This is the latest article in a Global News investigation into fertility in Canada, and the emotional and financial impact infertility has on Canadians struggling to conceive.
Is our society becoming more infertile?
While people may not always feel comfortable sharing their fertility struggle, one in six Canadian couples are believed to be affected by it. And there’s no shortage of advice online for them — every day it seems there’s a new article on how to improve fertility — what to eat, what not to eat, what may help, what may hinder.
Despite the onslaught of information, there is still a ton we don’t know about the topic. The last known study (in 2011) on the prevalence of infertility in Canada acknowleged that. Researchers, who attempted to estimate the country’s infertility rate, concluded it had increased to 15.7 per cent, up from 5.4 per cent in 1984.
However Canadian fertility experts Global News spoke to say there is no conclusive evidence that infertility has increased since then.
Here’s what they do know:
More people undergoing IVF doesn’t mean more people are infertile
Doctors do admit more people turn to fertility clinics than a generation ago. The number of those clinics across the country has also doubled (to 37) in the past 15 years, according to the Canadian Fertility and Andrology Society (CFAS).
Heather Shapiro, former CFAS president, attributes that to the “rapid evolution” of in vitro fertilization (IVF) technologies, and their success rates.
But Mark Evans of CFAS points out “increased usage of IVF is not correlated to an increase in infertility.
“Canada still has one of the lowest utilization rates for IVF among the G8 nations,” Evans said. “Access to treatment through funding is one factor that would explain growth in usage.”
Quebec and Ontario remain the only two provinces that specifically cover IVF. Ontario’s system allows a woman to take advantage of one covered IVF cycle in her lifetime, while Quebec’s offers a sliding scale of tax credits. You can see how other provinces compare below:
Hannam has his own theories on why fertility clinics have become busier in recent years.
“There’s a lot more fertility options than people ever had before.”
Better reproductive technology means more people are turning to surrogacy, and fewer are turning to adoption due to the latter process having grown more lengthy (the list of children up for adoption is also shorter).
This summer, one Toronto couple actually turned to social media in the hopes of fast-tracking an adoption rather than putting themselves on a provincial wait list.
Is male factor infertility inherited?
Much of the fertlity focus in recent years has been on men. More guys aged 18 to 45 have infertility than diabetes.
Last month, a Belgian study of 54 men aged 19-22 suggested male infertility might be inherited. It found men conceived with the help of intracytoplasmic sperm injection (ICSI) — a type of assisted reproductive technology that forms part of IVF; men who used the procedure had almost half the total sperm count of those who conceived “naturally.”
André Van Steirteghemat, co-author of the findings published in the Human Reproduction journal, believes this gives credence to what’s long been speculated: since many cases of male fertility are caused by genetic defects, men born thanks to ICSI “might inherit such defects from their fathers.”
An Australian professor also warned last week against becoming too reliant on assisted conception techniques, the Sydney Morning Herald reported.
“We are taking recourse to IVF in increasing numbers,” said University of Newcastle’s John Aitken.
“The thing we have to remember as a society is that the more you use assisted conception in one generation, the more you’re going to need it in the next.”
Aitken expressed concern as well over “ongoing health problems with IVF children.” He argued research has shown boys whose fathers smoked and used assisted conception techniques have a greater risk of developing cancer.
Toronto fertility doctor Tom Hannam told Global News “people do worry worldwide that sperm counts are falling.”
But he cautions that “there’s a lot of bias in where the data comes from,” which he says is often fertility clinics.
The age debate
When it comes to females, the number of first babies born to women between 30 and 49 years of age has risen significantly. More than half of all live births in Canada in 2013 were to mothers in this age group, up from 39.6 per cent in 1993.
Mothers over 40 increased their share of first-time births as well. About 3.5 per cent of all live births in 2013 were to women between 40 and 49 years old. A decade prior, that number was 2.7 per cent.
More younger people come into her fertility clinic to discuss family planning than when she started her practice eight years ago. To her, though, that doesn’t mean there’s been an increase in infertility which she says is not “scientifically proven.”
“What we are seeing is there’s an increase in awareness.”
She believes the trend is due to couples being better educated on the topic of fertility, and feeling more empowered to talk to their doctor about family planning.
The majority of Dixon’s clients are still 35 and over. They’re often people “who have travelled, met their mates later in life,” and focused on their academic and professional careers.
Dixon and Hannam both stress that couples who want to have kids shouldn’t delay in consulting a doctor if they’re struggling to get pregnant.
Up to 60 per cent of the patients Dixon sees have been helped through low-intervention methods that sometimes cost as little as a couple hundred dollars (that’s how much a 10-day round of ovulation medicine can cost).
“Often we just keep calm and carry on,” she said. “We’re busy taking care of our careers and partners.”
She says the sooner a fertility problem is addressed, typically the better the prognosis.
“Knowledge is power.”
— With files from Monique Muise, Patrick Cain, Shallima Maharaj and Beatrice Politi, Global News