THYMEMATERNITY.COM WE’VE GOT YOU COVERED FOR EVERY TRIMESTER! FERTILITY & PREGNANCY 1 IN 6 CANADIAN COUPLES SUFFER IN SILENCE Canadian and International celebrity, Julie Snyder, understands the suffering and rollercoaster of emotions . She has battled infertility—and won. PHOTO:JEAN-CLUADE LUSSIER AN INDEPENDENT SUPPLEMENT FROM MEDIAPLANET TO THE NATIONAL POST Funding Bolstering Canada’s sagging birth rate Hope is here... When genetic disease can create obstacles No. 2/June 2010
Transcript
THYMEMATERNITY.COM
we’ve got you covered for every
TRIMEsTER!
Fertility & pregnancy
1 in 6 canadian couples suffer
in silenceCanadian and International celebrity, Julie Snyder, understands the suffering
and rollercoaster of emotions. She has battled infertility—and won.photo:jean-cluade lussier
AN iNdepeNdeNt SUppLeMeNt froM MediApLANet to tHe NAtioNAL poSt
fundingBolstering Canada’s sagging birth rate
Hope is here...When genetic disease can create obstacles
No. 2/June 2010
AN iNdepeNdeNt SUppLeMeNt By MediApLANet to tHe NAtioNAL poSt2 · jUNe 2010
challenge
the challenges infertility patients face
Every disease presents challenges of some sort, and infertility is no exception.
infertility affects the extended family as well. I personally facilitated a support group in Montreal for several years and I witnessed some of the intricate problems experienced.
Some patients/couples were able to take their infertility in stride, while others were devastated by their diagnosis. I recall one couple who were absolutely panic-stricken at the prospect of disclosing their problem to their parents. The young lady in question looked at me with tears in her eyes and said, “My moth-er’s heart will be broken, as she has been waiting for grandchildren for-ever.” This is just one simple exam-ple of how the rest of the family can be adversely affected as well.
In reviewing the numerous psy-chological articles that the Infertil-ity Awareness Association of Canada (IAAC) has published over the years it is interesting to note that stud-ies reveal that only 56 percent of couples actually seek medical care. What’s more, anywhere from 44-64 percent drop out of treatment for psychological reasons, while adop-tion and childfree living present their own set of challenges.
IAAC believes that education is the best way to help and empower patients. Here are three key ways to guide patients through their treat-
ments, adoptions, or their decision to live child free:
Online library collection
1 We know patients will find comfort by reviewing any
of the more than 300 articles which are displayed in the library on our website at www.iaac.ca. There are numerous medical and psychologi-cal articles. There are also many articles written by patients who have shared their personal stories in the hope of providing others with their experience, strength and hope. Written by patients for patients, these are an invaluable collection.
Webcast
2 On May 16th, during Canadian Infertility Awareness Week,
Janet Takefman, PhD, assistant pro-fessor & clinical psychologist at McGill University and I participated in a web cast entitled “Triumphing Over the Emotional Challenges of Infertility” where we discussed cop-ing with the emotionally challeng-ing aspects of infertility. Dr. Takef-man debunked common myths and offered practical tips on handling relationship, social and treatment struggles. I described how to access the patient services and support groups offered by IAAC and dis-cussed the benefits of sharing with
others. This webcast can now be accessed online at www.fertilitywe-bcast.ca/ .
DVD
3 During this same week a new and unique educational pro-
gram that is available on DVD and on-line was launched for anyone considering an assisted reproduc-tive treatment such as in vitro fertil-ization. The DVD, called “Fertility Treatments—Understanding Your Options,” was developed in conjunc-tion with experts in the field of infertility such as reproductive endocrinologists and embryologists. The DVD fulfills an educational need by giving patients useful informa-tion about how to improve the chances of having a healthy preg-nancy and birth, including sugges-tions about nutrition, treatment options and the social and psycho-logical issues associated with infer-tility. To obtain or view a copy of the DVD, talk to your doctor or visit www.yourfertilitytreatments.ca .
I will close with this quote from the former Secretary-General of the United Nations, Kofi Annan: “Knowledge is power. Information is liberating. Education is the premise of progress, in every society, in every family.”
Beverly Hanck, executive director, the infertility Awareness Association of Canada
“... it is interesting to note that studies reveal that only 56 percent of couples actually seek medical care.”
“infertility is a major medical issue that affects one in six Canadian couples of reproductive age. the most effective treatment for infertility is iVf...”
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responsible for this issuePublisher: duane [email protected] 977 7100Designer: missy [email protected] Contributors: jessica hume and Winnie Yu schererDistributed within: national post, june 2010this section was created by mediaplanet and did not involve the national post or its editorial departments.
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■■ Question: is there any hope for women with poor egg quality or a pre disposal to genetic disease to conceive and deliver healthy babies?
■■ Answer: there is hope, although it won’t come cheap, and medical procedures continue to be improved.
Preimplantation genetic diagnosis
Though older women and those at risk of carrying genetic diseases are known to have more difficulty conceiving and delivering healthy babies, a controversial medical pro-cedure can assist with both.
Preimplantation genetic diagno-sis (PGD) is a procedure performed on embryos extracted from the uterus during in vitro fertilization, a common treatment for couples suffering from infertility. After being removed, doctors use the PGD screening process to check for the presence of specific genetic defects—thalassemia, for example—
in any given embryo. By identifying problems, PGD has the potential to allow women to avoid becoming pregnant with and delivering babies that will suffer congenital diseases.
An almost identical process, pre-implantation genetic screening (PGS), was designed for a slightly different purpose: to check the qual-ity of a woman’s eggs prior to IVF treatment. Used almost exclusively in older women (those aged 35 and above), PGS can help identify eggs most likely to result in a healthy baby.
ChallengesDr Matt Gysler has helped couples
suffering with infertility for about 30 years and runs the ISIS Regional Fertility Clinic in Mississauga. He began performing the embryo-screening procedures roughly 20 years ago.
When both prospective parents have been identified as possible car-riers of genetic disease, they have an “excellent reason” for choosing PGD, he says. Women for whom multiple
attempts at IVF have been unsuc-cessful are perfect candidates for PGS.
The problem, Dr Gysler explains, is the testing itself.
In PGS, the single cell tested may not be representative of the whole embryo; genetic information from the sample may not be entirely accu-rate. But research is ongoing and Dr Gysler expects to see more advanced technology within three to five years that will improve accuracy in the testing.
But the procedure involves other risks.
“When you’re reducing a speci-men to a single cell, you could poten-tially injure other cells, damage them or rupture them,” Dr Gysler
says, adding that complications almost always exist in surgeries and that those resulting from PGD or PGS are “infrequent.”
Dr Gysler admits neither treat-ment comes cheaply, and could add about $3,000 to already costly IVF bills which are not yet covered by OHIP.
PGS in CanadaWhile both PGS and PGD are regu-
lated by the Assisted Human Repro-duction Act, Dr Gysler explains neither procedure is common in Canada and many samples taken in Canadian clinics are sent to the US for testing.
Initial concerns about the abil-ity of embryo screening to lead to “designer babies” remains in other countries, such as India, where male-only embryos are selected. In Canada, sex selection in embryos is banned according to the country’s medical code of ethics.
1 Doctors recommend Rice Baby Cereal as a first solid food at
about six months. It has a 100 per-cent of the iron babies need, and is easy to digest.
2 Introduce pureed vegetables before fruits so babies don’t
get used to sweet tastes. Heinz Baby Food offers Veggie Fruit Blends to help introduce vegetables to babies who prefer sweeter foods.
3 If you buy Canadian for your-self, do it for baby food too.
Read the packaging as some large baby food manufacturers have been proudly prepared in Canada for over 75 years and often contain Cana-dian-grown ingredients.
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5 Mom can eat baby food too as a great way to get pure fruits in a
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tips
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If they fund, we saveinvitro fertilization not only creates new lives, but saves Canada millions of dollars.
AN iNdepeNdeNt SUppLeMeNt By MediApLANet to tHe NAtioNAL poSt
Fertility treatments: know your optionsInfertility, the inability to con-
ceive a child after persistent attempts, affects more than 600,000 Canadians, or about 10 percent of the reproductive age population. Among couples who seek medical help, infertility is a problem in the female in about one third of cases, and in the male in about one third of cases. In the balance of cases, infertility results from problems in both part-ners or the cause of infertility can’t be explained. But thanks to medical advances, a diagnosis of infertility doesn’t have to mean childlessness. It does imply that becoming preg-nant is a challenge—one that can often be overcome by medical treat-ment.
To help guide couples in achiev-ing their goal of parenthood, Ferring Pharmaceuticals, a leader in the field of reproductive medicine, is launch-ing a new and unique educational program. The new online program is for anyone considering an assisted reproductive treatment (ART) such as in vitro fertilization (IVF). The educational program, entitled “Fer-tility Treatments: Understanding Your Options” was developed in con-junction with medical experts in the field of infertility such as reproduc-tive endocrinologists, embryologists
and specialized nurses. The online program can be accessed by visiting www.YourFertilityTreatments.ca.
The program fulfills an unmet educational need by providing useful information about how to improve the chances of having a healthy pregnancy and birth. It describes the habits of successful fertility patients, and includes sug-gestions about nutrition, vaccines, and a healthy environment, as well as the causes of infertility, risks of multiple births, treatment options and the social and psychological challenges associated with infertil-ity. The program also suggests sev-eral ways men can improve their sperm count. For anyone striving to become pregnant, this new pro-gram answers the most common questions and explains the factors couples can control to achieve a suc-cessful pregnancy.
To learn more about your fertility and treatment options, visit www.YourFertilityTreatments.ca or talk to your doctor.
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AN iNdepeNdeNt SUppLeMeNt By MediApLANet to tHe NAtioNAL poSt4 · jUNe 2010 AN iNdepeNdeNt SUppLeMeNt By MediApLANet to tHe NAtioNAL poSt
■■ Question: is there hope for couples that suffer from infertility?
■■ Answer: yes, but unfortunately—no guarantees.
Danielle Alderman has spent today, like every other for the past eight months, attending to the needs of her infant daughter Elizabeth. It’s almost nap time, she explains, during which she will have brief reprieve from
the demanding lifestyle that comes with new mother-
hood. Though it is drain-ing, Alderman says she enjoys every moment of it; she and her hus-
band, Jeff, fought long and hard for this
child, spend-ing five years in infertility treatments and about $68,000 trying to con-ceive.
Today about one in six Cana-
dian couples suf-
fer from infertility, a statistic that has risen over the past 30 years. Health experts attribute this reality in part to women having children later in life—their 30s—when the chances of conceiving are lower and the quality of the eggs potentially diminished. Lower sperm count in men from industrialized countries has led to ongoing studies looking at how envi-ronmental factors affect male fertility.
A lesson in patienceIn 2004, upon learning she and her
husband could not become pregnant naturally, Alderman began in vitro fertilization treatments, of which about 5,000 are performed annually in Ontario, though not yet covered by OHIP.
“I learned patience, that’s for sure,” Alderman says, describing the stress-ful five years of undergoing treat-ments without becoming pregnant.
And though she explains that insurance helped cover some of the cost, “it was frustrating to see the money go when the treatments were unsuccessful.” Now, she says, it was worth it.
Waiting for the payoffUnfortunately, not all couples are
lucky enough to see the payoff of dif-ficult and expensive IVF and other infertility procedures. Kara De Rose, 29, counts herself among them.
The professional photographer and her husband have been trying for five years to have a child. They are among the roughly 33 per cent of couples whose cause of infertility is unknown. De Rose has undergone intra-uterine insemination and IVF—procedures that cost them about $20,000 in 2009 alone—but to no avail.
“There are lots of hard parts,” De Rose admits. “You never know if what you’re going through to get to the point of having a baby will work out.”
But De Rose remains optimistic and in 2009, organized an annual Portrait in the Park event in Kitchener, where she lives, through which she hopes to raise awareness of infertility issues in Canada. At the top
of that list is government assistance, something the Infertility Awareness Association of Canada has been pres-suring the provincial government to adopt.
In the meantime, De Rose says the couples she has met through Portraits in the Park have illuminated for her the fact she is not alone in the painful experience of dealing with infertility.
Question: To what does talk show host and producer Julie Snyder attribute her ability to overcome infertility? Answer: Some valuable advice from Celine Deline, and of course—a bit of luck.
no pain, no gain for hopeful mother-to-beThere was a time when Julie Snyder wasn’t sure she would ever have a child. That was eight years ago. Today, after years of stressful infertility treatments and painful disappoint-ments, Snyder’s marriage remains strong and the family has grown to include her two young children.
The Quebecois television person-ality had waited until the age of 34 before trying to start a family, and after more than a year without suc-cess, it became clear she and her hus-band were one of the almost 17 per cent of Canadian couples suffering from infertility.
“I thought conceiving would be easy; I was in perfect health,” she remembers. “When it doesn’t hap-pen in the first month you don’t panic, but after eight, nine months I became really sad.”
tic…toc…Doctors couldn’t immediately pin-point what was causing Snyder’s inability to become pregnant, but her age dictated she was among the demo-graphic for whom conception can be challenging. Not unsimilar to many Canadian women, she had focused on education and building a career dur-ing her twenties, the years in which fertility is, biologically speaking, opti-mal.
After initial consultations with doctors Snyder began hormone treat-ments and artificial insemination. When she still failed to become preg-nant, she turned to in vitro fertiliza-tion.
Though the first treatment didn’t result in pregnancy, the second did.
“I found out I was pregnant on December 24; I thought it was a Christmas gift and I was so happy. IVF is so stressful,” Snyder says, describ-ing the difficulty in learning that two
weeks after the positive pregnancy test, the fetus had no heartbeat. “I had had a miscarriage. It was so cruel.”
trying timesThe sadness that comes along with infertility can put significant strain on a relationship, both the marriage itself and the two people individually, Snyder says, describing it as painful to see other women on the streets with their babies.
But, determined to exhaust all pos-sibilities before giving up, Snyder con-sulted a friend, Celine Dion, who had also experienced infertility, shortly after traveling to New York City to see fertility experts there.
“We went through everything all over again, all the tests. Everything was set and we had an appointment to start IVF,” she says. “That’s when I found out I was pregnant.”
Snyder explains that doctors even-tually attributed her difficulty con-
ceiving to poor egg quality, adding that although she became pregnant naturally, she believes the hormone treatment she had previously under-gone helped.
A Second BlessingWhen she and her husband wanted a second child, they were again unable to conceive and launched back into arti-ficial insemination procedures and another session of IVF with doctors from McGill University in Montreal.
After a total of five IVF proce-dures, acupuncture sessions and a bit of what Snyder believes is luck, she became pregnant again and five months ago gave birth to a daughter.
“I’ve worked a lot and always enjoyed it, but now, I feel my life has more meaning. It really is more pre-cious than before.”
iVF expensive but worth it, say contented patients
Julie Snydertelevision hostess, international celebrity, iVf advocate and now Mom! pHoto: jeAN-CLAUde LUSSier
Alderman Family(left)
Derose Family(right)
pHotoS: priVAte
—no guarantees. infant daughter Elizabeth. It’s almost nap time, she explains, during which she will have brief reprieve from
the demanding lifestyle that comes with new mother
hood. Though it is draining, Alderman says she enjoys every moment of it; she and her hus
band, Jeff, fought long and hard for this
child, spending five years in infertility treatments and about $68,000 trying to conceive.
Today about one in six Cana
dian couples suf
Alderman Family(left)
Derose Family(right)
pHotoS:
AN iNdepeNdeNt SUppLeMeNt By MediApLANet to tHe NAtioNAL poSt AN iNdepeNdeNt SUppLeMeNt By MediApLANet to tHe NAtioNAL poSt jUNe 2010 · 5
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panel oF experts
Question 1:What are the pre-requi-sites for establishing an effective Single Embryo Transfer Program (SET)?
Question 2:What do we need to see happen from the government’s perspective with respect to their funding for IVF?
Question 3:What role does PGD play for couples with hereditary disease?
Seang Lin tan, MBBS, Fr-COG, FrCSC, MMed, MBAprofessor and chairman, dept of obGyn, mcGill university; medical director, mcGill reproductive centre
A. Albert Yuzpe, BSc,MSc, MD, FrCS(C), FACS, FSOGCco-Founder and co-director, the Genesis Fertility centre, Vancouver British columbia,canada
Governments need to realize that there is a high cost to the health-care system as a result of multiple pregnancies and that they can save money by funding IVF in exchange for performing eSET in good prognosis patients. Multiples are associated with longer hospital stays and the need for neonatal intensive care nurseries for the babies due to the high incidence of prematurity. Infertility is a medical illness and should be funded the same way that other illnesses are covered in a universal health care system.Infertility patients undergo many less effective treatments which are funded.
In order to encourage governments to fund IVF procedures for those in need, we must convince the politi-cians that infertility treatments and the treatment of infertility are as much part of health care as any other treatment. We must demonstrate to government that through public and universal funding we can enforce not only single embryo transfer poli-cies and practice guidelines but also directly impact the high rate of twin births resulting from modern infertil-ity treatments.
The government needs to understand that infertility is a healthcare issue and is taking a very short-sighted view in not funding it. By funding IVF with SET as a prerequisite, they would save a substantial amount of healthcare dollars by not having to care for multiple pregnancies in neo-natal nurseries. As well Canada’s birth rate is dropping to critical levels. At some point , we won’t be able to look after our aging population since there won’t be enough young people to pay the taxes needed to support our social programs.
Mathias Gysler MD, FrCS(C)medical directorisis regional Fertility center
Ken Cadesky MD FrCS (C)medical directorlifeQuest center for reproductive medicine
When couples carry a genetically transmitted illness, and where there is a marker to identify the abnormal genetic material in the chromosomes of a cell, the possibility exists to sepa-rate embryos affected by the defect from those that will not carry the inherited disease. The physician can therefore offer the couple a reliable test to make a specific diagnosis on each embryo. One would then only replace those embryos that do not carry the disease and the couple can avoid the difficult decision whether to continue the pregnancy when such a diagnosis is made later in pregnancy.
PGD (Preimplantation Genetic Diag-nosis) can be quite a useful tool for car-riers of hereditary disease. Our Centre probably does more than most units in Canada. A genetic marker is designed for the specific genetic disease. An IVF procedure is performed and each of the resulting embryos have a single cell removed on Day 3. That cell will be the genetic representative of that embryo. Each cell is tested with the marker. A result returns on Day 5 as to the status of each embryo. We are then able to transfer only embryos that we know are genetically unaffected.
A reduction in the multiple-birth rate associated with assisted reproductive technologies.
PGD plays a major role as it is used to screen embryos for couples at risk of passing an inherited disease on to their children. PGD is used to screen for a multitude of diseases including: Cystic fibrosis (508),Tay Sachs, Hemo-philia A, Fragile X Syndrome, Alpha I antitrypsin deficiency, RhD blood typing, Myotic Distrophy, Marfan Syndrome, Lesh Nyham Syndrome, Huntington’s Disease, Retinitis Pigmentosa, Duschenne Muscular Dystrophy, Adenomatous polyposis coli, Spinal muscular atrophy (SMA). It can also be offered for any genetic disorder where a genetic defect has been properly characterized.
Many diseases or birth defects result from the transmission of a genetic abnormality from to an offspring. Examples of include Huntington’s Disease and muscular dystrophy. Pre-implantation genetic diagnosis (PGD) is a diagnostic procedure which can be used to determine whether a human embryo is a carrier of a specific single gene or chromosomal defect. PGD involves the use of in vitro fertiliza-tion (IVF) and analysis of the result-ing embryos by to establish whether the embryo is carrying the abnormal gene or chromosome. Only unaffected embryos are replaced into the wom-an’s uterus thus eliminating the risk of transmission of the condition.
Only in good prognosis patients over 35 years old, three top quality embryos on day three, good blastocyst culture system, good embryo cryopreserva-tion program.
The most important prerequisite is a successful embryo freezing program. The laboratory must be capable of developing embryos successfully to the blastocyst stage, and the staff must promote single embryo transfer and singleton pregnancies as the only acceptable outcome of a successful in-vitro fertilization program. Patients and caregivers can be encouraged to pursue single embryo transfer policy by appropriate funding and therefore eliminate the financial burden.
Since Day 5 SET have a significantly higher pregnancy rate compared with Day 3 embryos, the Centres offering SET have to have a well established and successful lab that is used to growing Blastocysts (Day 5). As well, selection criteria for prospective SET patients have to be met, i.e. Younger than 38 yrs old, 1st IVF try, more than two blastocysts. Appropriate counsel-ling and consent is essential.
The prerequisites are the following: good pregnancy rates, a success-ful embryo freezing program, good blastocyst culture and good-quality embryos.
AN iNdepeNdeNt SUppLeMeNt By MediApLANet to tHe NAtioNAL poSt AN iNdepeNdeNt SUppLeMeNt By MediApLANet to tHe NAtioNAL poSt jUNe 2010 · 7
provinces to save millions by funding iVF treatmentIn Ontario alone, where 65 percent of all in vitro fertil-ization (IVF) treatment is per-formed, the government will save a minimum of $185 mil-lion annually by reducing mul-tiple births.
Government funding of IVF will reduce perinatal hospitalization costs, post-natal costs related to the first year of care for the surviving low birth weight babies and long-term health and social services costs of caring for children with perma-nent disabilities as a result of pre-term birth, says Bev Hanck, execu-tive director of the Infertility Aware-ness Association of Canada (IAAC). At the same time, it will improve the health of mothers and babies. Hanck says, “These significant savings will more than offset the costs of provid-ing assisted reproduction services.” Beyond the clear financial advan-tages, she believes it is also unethi-cal for any government to continue to endorse the birth of tiny babies who are at high risk of developing problems throughout their lives. For these very reasons 24 countries cur-rently fund IVF treatments.
It is frustrating to wait so long for governments to act on this issue
when the families of many Canadi-ans hang in the balance. “Funding treatment will also bolster Cana-da’s sagging birthrate and we fail to understand why governments continue to neglect this important issue,” Hanck says.
Funding treatmentThis June, Quebec will be the first
jurisdiction in North America to fully fund three cycles of IVF, and Hanck is confident that the entire country will be funding treatment within the next few years. Quebec has had a 50 percent refundable tax credit since 2008 and their new funding will be instated together with a single embryo transfer (SET) protocol which was originally pro-posed by IAAC. Only one embryo will be transferred in all cases; when the quality of the embryos is question-
able, physicians will be allowed to transfer two embryos in patients under 37 years of age and three in patients over 37. Quebec is deter-mined to reduce their multiples down to 10 percent by 2012 from more than 30 percent currently, thereby saving millions of precious health care dollars.
Fertility treatment tax creditAfter reviewing the Budget Impact
Analysis that IAAC sent to Manitoba, Teresa Oswald, minister of health in Manitoba, quickly stepped up to the plate. Their new Fertility Treatment Tax Credit will provide a 40 percent refundable tax credit on eligible expenses up to $20,000 a year, for a maximum benefit of $8,000. This can be combined with the exist-ing 10.8 percent provincial medical expenses tax credit and the existing
federal medical-expense credit of 15 percent; Manitobans could have up to 66 percent of their fertility treat-ment expenses reimbursed. Hanck saysshe commends Oswald for her ‘no nonsense’, ‘let’s get the job done’ attitude. We believe that other prov-inces are waiting to see how this strategy plays out in Quebec but we would like to see provincial govern-ments being more independent and confident and not have to wait to see “what the other guy is doing.”
One in six...Infertility is a major medical issue
that affects one in six Canadian cou-ples of reproductive age. The most effective treatment for infertility is IVF, because the number of embryos transferred can be monitored. But the need for IVF far exceeds its accessibility. Many infertile couples simply cannot afford it. As a result, many couples resort to cheaper but less effective alternatives such as ovarian stimulation by fertility pills and/or hormone injections (with or without artificial insemination) and these regimens boost the risk for multiple pregnancies.
“infertility is a major medical issue that affects one in six Canadian couples of reproductive age.”Beverly Hanck, executive director, the infertility Awareness Association of Canada
LESS IS MOrEGovernment funding helps Canadian couples realize their dream.Photo: PurPle door PhotograPhy
Expectant parents face numer-ous decisions, be it having a pre-natal test or choosing the color of the nursery. Now, they’re also deciding whether to save their newborn baby’s cord blood, a procedure known as cord blood banking.
Cord blood is the blood remain-ing in your baby’s umbilical cord after delivery. The cord blood is a source of stem cells, which are the building blocks for all cells in your body. Stem cells have the potential to develop into the various tissues of your body in order to replace damaged or abnormal cells for the treatment of various diseases.
With cord blood banking, par-ents have the option of storing the blood in a public bank, where the cells may be used to help a sick person, or in a private, family bank, where it may be used some-day to benefit your child or one of his siblings.
According to Clifford Librach, MD, director of the CReATe Cord Blood Bank in Toronto, growing numbers of parents are taking advantage of cord blood banking. People are saying, ‘Why would I want to throw something out that could have benefit for my children someday?’ I did it for my own kids. He said his company’s bank currently has about 5,000 deposits.
Cord stem cells are used to treat myriad diseases including leukemia, lymphoma, Hodgkin’s Disease, various other cancers, blood diseases, genetic conditions and immune disorders, Librach says. Research is also examining whether stem cells can be used to treat diabetes, multiple sclerosis, lupus and many other illnesses.
The cost of cord blood bank-ing varies, depending on the bank. At CReATe, it costs $925 for a single child in the first year, which includes registration, the cord blood processing fee and the first year of storage. Subsequent storage fees cost $115 a year. “The blood doesn’t go bad, it’s good for your lifetime,” Librach says. “But if you don’t do it at the time of birth, you’ve missed it.”
In addition to banking cord blood, Librach says his company is banking stem cells found in the tissue surrounding the blood ves-sels of the umbilical cord, which his company is calling Peristem. These specialized cells are the building blocks in structural tissues such as bone, cartilage, muscle and heart. These cells have also been shown to decrease inflammatory reactions and may be beneficial in treating autoim-mune diseases such as lupus, type I diabetes and Crohn’s disease someday.
Librach says the decision to bank cord blood is much like buy-ing any kind of insurance. “You hope you never have to use it,” he says.
Questionnaire
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A Canadian fertility spe-cialist has some advice for couples considering in vitro fertilization: Less, he urges, is more.
Co-founder of the Vancouver-based Genesis Fertility Centre, Dr Al Yuzpe is referring to the number of eggs fertilized at a time through IVF, a medical procedure in which a woman’s eggs are fertilized by sperm in a laboratory rather than the womb.
Though IVF can help couples struggling to conceive naturally, Dr Yuzpe says desperation often leads women to make decisions that can negatively impact her own health and that of the child; specifically, having more than one egg fertilized at once.
Seeing double Though couples see dual embryo
transfer (DET)—having two or more eggs fertilized in vitro—as increas-ing their chances of conception, the reality, Dr Yuzpe says, is that it often results in multiple births and higher risk of health problems for both mother and child than elec-tive single embryo transfer, the procedure he recommends for his
patients. Success rates for concep-tion with both elective SET and DET are comparable, Dr Yuzpe says, though the chance of twins is 20 times more and that of triplets 400 times that if only one egg is fertil-ized at a time.
“It’s exactly the same in terms of cost, but with elective single embryo transfer you reduce the rate of mul-tiple births,” he says. “Having twins
is not good: the risk of a learning dis-ability is increased four- to six times, and there’s a higher risk of prema-ture birth, pregnancy loss, need for Cesarian section.”
Elective SET differs from SET in that women undergoing the former have more than one egg from which to choose, whereas with non-elec-tive SET applies to women with only a single egg.
Infertility treatments and tech-nologies have been refined over the past 35 years, Dr Yuzpe says, and though many Canadian fertility clinics remain ill-equipped to per-form elective SET, he says the pro-cedure is becoming more accessible and attractive as the disadvantages of DET are better understood.
Dr Cliff LibrachMedical director – the CreAte fertility Centre
to bank or not to bank?
“infertility treatments and technologies have been refined over the past 35 years...”A. Albert Yuzpe, BSc,MSc, MD, FrCS(C), FACS, FSOGCCo-founder and Co-director, the genesis fertility Centre, Vancouver, British Columbia
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