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.
Olivia Lan is a meticulous organizer, so when the Edmonton woman (whose name has been changed to protect her privacy) was ready to get pregnant, she naturally thought everything would go according to plan.
“Usually when I plan things,” she explained. “I get them.”
November 2014 would be the baby-making month for her and her husband, who was 23 at the time. Lan, then 25, had already calculated a December conception would equal a spring pregnancy and summer baby.
“That’ll be nice,” she recalled thinking.
Unfortunately, fertility can have a mind of its own. Two years — and countless pricey pregnancy tests — later, the couple is still childless.
“We thought we had this under control. But really, we obviously don’t,” she said.
“You hear so much about accidental pregnancies and teen pregnancies and it seems so easy to have a baby — except when you actually want one.”
Searching for answers
The hardest part of the whole ordeal for the Lans has been not knowing why they haven’t been able to conceive for the past 24 months.
At first the duo tried to conceive “normally.” Then as a slight panic set in, their sex life became “precisely” mapped out through fertility apps and $60 ovulation kits in an effort to optimize their chances.
The two also saw their family doctor, who sent them for some basic fertility testing: blood work for both (which can identify hormone imbalances that can affect the ability to conceive) and a sperm sample. When the results came back normal, the doctor told them to just keep trying.
Fertility specialists say a vaginal ultrasound (which can show the volume of eggs, any uterine abnormalities and Fallopian tube blockages) is also typically performed on for female patients. Lan doesn’t know why one wasn’t ordered for her but plans to now ask for one.
She eventually visited a gynecologist, who prescribed her some fertility pills but also insisted everything looked “fine.”
“You’re so sick of hearing that,” Lan said. “If you’re totally ‘fine,’ why is this happening?”
Lan says it’s been “frustrating” to have her fertility concerns seemingly brushed off by doctors, who’ve told her things like: “You guys are so young. You have so much time to have a baby… This is not an issue at all.”
“Yes, we’re young. But we’re so ready to have a baby. It’s all we want. It’s all we’ve wanted for two years,” the 27-year-old said before tearing up.
“You sort of feel like your life is on hold… It’s two years today. But maybe it’s five years tomorrow.”
The best chance anyone has of getting pregnant in a month, “even if they’re 21,” is 25 per cent, says Dr. Al Yuzpe of the Olive Fertility Centre in Vancouver. That number drops by five per cent when a woman hits 30, he adds.
Health Canada suggests women under 35 try for a year before seeking medical advice (unless there are other concerns like painful or irregular periods).
During that year, 85 per cent of couples will conceive, according to Dr. Sony Sierra, a reproductive endocrinology and infertility specialist at Women’s College Hospital in Toronto. After 18 to 20 months of trying, success rates of getting pregnant on one’s own drop to five per cent per cycle.
There’s no Canadian data readily available on how many couples in their 20s are affected by infertility. But a 2012 Age and Fertility report by the American Society of Reproductive Medicine found the following:
- 7 per cent of women in the U.S. between the ages of 20 and 24 are infertile
- 9 per cent are infertile between the ages of 25 and 29
- 15 per cent are infertile between the ages of 30 and 34
That’s just women. It’s believed male factor infertility accounts for up to 50 per cent of cases.
The fertility treatment route
Lan’s first foray into the world of fertility treatments took place a couple weeks ago. After a referral from her gynecologist (and five months of trying to get an appointment), she underwent what’s called a hysterosalpingogram (HSG) at a hospital.
It’s a roughly five-minute X-ray procedure that uses dye to check if the Fallopian tubes are open and whether the inside of the uterus looks normal, according to the American Society of Reproductive Medicine (ASRM). It’s similar to the sonohysterogram, which uses saline solution instead of dye.
Doctors tend to view HSG as a diagnostic tool rather than a treatment. However, women on some forums have reported success getting pregnant a couple months after the procedure.
The ASRM says the claims of HSG enhancing fertility are “controversial,” but acknowledges some studies have reported seeing a “slight increase in fertility” that seems to last about three months.
“Maybe it’s just timing because so many people have tried everything else at that point,” Lan acknowledged with a laugh.
Doctors say fertility treatments tend to have the highest success rates on younger patients such as Lan. Like many in her shoes, though, she’s put off a visit to a fertility clinic for fear of the fees.
But depending on the treatment, the cost can sometimes even be in the hundreds (rather than thousands) of dollars.
Dixon says up to 60 per cent of the cases she comes across can be fixed through low-intervention treatments.
For cases of unexplained infertility, treatment usually consists of drugs combined with intrauterine insemination. In vitro fertilization (IVF) would be a last resort.
Lan isn’t opposed to exploring her options, but already knows IVF isn’t something she would want to do.
“The cost is ridiculous and there’s no guarantee,” she said.
WATCH: How successful are different fertility treatments?
An array of alternative treatments
For now, though, Lan has opted primarily for the alternative therapy route.
“Some people might roll their eyes at alternative medicine but the regular medicine hadn’t really been helping us,” she said.
Anova fertility clinic founder Dr. Marjorie Dixon doesn’t see anything wrong with a multi-disciplinary approach. She says it’s been supported by large randomized controlled studies despite doctors of the “previous” generation sometimes doubting that “there might be a benefit to acupuncture,” meditation, or naturopathic medicine and supplements.
Things like eating healthfully, exercising regularly and maintaining low blood pressure and cholesterol can all make a difference, Dixon believes.
Lan has so far seen a homeopath and an acupuncturist who specializes in fertility (and offers different treatments based on where a woman is in her cycle). Between the two specialists, she’s been given diet recommendations, vitamins, herbal medicine, and had her short cycle extended by four days to give her a wider ovulation window.
She’s also been told to reduce her stress levels and not think about getting pregnant so much.
“At the same it’s like, ‘but track your temperature,’ so you are thinking about it every day,” Lan said with a laugh. “Or it’s like, ‘try to get booked into this appointment. But don’t think about it!'”
That’s easier said than done. It doesn’t take much to go down the rabbit hole of fertility forums, blog posts and articles — only to get overwhelmed hours later by the onslaught of information.
“Every three months, it’s like, ‘oh there’s this thing we haven’t tried yet.'”
She’s still hopeful one of the many things she and her husband have given a go will deliver them a “Christmas surprise” on the next pregnancy test.
If not, she’s ready for the next item on her list, which is a visit to a fertility clinic.
“We’re just going to keep on chugging along.”
— With file from Carmen Chai, Global News