By Carol McGrath and Sophie Lui Global News
Published October 1, 2022
14 min read
When the pandemic hit and the lockdowns set in, many people suspected there was going to be a Canadian baby boom.
There was — but perhaps not in the way people imagined.
Canada’s birth rate has fallen since the pandemic began, but what rose was interest in the field of fertility. COVID-19 sparked a reassessment of priorities: Canadians who were putting off having a family began considering starting one.
The evidence? A boom in baby-making services. The fertility clinics and sperm banks that Global News reached out to reported a rise in clients using their services – some by as much as 20 per cent compared with previous years.
Tiffany Soper, a single professional living in Vancouver, was one of those clients who was prompted to action because of the pandemic.
“It gave me that opportunity to really stop, re-evaluate everything,” she said. “I realized that I was working too much and then I didn’t have to live my life that way anymore and that I could fit in time for a baby and time for family, if I wanted to, if I made the decision to do that.”
But as we all learned in health class: there’s no innate correlation between wanting a baby and conceiving one, particularly when you are doing so later in life. Biology does not wait for everyone – and overcoming that has been the goal of fertility scientists since the first successful in vitro fertilization baby was born in 1978.
It turns out there’s been a boom in fertility innovation when it comes to assisting people who struggle to conceive – a lot of it happening right here in Canada.
And that was great news for Erika Fryer and Stephen Quinlan, a couple living in Maple Ridge, B.C., who knew they had some big biological hurdles to overcome if they were ever going to have a baby.
Quinlan was a widower with two grown children and Fryer never had children of her own.
They met and moved in together a couple of years ago. During the pandemic, Fryer realized that having a baby was something she really wanted. She and Quinlan began talking about whether it was something they should explore.
“I wanted to see if Steve would be open to that,” said Fryer.
It wasn’t an easy discussion for either of them.
“We went to see a counsellor to talk things through,” Fryer said. “It was really hard on our relationship.”
Quinlan was worried about the timing of it all.
“My main concern is that I’m 60 now and I need to stay healthy.”
And Fryer, who was in her 40s, knew she wasn’t the ideal candidate for pregnancy.
“I’m older, my eggs are older. So there was that that played into it, too. This wasn’t a guarantee.”
After deciding they were ready to go for it, the couple met with Dr. Sonya Kashyap, director of Genesis Fertility in Vancouver.
Biology does not give women a big window to work with when it comes to conception, said Kashyap.
“The natural pregnancy rates at age 40 are about six per cent per month compared to at age 30, which are about 20 per cent per month.”
To improve Fryer’s odds, Kashyap prescribed hormonal treatments to stimulate her ovaries.
“I took the injections for 10 days to try and get as many eggs as we could, and we were hoping for 10 (eggs). But there was only four.”
There were also real concerns about Quinlan’s ability to procreate because he had a vasectomy over 20 years ago.
“So if we were going to do this, it would have to be very purposeful,” Fryer said.
Kashyap says after seven years, a vasectomy reversal has a low success rate – hence why they needed to explore other options.
“In order to use his sperm, you have to go through a procedure to extract the sperm,” Kashyap said.
To retrieve Quinlan’s sperm, they sought the help of Dr. Ryan Flannigan, assistant professor at the University of British Columbia, and founder of the Flannigan Fertility clinic in Vancouver. His specialty is male infertility and sexual medicine for men.
An initial examination showed that Quinlan had healthy, detectable sperm but because of his vasectomy, Flannigan had to use a process called percutaneous epididymal sperm aspiration (PESA) to retrieve it. A needle is inserted into the testicle and sperm is withdrawn and sent to a lab to be examined and preserved.
It was a learning process for both Quinlan and Fryer.
“They find a sperm that works the best and actually inject it right into the egg. So it’s a bit of a different procedure than just the regular IVF. So we didn’t know that that was possible,” Fryer said, still sounding amazed at the process.
There is amazement, likely, because we’ve come to accept certain fertility treatments as par for the course these days. The fertility tech boom started in the 1970s with the development of in vitro fertilization – where egg and sperm are united outside of the womb, then implanted in the uterus.
Science has taken off in the decades since with the ability to freeze eggs, retrieve sperm and detect healthy embryos. But there’s always room for more innovation. And it turns out a lot of that is happening in Canada.
Flannigan is on the cutting edge of modern techniques to help men successfully fertilize an egg. It’s an important field in fertility.
“Low sperm count can often be some of the most challenging things to overcome,” says Flannigan.
One technique he uses is called MicroTESE.
”When they don’t see it (sperm), it’s because the testicles are failing to make enough of it, and then the only way to retrieve it is through a microsurgical procedure where essentially we’re looking inside the testicle, using a microscope to try to find rare areas of sperm production that could then be used with IVF.”
MicroTESE differs from PESA — the procedure Quinlan had — because it involves taking a tissue sample that a clinician searches through to look for active sperm.
“When we do these biopsies during the MicroTESE procedure, we may be collecting tens of millions of cells and we’re asking them to find tens to hundreds of sperm in order to facilitate an IVF round,” Flannigan explained.
It’s like looking for a needle in a haystack on a microscopic level.
“They will literally search for hours under a microscope,” Flannigan said. “They’re trying to use their eye to distinguish amongst hundreds of cells in a field to try to find this single sperm.”
And sometimes they may not find a single sperm in thousands of fields. In fact, Flannigan said the odds are only 50 per cent that they will find anything they can use. That’s why he’s developing a new way to increase the odds of success.
“We have been working on trying to create a technology where we’re using artificial intelligence to train an algorithm, to identify a sperm among all these millions of other types of cells.”
It’s still in the early stages of development, and will need to go through several trial runs before it is put into action, but Flannigan hopes in the near future this artificial intelligence (AI) will make it faster and easier to identify healthy sperm.
Toronto fertility specialist Dr. Dan Nayot is also using AI to increase the odds of conception. But his focus is on eggs.
Women freeze their eggs for all sorts of reasons — some because they are aware of the biological clock ticking and want to ensure their future, others because they have a medical condition, like cancer, that may affect their fertility. And then there are egg donors.
As different as their motivations are, they all have one thing in common: they have no way of knowing how healthy those eggs are.
The human eye is incapable of confirming the quality of an egg, even with the aid of a microscope.
“Although we’ve tried to visually score eggs for decades now, there hasn’t been a validated evaluation system,” Nayot says.
Like Flannigan, he believes machine learning could be the solution. Nayot thinks they can more accurately predict which eggs will become the best candidates for making babies by feeding a computer program thousands of pictures of eggs and correlating them to successful pregnancies.
“What we’re doing with our AI is personalizing that feedback and is to say, ‘Yes, you’re 36 years old and you have 10 eggs. But when we’ve analyzed each egg, this is our personal prediction of what we think your chances of success are.’”
It’s something that gives women more data to help them decide whether they want to freeze more eggs as a backup.
“That’s really important information,” Nayot said. “Because when she comes back in the future and if it does not work, she may not have this opportunity again.”
The program is already starting to be used in some clinics as a counselling tool, and Nayot says they have had a surge in interest from North America and Europe. His hope is that the system will only get more accurate with time, as they continually add more information to it.
Checking the quality of her eggs wasn’t an option Erika Fryer explored because of her age as well as the cost of the fertility treatment she was already undergoing. She was only prepared to give her fertility treatment one shot.
“We feel very lucky that we were able to pay for it once,” she told Global News. “A lot of people are not able to pay for it at all. So we feel fortunate in that respect. But it is very expensive.”
Her treatment was approximately $25,000.
“So we were like, ‘We’re just going to do this once. If this doesn’t work, well, I’m going to have to be OK with not having kids.’ And I’ve resigned to that.”
Three of the four eggs taken from Fryer and injected with Quinlan’s sperm were healthy enough to be implanted in her uterus. Then it was time to wait. As soon as she knew she might see results, the testing began.
How many? Erika laughed: “I took so many pregnancy tests.”
Ten days later she got a positive pregnancy test. And nine months after that, baby Elliot arrived.
She can’t wait to tell him all about the journey it took for him to arrive.
“Genesis (the fertility clinic) gives you a picture of the embryos right before they put them in,” she said.
“You know, there’s this little clump of cells. And so I have this picture of these three embryos, and one of those is him. And how cool is that to be able to show him and say like, ‘That was you. Like, that’s the earliest baby picture you can possibly have!’ I think he’ll like the story.… It’s a really cool story.”
When Fryer embarked on her journey to have a baby later in life she was fortunate to have the support of Quinlan, but some people take that journey alone.
At the age of 42, Tiffany Soper, a public relations professional in Vancouver, also decided during the pandemic that she wanted to make her dream of having a child become a reality.
“I’ve had serious relationships, (but there) was never the right person at the right time to be like, ‘Yes, let’s do this. Let’s start a family,’” Soper told Global News.
Soper had actually planned ahead, thinking this day might come.
“I wanted to have a family and I knew that perhaps that traditional family unit wasn’t going to be my reality. And so I started to kind of prepare for that, knowing that I wanted to have a baby regardless of the situation.”
In her 30s, while she was busy with her career, Soper froze some of her eggs — a process that’s become instrumental in closing what Kashyap calls “the fertility gender gap.”
“Men make new sperm every two to three months. So throughout their life, they can reproduce. For women, we don’t make new eggs. We’re actually born with a finite number of eggs that we will deplete in quantity and quality as we age. After age 35 or 37, the quality of those eggs also diminishes,” Kashyap explained. “Mother Nature has just not caught up with us yet.”
And during the pandemic, it seems more people became aware of this short window.
“We certainly saw an uptick in couples, individuals and same-sex couples being interested in starting their families and women freezing their eggs.”
Without a partner, Soper needed the use of a sperm bank.
“I went through an online portal, a sperm donation clinic based in the U.S. I spent several months researching donors. It was a really, really hard decision to make.”
In Canada, it is illegal to compensate egg donors or sperm donors. Hence, most people turn to sperm banks in the U.S.
There are a variety of options you can choose from when picking a sperm donor, everything from education to eye colour to ethnicity. The one thing that is not allowed through traditional sperm banks is knowing who that donor is, at least until the child reaches the age of 18 years. And the sperm donor has to agree to be contacted at that time.
But some women want their sperm donor to come with a degree of parental involvement and there are new services out there that are helping to make that happen.
Stephanie Reibel, a 42-year-old single woman working in sales and living in Los Angeles, also wants a baby – but she wants her sperm donor to be involved in the child’s life.
Ivan Fatovic is working with her to make that happen. He is the founder of Modamily. It’s basically a dating site, for people who want to be parents.
“We connect people who are ready to have kids and start a family, whether you’re looking for a romantic relationship or a platonic co-parent or a known sperm donor,” Fatovic told Global News “We have one of the largest databases in the world of co-parents and donors and people just looking to start a family or help you start your family.”
It’s exactly what Reibel is looking for.
“I would like a romantic relationship and a partner that’s ready to have a kid, but I like that this site can give me an option for a platonic relationship, which kind of takes the pressure off. So if I do want to find somebody down the road, at least then I’ve had my children and I have a great co-parent and then they can come into my life in a romantic way and they can still be involved.”
Fatovic says with Modamily, men have the option to go beyond being just sperm donors.
“We have one of the largest known sperm donor databases where there’s men all over the world that are open to being a known donor as opposed to an anonymous donor.”
Those donors can choose how much involvement they want in the child’s life. It could be anything from occasional hangouts to full-time co-parenting.
“There’s a lot of men in their 40s and 50s that maybe spent a lot of time in the singles scene and not settling down,” Fatovic said. “And they’re getting to a point where they want to have children or maybe they had a child and they were married and divorced and they want another child, but they don’t want to get married again.”
While sperm banks struggle to attract donors from various ethnic backgrounds, Fatovic maintains that for Modamily, that’s not a problem.
“We do help people find those harder-to-find donors, whether you’re looking for an African-American donor, an Asian donor or a Jewish donor.”
Reibel is excited to find her match.
“I mean, if I could do it by the end of the year, that would be ideal.”
Meanwhile, Soper’s insemination was a success. She got pregnant on the first try and is now the mother of a baby girl named Byrdie.
“It was the most profound experience of my life. I’m really grateful to have gone through that, even just the pregnancy and everything. And the birth was such a phenomenal experience.”
Although Byrdie won’t know her father until she turns 18 years old, her mom is looking forward to sharing the story of the family she created.
“As soon as she’s old enough to sort of understand or to start to talk about it, I’ll be messaging, ‘We have a unique family. I needed a little bit of help to get here. And I just really wanted you so badly,’” Soper said with a smile. “I definitely want to be open and honest about it.”