|In Vitro Fertilization
|Anti Mullerian Hormone
|Assisted Reproductive Technologies
|Frozen Embryo Transfer
|Intracytoplasmic Sperm Injection
|In Vitro Fertilization
|Polycystic Ovarian Syndrome
|Percutaneous Epididymal Sperm Aspiration
|Preimplantation Genetic Testing
|Preimplantation Genetic Screening
|Preimplantation Genetic Testing for Aneuploidies
|Preimplantation Genetic Testing for Single Gene Mutations
|Preimplantation Genetic Testing for Chromosomal Structure Rearrangements
|Microsurgical Testicular Sperm Extraction
|Ovarian Hyperstuimulation Syndrome
|Ontario Fertility Program
|Ovum Pick Up
|Testicular Sperm Aspiration
Which fertility drugs might I need to take?
Depending on your needs, we can do IUI with or without the use of fertility medication. Common fertility medications include clomiphene citrate, letrozole, and hormones called gonadotropins. If you need to take fertility medication, you would take it during the first part of your menstrual cycle. When ovulation occurs, we will do the IUI. Find out more in our Guide to Fertility Medications.
What is sperm banking?
Sperm banking is the process of freezing and storing sperm. Although you may plan to have a fresh sperm sample, you may also wish to have back-up sperm frozen ahead of time.
The sperm sample should be taken about two to five days after a previous ejaculate. This is when the sperm count is highest. It is important to keep in mind that about 30% of sperm will not survive the freezing and thawing process. To schedule an appointment with the sperm bank, email [email protected]. Appointments are Monday to Friday and last about an hour.
For more information, see our Sperm Sample Collection Instructions.
What is a sperm wash?
This is a procedure where our lab prepares the sperm for insemination. We will place the sperm sample in a test tube and put it in a machine called a centrifuge which spins the tube around. This causes the contents within the tube to separate into layers. The sperm will collect in a pellet at the bottom of the tube. We will remove the seminal fluid (semen) and then place another fluid called media above the sperm. The most active sperm will swim up into the media. The final sample will consist of the most active sperm in a small amount of media. The sperm wash takes about two hours.
What are the fees involved?
Blastocyst: A structure formed in the early development. It possesses an inner cell mass which subsequently forms the embryo. The outer layer of the blastocyst consists of cells collectively called the trophoblast. This layer surrounds the inner cell mass and a fluid-filled cavity known as the blastocoel. The trophoblast gives rise to the placenta.
Amenorrhea. The complete absence or suppression of menstrual periods.
Amniocentesis. A procedure in which a small amount of amniotic fluid is removed through a needle from the fetal sac at about 16 weeks into a pregnancy. The fluid is studied for chromosomal abnormalities that may affect fetal development.
Aneuploid Embryo: An embryo that carries an abnormal number of chromosomes is ‘aneuploid’. Examples of aneuploid embryos include trisomy 18 and trisomy 21, otherwise known as Edward syndrome and Down Syndrome.
Anovulation. A condition in which there is an absence of, or infrequent, ovulation.
Antisperm Antibody Test. A test that can determine if antibodies on the surface of sperm are interfering with the ability of sperm to move, penetrate the cervical mucus, or fertilize an egg.
Antral follicle count (AFC). The number of fluid-filled follicles on the ovary observed using ultrasound.
Assisted Hatching. Assisted Hatching is a laboratory procedure where a laser is used to thin or make a small hole in the shell around the embryo to make it easier for the embryo to hatch.
Atresia (ovarian). The natural process by which eggs age and degenerate.
Blastocyst. A stage of embryo development. Embryos reach the blastocyst stage of development after about 5-6 days. At this stage, the embryo has two distinct groups of cells. The inner cell mass, which is the group of cells which will develop into the fetus, and the trophectoderm, the group of cells which will develop into the placenta
Cervical Mucus. Mucus produced by the cervix that increases in quantity as ovulation approaches.
Cervix. The lower narrow end of the uterus that connects the uterine cavity to the vagina.
Chorionic villus sampling. A procedure in which a small sample of cells is taken from the placenta early in a pregnancy for chromosomal testing.
Chromosomes. Rod-shaped structures located in the nucleus of a cell which contain hereditary (genetic) material. Humans have 23 pairs of chromosomes (46 total). Two of the 46 are the sex chromosomes, which are the X and Y chromosomes. Biologic females have two X chromosomes and biologic males have one X and one Y chromosome.
Chromosome translocations. (or PGT-S) During the process of cell division, occasionally chromosomes may become attached to each other, or pieces of different chromosomes may interchange. This change in chromosome structure is called a translocation. The change may take place so that there is no extra or missing chromosomal material, or the break in the chromosome may not affect gene function, and there is no effect on the individual. If there is no additional or missing chromosomal material, the translocation is “balanced”. When there is additional or missing chromosomal material, however, it is known as an “unbalanced” translocation and this can make it difficult for an embryo to implant in the uterus, can lead to miscarriage and/or cause recurrent pregnancy loss, and can also lead to mental or physical conditions in the child. This is also known as PGT-S.
Clomiphene citrate challenge test (CCCT). A test of ovarian reserve in which serum FSH is checked on days 3 and 10 of the menstrual cycle and clomiphene citrate is taken on days 5 through 9.
Corpus Luteum. Literally, a “yellow body.” A mass of yellow tissue formed in the ovary from a mature follicle that has collapsed after releasing its egg at ovulation. The corpus luteum secretes estrogen and large quantities of progesterone, a hormone that prepares the lining of the uterus (endometrium) to support a pregnancy.
Cryopreserved (frozen). Sperm or embryos may be frozen and stored for future use.
Donor egg. An egg from a fertile individual that is donated to another individual to be used in an assisted reproductive technology procedure, such as IVF, for the purpose creating embryos and/or achieving a pregnancy.
Donor sperm. Sperm donated by a fertile individual to another individual to be used in an assisted reproductive technology procedure, such as IUI or IVF, or the purpose creating embryos and/or achieving a pregnancy.
Down syndrome. A genetic disorder caused by the presence of an extra chromosome 21 and characterized by mental retardation, abnormal facial features, and medical problems such as heart defects.
Dyspareunia. Difficult or painful sexual intercourse
Early menopause. Also called premature ovarian failure. Cessation of menstrual periods due to failure of the ovaries before age 40.
Ectopic Pregnancy. When an embryo implants outside the uterus.
Eggs. Also called oocytes or ova. Sex cells produced by the ovaries that, when fertilized by sperm, produce embryos, the early form of human life.
Embryo: an early stage of development of a multicellular organism. An embryo develops from a zygote, the single cell resulting from the fertilization of the egg cell by the sperm cell. The zygote possesses half the DNA from each of its two contributing individuals. The result of this process is an embryo.
In human pregnancy, a developing fetus is considered as an embryo until the ninth week, fertilization age, or eleventh-week gestational age. After this time the embryo is referred to as a fetus.
Embryo donor(s). A person or persons who choose(s) to donate their embryo(s) to a known* or anonymous recipient for the purpose of achieving pregnancy for the recipient and their partner (if applicable). *Our Embryo Donation program is currently anonymous only.
Embryo donor recipient. An intended parent who will undergo an embryo transfer of a donated embryo for the purpose of achieving a pregnancy for themselves and their partner (if applicable).
Embryo donor (oocyte donor). A person who provides the oocyte for an embryo, which will be donated to a recipient for the purpose of achieving a pregnancy for the recipient and their partner (if applicable).
Embryo donor (sperm donor). A person who provides sperm for an embryo, which will be donated to a recipient for the purpose of achieving a pregnancy for the recipient and their partner (if applicable).
Endometriosis. Common gynecologic disease where cells that normally line the uterine cavity (the endometrium) are found elsewhere in the pelvis and abdomen.
Endometrium. The tissue that lines the inside of the uterus.
Estradiol. The predominant estrogen (hormone) produced by the follicular cells of the ovary.
Estrogen. A sex hormone produced by the ovaries responsible for the development of sex characteristics such as breast development. Estrogen is largely responsible for stimulating the uterine lining to thicken during the first half of the menstrual cycle in preparation for ovulation and possible pregnancy. Estradiol and estrone are the main two estrogens.
Euploid embryo. An embryo that contains the normal number of chromosomes in all its cells.
Fallopian Tubes. Either of a pair of tubes along which eggs travel from the ovaries to the uterus.
Fertilization. The fusion of sperm and egg.
Follicle. A fluid-filled sac located just beneath the surface of the ovary, containing an egg (oocyte) and cells that produce hormones. The sac increases in size and volume during the first half of the menstrual cycle and at ovulation, the follicle matures and ruptures, releasing the egg. As the follicle matures, it can be visualized by ultrasound.
Follicle-stimulating hormone (FSH). In women, FSH is the pituitary hormone responsible for stimulating follicular cells in the ovary to grow, stimulating egg development and the production of estrogen. FSH is also the pituitary hormone that travels through the bloodstream to the testes and helps stimulate them to manufacture sperm. FSH also can be given as a medication.
Gamete. A medical term to describe sperm and eggs
Gamete donor. A person who donates oocytes or sperm to a known or anonymous recipient for the purpose of achieving a pregnancy for the recipient and their partner (if applicable).
Gamete donor recipient. An intended parent who will undergo ART procedures using either donor sperm or donor oocytes for the purpose of achieving a pregnancy for themselves and their partner (if applicable).
Gamete provider. A person who provides either the oocyte or sperm for an embryo which will be transferred to a surrogate for the purpose of achieving a pregnancy for themselves and their partner (if applicable).
Genetic. Referring to inherited conditions, usually due to the genes located on the chromosomes.
Gestational Surrogate. Also known as a gestational carrier. A person who undergoes an embryo transfer in order to achieve and carry a pregnancy for another person/couple, who will be the intended parent(s) of the child. The gestational surrogate is not genetically linked to the embryo.
GnRH agonists or antagonists. Recombinant hormones that are very similar to GnRH. In IVF they are used for a number of different reasons including preventing premature ovulation and triggering final egg maturation.
Gonadotropin releasing hormone (GnRH). A reproductive hormone made by the brain that is key to the regulation of the menstrual cycle. It controls the release of other hormones such as FSH and LH.
Hormone. A substance secreted from organs of the body, such as the pituitary gland, adrenal gland, or ovaries, that is carried by a bodily fluid such as blood to other organs or tissues where it exerts a specific action.
Human Chorionic Gonadotropin (HCG). A hormone that can be used to trigger ovulation and/or mature the eggs for IVF.
Hypothalamus. A thumb-sized area in the brain that controls many functions of the body, regulates the pituitary gland, and releases gonadotropin-releasing hormone (GnRH).
Hysterosalpinogram. A high-tech X-ray which involves injecting dye through the cervix into the uterus to determine if the fallopian tubes are open and the uterine cavity is normal.
Hysteroscopy. A procedure in which a small camera is inserted through the cervix and into the uterus to allow visualization of the uterine cavity.
Infertility. Infertility is the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the reproductive tract that prevents the conception of a child or the ability to carry a pregnancy to delivery. The duration of unprotected intercourse or exposure to sperm with failure to conceive should be about 12 months before an infertility evaluation is undertaken, unless medical history, age, or physical findings dictate earlier evaluation and treatment.
Insemination. Placement of a concentrated sample of sperm via a syringe into a uterus for the purpose of producing a pregnancy.
Intended Parent(s). A person or couple who intend to parent a child who is conceived through third party reproduction. And intended parent may provide their gamete for the creation of an embryo.
In vitro fertilization (IVF). A method of assisted reproduction that involves combining an egg with sperm in a laboratory dish. If the egg fertilizes and begins cell division, the resulting embryo is transferred into the uterus where it hopefully implant in the uterine lining and further develop. IVF bypasses the fallopian tubes and is usually the treatment choice for badly damaged or absent tubes.
Laparoscopy. A surgical technique that involves the use of small incisions and a camera (laparoscope) inserted through the umbilicus to visualize the inside of the abdominal cavity.
Libido. Sexual drive and desire.
LH surge. The secretion, or surge, of large amounts of luteinizing hormone (LH) by the pituitary gland. This surge is the stimulus for ovulation to occur.
Luteinizing hormone (LH). The pituitary hormone that triggers ovulation and stimulates the corpus luteum of the ovary to secrete progesterone and androgens during the second half of the menstrual cycle.
Luteal Phase. The second half of the menstrual cycle.
Male* Factor Infertility. A medical term used to describe an individual or couple whose difficulty conceiving is due, at least in part, to conditions such as abnormal sperm parameters or other urologic conditions.*This includes people who do not identify as male but who also experience infertility related to the above conditions
Menopause. Natural cessation of ovarian function and menstruation. It can occur between the ages of 42 and 56 but usually occurs around the age of 51, when the ovaries stop producing eggs and estrogen levels decline.
Miscarriage. The naturally occurring expulsion of a nonviable fetus and placenta from the uterus; also known as spontaneous abortion or pregnancy loss.
Morphology. The form, structure, and shape of sperm. At least 30% of the sperm in a semen sample should have oval heads and slightly curving tails.
Mosaic embryo. An embryo that contains both chromosomally normal (euploid) and chromosomally abnormal (aneuploid) cells
Mosaicism: When a person has 2 or more genetically different sets of cells in his or her body. Chromosomes are stick-shaped structures in the middle of each cell in the body. Each cell has 46 chromosomes grouped in 23 pairs. A person with mosaicism may have some cells in his or her body with 46 chromosomes. But other cells have 47 chromosomes. This can cause health problems in the body.
Motility. The percentage of all moving sperm in a semen sample. Normally 50% or more are moving rapidly.
Oligospermia. A low sperm concentration in the ejaculate.
Oocyte donor. A person who donates oocytes to a known or anonymous recipient for the purposes of achieving a pregnancy for the intended parent(s).
Oocyte donation recipient. An intended parent who will undergo ART procedures using donor oocytes for the purpose of achieving a pregnancy for themselves and their partner (if applicable).
Oocyte provider. May also be known as an egg donor. A person who provides the oocyte for an embryo which will be transferred to a surrogate for the purpose of achieving a pregnancy for themselves and their partner (if applicable)
Oocytes. Also known as eggs. Sex cells produced by the ovaries that, when fertilized by sperm, produce embryos, the early form of human life.
Ovarian reserve. Fertility potential relating to the ovary or ovaries in the absence of specific pathophysiologic changes in the reproductive system. Diminished ovarian reserve is associated with depletion in the number of eggs and worsening of oocyte quality.
Ovaries. Two sex glands in the pelvis, located one on each side of the uterus. The ovaries produce eggs and hormones including estrogen, progesterone, and androgens.
Ovulation. The release of a mature egg from its developing follicle in the outer layer of the ovary. This usually occurs approximately 14 days preceeding the next menstrual period (the 14th day of a 28-day cycle).
Ovum. An egg.
Partner. For this purpose, a partner is a person who is in an intimate relationship with a person who is undergoing assisted reproductive technology.
Pelvic Inflammatory Disease (PID). An infection of the upper genital tract that can include the uterus, fallopian tubes, ovaries and/or pelvic peritoneum. It may or may not be caused by a sexually transmitted disease.
Pituitary gland. A small hormone-producing gland just beneath the hypothalamus in the brain that controls the ovaries, thyroid, and adrenal glands. Ovarian function is controlled through the secretion of FSH and LH. Disorders of this gland may lead to irregular or absent ovulation in the female and abnormal sperm production in the male.
Polycystic Ovary Syndrome (PCOS). A common hormonal condition in which an imbalance in the sex hormones may cause menstrual abnormalities, skin and hair changes, obesity, infertility and other long-term health problems. The name comes from the multiple small cysts which line the ovaries of most people with the disorder.
Premature ovarian insufficiency/failure (POI/POF). Cessation of menstrual periods due to failure of the ovaries before age 40.
Priming. Priming involves taking oral medication in the weeks leading up to the injections for an egg freezing or IVF cycle to help time the start of the cycle and synchronize the growth of the follicles (so they grow more slowly and in a more coordinated way).
Progesterone. A hormone secreted by the corpus luteum after ovulation during the second half of the menstrual cycle (luteal phase). It prepares the lining of the uterus (endometrium) for implantation of a fertilized egg and allows for complete shedding of the endometrium at the time of menstruation. In the event of pregnancy, the progesterone level remains stable beginning a week or so after conception.
Reciprocal IVF. Also known as partner assisted reproduction. An assisted reproductive technology which involves the retrieval of eggs from one partner, fertilization through IVF, and the transfer of the embryo to the uterus of the other partner so that the child is carried on behalf of both people.
Retrograde Ejaculation. A condition in which semen enters the bladder during ejaculation instead of leaving the penis.
Semen analysis. The microscopic examination of semen (ejaculate) to determine its volume, the number of sperm (sperm count), their shapes (morphology), and their ability to move (motility) in addition to other parameters.
Sperm. Sex cells produced by the testes that fertilize an egg. The sperm head carries genetic material (chromosomes), the midpiece produces energy for movement, and the long, thin tail wiggles to propel the sperm.
Sperm donor. A person who donates sperm to a known or anonymous recipient for the purposes of achieving a pregnancy for intended parent(s).
Sperm donation recipient. An intended parent who will undergo ART procedures to carry a pregnancy using donor sperm for the purpose of achieving a pregnancy for themselves and their partner (if applicable).
Sperm provider. A person who provides sperm for the purpose of achieving a pregnancy for themselves and their partner (if applicable)
Superovulation. Stimulation of the ovaries, usually done with hormones, that causes them to produce multiple eggs instead of one.
Surrogate. A person who undergoes an embryo transfer or donor sperm insemination in order to achieve and carry a pregnancy for another person/couple, who will be the intended parent(s) of the child. The intended parent(s) may or may not be genetically linked to the pregnancy. The term “surrogate’ includes gestational and traditional surrogates.
Testes. The two reproductive glands located in the scrotum which produce testosterone and sperm.
Testosterone. The primary hormone produced by the testes. It is responsible for the development of sperm, physical characteristics such as facial hair and Adam’s apple, and sex drive. Testosterone is also produced in small quantities by the ovaries.
Traditional surrogate. A person who undergoes an insemination from a sperm donor or sperm provider in order to achieve and carry a pregnancy for another person/couple, who will be the intended parent(s) of the child. The intended parent(s) may or may not be genetically linked to the embryo. A traditional surrogate is therefore both an egg donor and the carrier for the pregnancy.
Trophectoderm. A group of cells that supplies the embryo with nourishment and later form the placenta.
Tubal Ligation. A surgical procedure in which the fallopian tubes are surgically closed to prevent pregnancy.
Ultrasound. A picture of internal organs produced by high-frequency sound waves viewed as an image on a video screen; used to monitor growth of ovarian follicles or a fetus and to retrieve eggs. Ultrasound can be performed either abdominally or vaginally (internally).
Uterus (womb). The hollow, muscular organ in the pelvis where an embryo implants and grows during pregnancy. The lining of the uterus, called the endometrium, produces the monthly menstrual blood flow when there is no pregnancy.
Varicocele. A varicose vein in the scrotum that may affect the quality and the production of sperm.
Vasectomy. A surgical procedure that prevents sperm from reaching the urethra causing sterilization.
Zygote. An early stage in the development of a fertilized egg.
American Society for Reproductive Medicine (ASRM). (2012). Age and Fertility. Retrieved from https://www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/agefertility.pdf
Canadian Fertility & Andrology Society (CFAS). (2016). Guidelines for Third Party Reproduction. Retrieved from https://cfas.ca/wp-content/uploads/2016/03/Third-Party-Procreation-AMENDED-.pdf