AND YOU HAVE TO TRY AND GET
THEM EVEN.
AND THIS WOULD BE THE MOUTH,
AND THE HANDLE IS THE

- IS THE NOSE.

Myke says SO HOW DO YOU KEEP THIS
ON, ONCE IT'S ALL CUT OUT?

Patti says YOU COULD PUT AN ELASTIC,
LIKE FOR A WAIST BAND
ELASTIC.

Myke says OKAY, I GUESS EVEN AN
ELASTIC BAND WOULD WORK
WELL?

Patti says YEAH, OR A LARGE ELASTIC
BAND.
AND THEN SO IN THE SIDES YOU
WOULD JUST POKE TWO HOLES,
AND WE HAVE ONE READY HERE.

Myke puts on the mask that has several plastic strips that flare out and he can
see through the eyeholes.

Myke says GREAT!
HERE WE GO!
AND YOU CAN AFFIX AN ELASTIC
ON THE BACK, AND THE WHOLE
THING GOES ON YOUR HEAD LIKE
THIS.

A screen appears that reads 'Garbage' and each square has something unique like
a tin can, coin holders, and candles.

Myke says OKAY, NOW FOR THE
BIRDFEEDERS.

Patti says WHAT DO WE NEED MIKE FOR
THE BIRDFEEDERS?

Myke holds a clear water bottle and cuts into the side of the bottle leaving an
open flap.

A caption appears that reads, “We suggest adult supervision for cutting.”

Myke says WELL, EITHER A MILK JUG
OR ANY BIG JUICE JUG.
ANYTHING THAT'S GOT FLAT
SIDES AND WILL HOLD ENOUGH
THE SEED.
FIRST THING YOU NEED TO DO,
AND AGAIN, REALLY SHARP, IS
TO CUT THE ROOF OF THE
FEEDER.

Patti says AND IT KEEPS THE
SQUIRRELS OUT, THE LITTLE
FLAPS.

Myke pokes two holes in the water bottle.

Myke says OKAY, SO YOU'VE GOT A
LITTLE FLAP NOW.
SQUARE ONES WORK QUITE
WELL -- CLEAR ONES WORK
QUITE WELL BECAUSE YOU CAN
ACTUALLY SEE WHAT'S LEFT IN
IT.
AND YOU JUST POKE A LITTLE
HOLE IN THE BOTTOM, BECAUSE
THE BIRDS NEED SOMETHING TO
STAND ON.

Patti says YEAH, I'D GET AN ADULT TO
DO THESE PARTS.

Myke puts a twig in the two holes and then cuts the fishing line and places it
On the top and screws the cap on top of the fishing line.

Myke says AND YOU JUST GO OUTSIDE,
FIND YOURSELF A DEAD TWIG,
AND YOU POKE IT THROUGH THE
TWO HOLES.
GREAT, SO YOU'VE GOT
SOMEWHERE FOR THEM TO STAND
ON, A LITTLE ROOF TO KEEP
THEM DRY.
GET SOME FISHING LINE OR
WIRE.
CUT OFF A FEW FEET, AND...
THIS IS A REALLY EASY TRICK.
JUST LAY THE FISHING LINE
OVER THE TOP, PUT THE CAP ON,
SCREW THE CAP BACK ON, AND
IT'S INSTANTLY TIED.

Patti says CLEVER!
AND THEN YOU WOULD JUST
FILL IT UP WITH BIRD FEED.
AND HANG IT IN A TREE.

Dr. Virro MAKE SURE YOU AT LEAST
DOUBLE KNOT IT SO IT DOESN'T
FALL DOWN, AND VOILA, ONE
BIRDFEEDER.
Maureen is back in the studio.

Maureen says AND THAT IS ALL THE TIME WE HAVE FOR MORE TO LIFE GLAD YOU WATCHED
TODAY AND I HOPE THAT YOU WILL TUNE IN AGAIN ON MONDAY THROUGH FRIDAY AT ONE
OCLOCK.

A slate appears and it reads, “The Advice given in the preceding program is of
a general nature only. Viewers should consult their own medical professional for
medical advice specific to their circumstances.”

Watch: Infertility