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Writer's pictureKat Thompson

Exploring the World of Fertility Treatments and Success Rates

Updated: Nov 4, 2023

In the tapestry of life, parenthood is a cherished thread. For some, the path to parenthood unfolds effortlessly, while for others, it's a winding journey, marked by determination, resilience, and hope. In a world where science and compassion intersect, new possibilities emerge. Welcome to 'Hopeful Journeys: Exploring the World of Fertility Treatments.' I invite you to embark on a voyage through the realm of reproductive medicine, where hope meets innovation, and where dreams of becoming parents find a place to thrive.


Join me as we unravel the stories, the science, and the hope that accompany the pursuit of a precious dream.

In Canada and the US, several treatment options are available for individuals or couples struggling to conceive. Some of these include:

  • Fertility drugs: Medications such as Clomid and gonadotropins can be used to stimulate ovulation in women or increase sperm production in men.

  • Intrauterine insemination (IUI): This procedure involves placing sperm directly into a woman's uterus to increase the chances of fertilization.

  • In vitro fertilization (IVF): This procedure involves fertilizing an egg with sperm outside the body and then transferring the resulting embryo into the uterus.

  • Intracytoplasmic sperm injection (ICSI): This procedure involves injecting a single sperm directly into an egg to increase the chances of fertilization.

  • Donor eggs or sperm: For individuals or couples with severe fertility issues, donor eggs or sperm can be used to increase the chances of conception.

In other countries, treatment options for infertility may differ based on cultural, religious, or legal factors. For example, in some countries, surrogacy is not legal or is restricted to certain groups of people. In some countries, traditional medicine or herbal remedies may be used in conjunction with or instead of Western medicine. Additionally, the availability and accessibility of certain treatments may vary depending on factors such as location and healthcare infrastructure.

There are various fertility treatments available in Canada, and success rates can vary depending on factors such as the type of treatment, the age of the patient, and the underlying cause of infertility. Here are some success rates for common fertility treatments in Canada:


In vitro fertilization (IVF): The success rate of IVF in Canada varies by age group. According to the Canadian Fertility and Andrology Society, the live birth rate per IVF cycle in Canada was 22.3% for women under 35, 15.7% for women aged 35-39, and 5.4% for women aged 40-42.


Intrauterine insemination (IUI): The success rate of IUI in Canada is generally lower than that of IVF. According to a study published in the Journal of Obstetrics and Gynaecology Canada, the clinical pregnancy rate per IUI cycle was 9.7% for women under 35, 7.1% for women aged 35-39, and 3.1% for women aged 40-42.


Intracytoplasmic sperm injection (ICSI): ICSI is a type of IVF that involves injecting a single sperm into an egg. The success rate of ICSI in Canada is similar to that of IVF. According to the Canadian Fertility and Andrology Society, the live birth rate per ICSI cycle in Canada was 21.5% for women under 35, 15.5% for women aged 35-39, and 6.4% for women aged 40-42.


Here's a general overview of fertility treatments and the steps involved:


Ovulation Induction:

  • Often the initial step.

  • Medications like Clomiphene or Letrozole are used to stimulate ovulation.

  • Monitoring of follicle growth through ultrasound and hormone level tracking.

  • Timed intercourse or intrauterine insemination (IUI) may be performed.


Intrauterine Insemination (IUI):

  • Involves the injection of specially prepared sperm directly into the uterus.

  • Often used when there are mild male factor issues or unexplained infertility.

  • Success rates vary but tend to be modest, especially for women over 35.

Steps potentially involved in your IUI treatment:

  1. Ovulation Tracking: The process often begins with monitoring the woman's menstrual cycle to pinpoint when ovulation is likely to occur. This can be done through tracking menstrual periods, monitoring basal body temperature, or using ovulation predictor kits (OPKs).

  2. Semen Collection: When the woman is approaching ovulation, her partner or a sperm donor may be asked to provide a semen sample at the clinic. In some cases, the sample is collected at home, but it must be delivered to the clinic within a specified timeframe.

  3. Sperm Processing: The collected semen sample is processed in the laboratory. The goal is to isolate the healthiest and most motile sperm to increase the chances of fertilization.

  4. Insemination: The processed sperm is then gently placed directly into the woman's uterus using a thin catheter. This process is typically quick, minimally invasive, and usually painless.

  5. Post-Insemination Monitoring: Some clinics may recommend timed intercourse in addition to IUI. After the procedure, the couple may be advised to have intercourse on specific days to optimize their chances of conception.

  6. Waiting Period: Following the IUI, there is a waiting period to determine if the procedure was successful. This involves waiting for the woman's menstrual cycle to resume or taking a pregnancy test, depending on the timing of the cycle.

In Vitro Fertilization (IVF):

  • A more advanced treatment.

  • Involves stimulating the ovaries with hormones to produce multiple eggs.

  • Eggs are retrieved and fertilized with sperm in the laboratory.

  • Embryos are cultured and selected.

  • Embryo transfer into the uterus.

  • Success rates can vary but are generally higher than IUI, especially for younger individuals.

Steps potentially involved in your IVF treatment:

  1. Ovarian Stimulation: The woman is given medications to stimulate her ovaries to produce multiple eggs. These eggs are monitored through ultrasound and blood tests.

  2. Egg Retrieval: Once the eggs are mature, a minor surgical procedure is performed to retrieve the eggs from the ovaries. This is done under sedation or anesthesia.

  3. Sperm Collection: A semen sample is collected from the male partner or a sperm donor on the same day as egg retrieval.

  4. Fertilization: The eggs and sperm are combined in the laboratory, and fertilization is monitored. In some cases, Intracytoplasmic Sperm Injection (ICSI) may be used to assist fertilization.

  5. Embryo Culture: Fertilized eggs (embryos) are cultured in the laboratory for several days to allow them to develop and grow.

  6. Embryo Transfer: One or more healthy embryos are selected and transferred into the woman's uterus. This procedure is often similar to IUI and is usually not painful.

  7. Waiting for Pregnancy: After embryo transfer, there is a waiting period to determine if the embryo implants and pregnancy occurs. This may involve taking a pregnancy test about two weeks after the embryo transfer.

Intracytoplasmic Sperm Injection (ICSI):

  • A type of IVF where a single sperm is injected directly into an egg.

  • Used when there are severe male factor fertility issues.

  • Success rates are similar to standard IVF.

Donor Eggs or Sperm:

  • Used when there are issues with egg or sperm quality.

  • Success rates are often very high, as they depend on the age of the donor.

Surrogacy:

  • Used when a woman cannot carry a pregnancy to term.

  • Success rates depend on various factors, including the health of the surrogate.

Let's take a look at some success rates...


As for success rates by province, data from the Canadian Assisted Reproductive Technologies Registry (CARTR) shows that success rates can vary between provinces. For example, in 2018, the live birth rate per IVF cycle for women under 35 ranged from 20.5% in Manitoba to 34.4% in Ontario. However, it's important to note that success rates can be influenced by factors such as the quality of the clinic and the patient population it serves.

Success rates of fertility treatments can vary depending on many factors, including the quality of medical care, the availability of advanced technologies, and the age and health of the individuals seeking treatment. While it is difficult to make a direct comparison between countries, some studies suggest that some countries may have higher success rates for certain types of fertility treatments than others. For example, a study published in the journal Fertility and Sterility in 2017 found that the success rates of in vitro fertilization (IVF) were higher in some European countries, such as Denmark and Sweden, compared to the United States. However, it is important to note that success rates can also vary widely within a single country, depending on factors such as the clinic and the specific treatment being used.


The success rates of infertility treatments in Europe can vary by country and treatment type. In vitro fertilization (IVF) is one of the most common treatments used to assist with infertility in Europe. According to a 2020 report by the European Society of Human Reproduction and Embryology (ESHRE), the average live birth rate per embryo transfer in Europe was 32.4% for women under the age of 35. However, success rates varied depending on the woman's age, the number of embryos transferred, and the type of IVF procedure used.


The report also noted that success rates for other fertility treatments, such as intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI), can also vary widely depending on the patient's individual circumstances and the clinic providing the treatment. It is important to discuss the success rates of specific treatments with a fertility specialist and to choose a reputable clinic with a high success rate.


What about options beyond Canada's borders?


A significant number of individuals and couples explore fertility treatments abroad. Their motivations may range from the pursuit of higher success rates to a preference for a specific fertility clinic's quality. Regardless of the choice made, it's important to note that the best IVF success rates can differ from one country to another. Therefore, conducting additional research is advisable for confirmation. To assist with this, I've gathered information on various locations, providing insights into success rates and costs (excluding travel and accommodation expenses).


There is a study, ART in Europe, 2017: results generated from European registries by ESHRE, that was published that spoke about IVF success rates in Europe that has results from the 2017 study that may be useful for some to review. You can find that study here.


According to FertilityWorld, the following have the highest success rate of IVF in the world:

Dubai, India, Thailand, Canada, Australia, Kenya, Ethiopia, Nepal, Malaysia, and the Philippines

According to Brit-Med (which seems to be supported by other evidence-based information as well), the following have the highest success rate of IVF in the world:

Greece
Greece has one of the lowest costs of IVF treatment abroad. With treatment as low as 3,000 - 3,500 EUR. However, this price can be increased to around 5,000 - 6,000 EUR if the eggs used in the treatment are from donors.
Czech Republic
The Czech Republic has around 30 clinics scattered throughout the country and is well regulated by the Czech society for Assisted Reproduction. Similar to Greece, the cost of IVF treatment is also relatively low and can range from 2,500 - 4,000 EUR.
Spain
One of the more popular countries that have been visited for IVF treatment is Spain. With modern facilities and specialized physicians, and many laws and regulations to ensure the safety and care of patients, it’s no wonder why. Not to mention the multitude of destinations to be visited. One of the main reasons patients travel to Spain is for the egg donation this is attributed to its higher success rates. In comparison to the aforementioned countries, the cost of IVF treatment in Spain can be slightly more expensive, ranging from 3,500 - 5,000 EUR.
Turkey
Regarded as one of the cheaper countries for IVF treatment, Turkey offers some attractive reasons to travel to the country for the procedure. Aside from the cost of IVF treatment in Turkey being as low as 1,700 EUR (approx), the prominent existence of state-of-the-art clinics and highly qualified physicians make this country one of the most popular destinations among European and North American alternatives.
Denmark
Being home to one of the largest sperm banks, Cryos International, Denmark has consequently eliminated the waiting times for IUI (artificial insemination) and been at the front of one of the greatest proportion of babies born through Assisted Reproductive Technology (ART). For context, the US has 1.7% of all infants born through ART, whereas Denmark has an estimated of 8 to 10% conceived through ART 6. For these reasons among others, Denmark has been one of the most popular destinations for women undergoing fertility treatments. The typical cost of IVF in Denmark starts at around 3,400 EUR, with egg donation prices ranging from 5,000-6,000 EUR.

Let's get back to Canada's Fertility Treatments and Success Rates for a moment...


As of 2021, there were several recent advances and innovations in the field of fertility treatments. Please note that the field of reproductive medicine is continually evolving, so there may have been further developments since then. Here are some recent advances:

  1. In Vitro Maturation (IVM): IVM is a technique that allows immature eggs to mature in the laboratory before fertilization. It offers a more gentle and cost-effective alternative to traditional IVF.

  2. Preimplantation Genetic Testing (PGT): PGT involves the screening of embryos for genetic abnormalities before they are transferred into the uterus. This can help improve the chances of a healthy pregnancy and reduce the risk of genetic disorders.

  3. Time-Lapse Imaging: Time-lapse imaging systems have been developed to monitor the development of embryos in real-time. This technology can help embryologists select the healthiest embryos for transfer.

  4. Mitochondrial Replacement Therapy: In some cases of mitochondrial disease, a small number of embryos may have damaged mitochondria. Mitochondrial replacement therapy can replace the damaged mitochondria with healthy ones from a donor egg, potentially reducing the risk of inherited mitochondrial diseases.

  5. In Vitro Activation (IVA): IVA is a technique that may help women with primary ovarian insufficiency (POI) or premature ovarian failure (POF). It involves stimulating dormant follicles in the ovaries to produce mature eggs.

  6. Personalized Ovarian Stimulation: Some clinics are now using individualized ovarian stimulation protocols to tailor the treatment to a woman's unique needs, potentially improving success rates and reducing the risk of complications.

  7. Uterine Receptivity Testing: This testing evaluates the receptivity of the uterine lining to embryo implantation. It can help ensure that embryos are transferred at the optimal time for successful implantation.

  8. Non-Invasive Prenatal Testing (NIPT): While not a fertility treatment, NIPT is a significant advance in reproductive medicine. It allows for early detection of genetic abnormalities in the fetus, providing expectant parents with valuable information.

  9. Telemedicine and Virtual Consultations: The COVID-19 pandemic accelerated the adoption of telemedicine in reproductive medicine, making it more convenient for patients to access consultations and follow-up care.

  10. Fertility Preservation Techniques: Advances in egg freezing and ovarian tissue cryopreservation have improved the options available to individuals who want to preserve their fertility for future family planning.

It's also worth noting that success rates for fertility treatments can be impacted by a range of factors, including the underlying cause of infertility, the age and health of the patient, and the quality of the clinic and its medical staff. Making informed decisions about your fertility journey is vital, and it often involves considering not only the medical aspects but also the holistic well-being of both partners.


As your Full Spectrum Wellness Provider, I am here to support you every step of the way, offering comprehensive care that addresses the physical, emotional, and mental aspects of your fertility experience. I understand the unique challenges and emotions that come with this journey, and I'm committed to providing you with evidence-based guidance, emotional support, and personalized wellness strategies. When you're ready, I encourage you to reach out to me, and together, we can explore how I can be a valuable part of your fertility treatment plan, enhancing your overall well-being as you embark on this meaningful path to parenthood.


Citation
"Assisted Reproductive Technologies (ART) in Canada: 2017 Results from the Canadian ART Register," Public Health Agency of Canada, 2020. Available: https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/healthy-living/assisted-reproductive-technologies-canada-2017-results/assisted-reproductive-technologies-canada-2017-results.pdf

"Fertility Treatment Success Rates," Government of Canada, 2021. Available: https://www.canada.ca/en/public-health/services/health-promotion/healthy-pregnancy/preconception-care/fertility-treatment-success-rates.html

"Success Rates," Society of Obstetricians and Gynaecologists of Canada, 2021. Available: https://www.sogc.org/en/content/using-assisted-reproductive-technologies-art-success-rates

European Society of Human Reproduction and Embryology (ESHRE) - ESHRE publishes an annual report on assisted reproductive technology (ART) in Europe. The latest report for 2019 shows that the average clinical pregnancy rate per embryo transfer for all age groups was 33.9%.

Human Fertilisation and Embryology Authority (HFEA) - The HFEA is the regulatory body for fertility treatments in the UK. They publish success rates for each individual clinic in the UK on their website. The latest figures for 2019/20 show that the average live birth rate per embryo transfer for all age groups was 23%.

European IVF Monitoring Consortium (EIM) - EIM is a European network of IVF centers that collects and reports data on ART treatments. Their latest report for 2018 shows that the average clinical pregnancy rate per embryo transfer for all age groups was 36.4%.

Centers for Disease Control and Prevention (CDC) - The CDC is a US federal agency that collects and publishes data on ART success rates in the US. Although the CDC only publishes data for US clinics, it can be useful to compare success rates across countries. The latest figures for 2018 show that the average live birth rate per embryo transfer for all age groups was 37.1%.

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