ReproMed offers a comprehensive range of fertility treatments. Your treatment plan will be customized based on your family goals and assessment results. Treatments can range from simple interventions to more advanced assisted reproductive technologies.
Ovulation induction is the use of oral or injectable fertility medications to stimulate the ovaries to produce mature eggs. The purpose is to develop and ovulate one or more eggs in a female who normally does not ovulate. With increased egg production, the chance of conception also increases.
Ovulation induction may be right for you if you:
To be a candidate for ovulation induction you must have a normal uterine cavity and at least one normal fallopian tube, and your partner must have a normal sperm count.
IUI, or artificial insemination, is a common fertility treatment that involves inserting washed sperm into the uterus. It is done at the time of ovulation to improve the chances of pregnancy. It is considered a less invasive approach than some other ART (Assisted Reproductive Technology) procedures, because the critical steps necessary for conception occur as they naturally would, without any medical assistance.
Also known as Therapeutic Donor Insemination “TDI”
Donor sperm comes from accredited sperm banks that meet strict Health Canada standards. If this is a treatment option for you, the ReproMed team will provide you with the necessary information and instruction to move forward. We also have a close relationship with Origin sperm bank, should you consider this an option.
A session with a trained counselor who specializes in fertility issues is mandatory when using a donor for the artificial insemination process. This session will provide you with the opportunity to discuss common issues concerning this type of insemination, and to help you work through any concerns you may have prior to undergoing the procedure.
In Vitro Fertilization (IVF) is a procedure where an egg and sperm are introduced in a laboratory environment with the goal of fertilization . This is different from the procedure for IUI, where sperm is delivered into the uterus. There are several reasons why IVF may be recommended. Your ReproMed physician will help you determine if IVF is the best treatment option for your specific situation.
If it’s determined that IVF is right for you, our team will start formulating your personalized IVF journey. But it’s not a journey you’ll have to take alone. We’ll guide and support you every step of the way, including consultations, exams, medications, and treatment schedule.
First Stage: Ovarian Suppression
The process of ovarian suppression allows us to gain control over your cycle. Your doctor will determine if this stage is required for you or not. It involves taking an oral contraceptive and/or medication to suppress ovarian function and drop estrogen levels.
Second Stage: Ovarian Stimulation
Your ovaries typically produce and release a single egg per cycle, but conception through IVF usually needs more than that. In this procedure, we use medications to stimulate the
development of several ovarian follicles, so that we can retrieve more eggs.
Third Stage: Triggering the Egg Maturation Process
Once the ovarian follicles are ready, it’s time to “trigger” the ovaries to prepare the eggs for maturation and ovulation. This is done by injecting a pregnancy hormone.
Fourth Stage: Egg Retrieval and Embryo Development
Guided by ultrasound, your doctor will retrieve the eggs through your vagina. These eggs will then be combined with the sperm In Vitro, which should fertilize to form the embryo. Embryos grow in the lab until on average day 5 (blastocyst stage) at which time they are typically frozen for future use.
Fifth Stage: Embryo Transfer (Fresh or Frozen)
A developed embryo may be transferred to the patient’s uterus 5 days after egg retrieval – this is known as a fresh embryo transfer. Many patients, especially those using PGT-A, will undergo a transfer at a later date – this is known as a frozen embryo transfer.
Two weeks after the embryo transfer, you will learn if you are pregnant. Once your pregnancy has been confirmed, the ReproMed Fertility team will closely monitor the pregnancy with blood tests for your beta HCG levels. An ultrasound will also be performed to monitor the development of the pregnancy.
Our Andrology team at ReproMed leads solutions that improve sperm recovery, motility and fertilization potential.
Sperm Freezing for upcoming IVF Cycle(s)
It is possible for the partner of a patient undergoing In Vitro Fertilization or IUI to freeze sperm ahead of time if they are not going to be available or are concerned they may be unable to produce a sperm sample the day of the procedure.
Intracytoplasmic Sperm Injection (ICSI)
Sometimes, the sperm isn’t able to penetrate the egg's shell. In these cases, the doctor might use a procedure called Intracytoplasmic Sperm Injection (ICSI). In this procedure, a single sperm cell is injected directly into an egg.
Surgical Sperm Retrieval
Surgical sperm retrieval coupled with ICSI is used for the treatment where no sperm is found in the ejaculate due to obstruction in the genital tract. It is also used for men who had deficient spermatogenesis, (non-obstructive azoospermia).
Percutaneous Epididymal Sperm Aspiration (PESA)
With this technique, a small needle is inserted through the skin of the scrotum to collect sperm from the epididymis. We generally collect less sperm this way than with the MESA technique, but the procedure is easier and faster. PESA can also be performed with local anesthesia. Sperm retrieved by PESA must be used for IVF.
Microsurgical Epididymal Sperm Aspiration (MESA)
MESA is typically performed in an operating room with general anesthesia. With this
procedure, we make a small incision to collect fluid containing sperm from the small tubes of the epididymis in the testicle. We don’t cut into the testicle itself. We’re usually able to collect enough sperm to use and freeze for future use. Sperm retrieved by MESA must be used for IVF.
Testicular Sperm Aspiration (TESA)
This technique does not usually retrieve enough sperm to freeze and store for later use, but we can use it to obtain sperm if other methods haven’t worked. With TESA, a needle is used to take a small amount of tissue (called a biopsy) from the testicle. Sperm retrieved using this technique must be injected into the egg by ICSI (intracytoplasmic sperm injection) techniques.
Microsurgical Testicular Sperm Extraction (mTESE)
With this technique, the testicle is opened in the operating room under general anesthesia to look for sperm. It was once believed that for individuals who do not make sperm in the ejaculate (azoospermia), the only way to have a child would be through the use of donor sperm or adoption. mTESE allows a couple the ability to have a biological child.
Vasovasostomy is a surgical procedure to reverse the effects of a vasectomy. During this microsurgery the two ends of the vas deferens, which was cut during the vasectomy, are reconnected to allow sperm to travel once again from the testes to the point of ejaculation.
Repairing a varicocele – when veins become enlarged inside the scrotum – can improve semen parameters, testicular function and pregnancy rates. A surgeon uses a microscope to ligate all affected veins while preserving the tiny artery that brings blood to the testes.
Many patients consider IVF as an alternative to tubal reversal as tubal reversal outcomes may not be successful and the procedure has a long duration of healing.
To improve your chances of successful conception, our team will closely monitor your menstrual cycle through bloodwork and ultrasounds. Blood work helps measure your hormone levels throughout your cycle, and enable us to determine if medication is required to increase your chances of conceiving. Ultrasounds let us monitor the maturation of follicles in the ovaries. Cycle monitoring is used during timed intercourse cycles, enabling us to identify your ovulation window to time intercourse accordingly.