There are a few different avenues you can take:
Once a referral has been received, we will reach out to you via phone and/or email to schedule your appointment. We aim to respond within two business days. Typically, we are able to see new fertility patients within four weeks of receiving a referral. If you believe you were referred, please feel free to email us about the status of your referral. It’s helpful if you include the details of the referring physician.
Here are some ways to prepare for the initial consult with your physician:
You will usually be asked to come into the clinic to have testing done to support the fertility assessment. An Anova team member will be here to answer any questions and to help schedule any necessary testing.
Recurrent pregnancy loss (RPL), or recurrent miscarriage, is the occurrence of two or more consecutive pregnancy losses. If this describes you, we will gladly support you through your investigations and treatment.
Our medical team will carry out a series of investigations along with close surveillance pregnancy monitoring to ensure our patients feel well supported during this sensitive time. Investigations may include:
To become a patient, please have your physician send us a referral form, along with any supporting documentation.
Polycystic ovary syndrome (PCOS) is an endocrine disorder common among women of reproductive age. It affects 8% of women. Though the signs, symptoms and severity of PCOS vary, they may include:
Unfortunately, over 50% of PCOS patients don’t get diagnosed or receive the treatment they need. They often receive a diagnosis only after they are struggling to get pregnant. Raising awareness of PCOS and its treatment options will help improve diagnosis rate, patient experience and outcome.
Here at Anova, we do have a dedicated PCOS endocrinology program, and our specialists can address your questions and concerns around fertility and PCOS.
We commonly hear from patients how important a support network outside of the clinic can be. Although it is not mandatory except in certain situations*, we highly recommend that patients participate in individual or couples counselling. To ensure that all the Anova community is supported, we also facilitate support groups that are moderated by a trained counsellor. These occur in person and virtually, creating a safe environment for patients to be open and honest about their fertility experience.
If you are already a patient, you can join our closed Facebook support group. If you would like to join a virtual support group, please contact us.
*Counselling is a mandatory component for patients proceeding with third party reproduction.
If you are an Ontario resident with a valid OHIP number and are under the age of 43, then you may qualify for Ontario Fertility Program funding. This is a special program offered by the Ministry of Health and Long Term Care. It does have a limited yearly funding allocation, meaning that in a typical year, there are more patients requesting funding than the Ontario Fertility Program can accommodate. Anova is one of the fertility clinics in Ontario that receives a funding allocation, and our waitlist is currently around 18-24 months. Please note that you must be under the care of an Anova physician in order to be added to our waitlist. To learn more about Ontario Fertility Program eligibility, click here.
The wait time for each of our specialists varies. Our medical director, Dr. Dixon, has the longest wait time. It is about two months to have your initial visit with her. We have other knowledgeable and compassionate fertility specialists that are able to see you within two or three weeks. Our highly skilled physician team members have the same specialized training and work very closely together to ensure optimal patient care. Meet our medical team here.
Absolutely. Your cryopreserved eggs, sperm and embryos can be easily moved between clinics, but it does require the use of couriers who are familiar with the shipment of cryogenically stored products. We have a team member who works closely with patients and other facilities to safely move products from one facility to the next. It does take some planning to facilitate, so it is best to move the required samples before starting any treatment cycles. The costs associated with the shipment would be the patient’s responsibility. The clinic where your items are currently stored may also charge an administration fee to prepare the sample. If this is something you are considering, we can have someone reach out to you with additional details about the process.
For a patient wanting to retrieve eggs, our upper age limit is 44 years, 12 months, equal to their 45 birthday. We are unable to provide this service to patients after their 45th birthday. As with any retrieval, proceeding with a cycle is at the specialist’s discretion and requires a set of tests to ensure viability. For a patient wanting to carry a pregnancy and therefore go through a transfer cycle, we will transfer embryos into a patient up to the age of 50 years, 12 months. In other words, we are not able to perform transfers on patients after their 51st birthday.
At Anova, our BMI upper limit for our IVF program is 40. Our goal is to ensure every patient’s safety and to optimize their chances for success. Should a patient need support in reaching a BMI goal, we are happy to help with resources.
IVF includes the process of stimulating and retrieving multiple eggs from a patient’s uterus and fertilizing them with sperm to create embryos. The cost is $13,200 (not including medication, the cost of which could range from $5,000-$9,000+).
A sonohysterogram, commonly called a sono, is a procedure that examines the uterus and the uterine cavity. This is performed using a transvaginal ultrasound probe and a saline solution that safely expands the uterus and endometrial cavity. The purpose of this test is to detect any structural abnormalities. The sono procedure is typically booked between days six and 10 of your cycle. The sonohysterogram is a very safe procedure that is performed by a physician. It may cause some cramping, spotting and vaginal discharge. Some may experience cramping for several hours after the procedure, and patients are often recommended to take ibuprofen beforehand. You might find this link from the American Society of Reproductive Medicine useful.
As 1/3 of infertility diagnoses are related to the male partner, performing a semen analysis is an important part of the fertility assessment. This test measures the count, motility and morphology of the sperm. The analysis must be performed on a fresh sperm sample, which can be collected either at home or at the clinic, though there are very specific instructions about transport if the sample is collected at home. It is recommended to abstain from ejaculation for two to four days before your test.
To schedule a complimentary consultation about semen analysis, you’ll just need a referral. Click here if you have a referral. Click here if you’d like help getting a referral.
This test measures the level of anti-mullerian hormone (AMH) in your blood. It’s part of a standard fertility assessment. Knowing your AMH level helps us to understand your ability to produce eggs that can be fertilized for pregnancy. Along with other tests, it will provide your physician with a clearer picture of your ovarian reserve, as well as how you may respond to certain fertility medications. This test is not covered by OHIP and has a fee of $100.
You will need to have a full bladder for your first visit, which can be booked between cycle days two and five (even if it is referred to as day three cycle monitoring). During this first cycle monitoring appointment, the ultrasound technician will perform a pelvic and transvaginal ultrasound. Having a full bladder is needed to help clearly show the appearance of the ovaries and uterus. You will be asked to drink one liter of water one hour before your appointment. The scan should take about 30 minutes. Cycle monitoring appointments at later days in your cycle will not typically require a full bladder.
Whether your insurance, benefit or healthcare spending account covers fertility medications or other aspects of fertility care, such as egg freezing, is very plan specific. Often, we see a specified amount of medications being covered during the lifetime of a patient. This is important to consider, as you may need multiple rounds of medication along your fertility journey. Anova is not able to charge your benefits provider directly, though we are here to help you navigate your coverage. If you are asked to purchase medications, you will be provided with a detailed receipt including the drug identification numbers to submit to your plan provider. We are happy to work with you to understand if your benefits provider has fertility medication coverage.
Both the Pfizer and Moderna vaccines are based on a novel mRNA technology.
The COVID-19 mRNA vaccines provide our bodies with the template for our cells to make a harmless piece of a protein found on the coronavirus surface called the “spike protein.” When the mRNA template gets injected, cells in our body will generate the coronavirus spike protein, which will later be displayed on their cell surface. This will activate the immune system to create specialized antibodies that will identify and destroy the spike protein (and thus, any viruses that have these proteins on them).
The mRNA vaccines are considered safe because they do not contain any live, and they do not use any adjuvant, which may cause adverse reactions in people with a severe allergy. These vaccines do not enter the nucleus and do not alter human DNA in vaccine recipients.
While mRNA vaccines are considered to be safe, most study participants for both the Pfizer-BioNtech and Moderna vaccines experienced mild side effects similar to influenza-like illness symptoms following vaccination.
While mRNA vaccines are not considered live virus vaccines, they are not hypothesized to be a risk to pregnant or breastfeeding women. However, it is important to note both pregnant and breastfeeding women were excluded from the COVID-19 vaccine trials. Therefore, there is not enough data to suggest or deny efficacy or safety during pregnancy or breastfeeding.
According to an SOGC: “While there have been no red flags or hypothesized mechanisms for potential harm associated with administration of an mRNA vaccine during pregnancy until more data is available, the potential risks of vaccination to a pregnant individual and fetus remain unknown.”
While most pregnant women who become infected with SARS-CoV-2 will have mild-to-moderate symptoms, and many can be asymptomatic, some pregnant women are at high mobility risk. Risk factors for severe morbidity from COVID-19 include maternal age over 35 years old, asthma, obesity, pre-existing diabetes, pre-existing hypertension, and heart disease. For individuals at high risk of infection and/or morbidity from COVID-19, the SOGC states that the documented risk of not getting the COVID-19 vaccine outweighs the theorized and undescribed risk of being vaccinated during pregnancy or while breastfeeding, and therefore, vaccination should be offered to them.
In any case, pregnant and breastfeeding people should consult their prenatal care provider, who could weigh in their individual risk factors versus benefits and help them make an informed decision that is right for unique circumstances.
According to the SOGC recommendations, individuals planning a pregnancy, can complete the entire COVID-19 vaccination series (where possible) to achieve maximal vaccine efficacy ahead of pregnancy. However, it is not yet known whether an individual should delay pregnancy following receipt of the vaccine. If you are trying to conceive you should discuss your potential risks vs. benefits with your health care provider.
When COVID-19 vaccines became available to the public, some individuals noticed changes to their menstrual cycle. Some found that their cycles were longer or shorter than usual or noticed slightly more cramping. Researchers sought out to investigate if this was a true phenomenon. A recently-published study by Edelman et al. (2022) did in fact observe a change in the menstrual cycle after vaccination against COVID-19, however the effect was small and only temporary2. On average, the first vaccine dose appeared to be associated with a cycle length increase of 0.71-day and the second dose a 0.91-day increase2. These effects appeared to diminish within two post-vaccination cycles2. While this effect may be negligible for most, this is an important finding for those who rely on accurate menstrual cycle predictions to plan or avoid pregnancy.
1. Kozlov, M. (2022, January 6). Omicron’s feeble attack on the lungs could make it less dangerous. Nature. https://www.nature.com/articles/d41586-022-00007-8
2. Edelman, A., Boniface, E., Benhar, E. et al. (2022). Association between menstrual cycle length and coronavirus disease 2019 (COVID-19) vaccination. Obstetrics & Gynecology. Volume – Issue – 10.1097/AOG.0000000000004695 doi: 10.1097/AOG.0000000000004695
3. Narayanaswamy, V., Pentecost, B., Schoen, C. et al. (2022). Breastfeeding infants receive neutralizing antibodies and cytokines from mothers immunized with a COVID-19 mRNA vaccine. MedRxiv. Doi: https://doi.org/10.1101/2021.10.12.21264890
4. Kugelman N, Nahshon C, Shaked-Mishan P, et al. (2021). Maternal and Neonatal SARS-CoV-2 Immunoglobulin G Antibody Levels at Delivery After Receipt of the BNT162b2 Messenger RNA COVID-19 Vaccine During the Second Trimester of Pregnancy. JAMA Pediatr. doi:10.1001/jamapediatrics.2021.5683.
5. Yang, Y., Murphy, E., Singh, S. et al. (2021). Association of Gestational Age at Coronavirus Disease 2019 (COVID-19) Vaccination, History of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection, and a Vaccine Booster Dose with Maternal and Umbilical Cord Antibody Levels at Delivery. Obstetrics & Gynecology.
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