The thought of exploring fertility treatment to build a family is overwhelming for many people. But it doesn't have to be. We spoke to Dr. Kim Garbedian to address some of the commonly held myths about fertility treatment, from who can see a fertility specialist to how much it might cost.
Struggling to have a baby is one of the most painful things for would-be parents. Every diaper commercial, every baby bump you see, every pregnancy announcement on Instagram…they can all be triggering. And if you don’t know how to find or don’t feel you’ll be able to get help to conceive? That’s a double whammy. We spoke to Dr. Kim Garbedian, medical director of Pollin Fertility in Toronto, to debunk some of the more common myths about fertility treatment. (Spoiler alert: You can get access and it may not be as expensive as you think!)
ParentsCanada (PC): Thanks for chatting with us to help debunk some of the myths about fertility treatment, Dr. Garbedian! Let’s start with a basic but important question: Who can see a fertility doctor?
Dr. Kim Garbedian (KG): You can see a fertility doctor just because you want to. You don’t even have to be trying to get pregnant. Individuals and couples who are just curious can book an appointment with a fertility doctor. For example, I will get people who come to me and say they want to freeze their eggs. My response is usually, “Great! But come to me to learn about your fertility and your options, one of which is egg freezing.”
This education part goes for everyone. We want people to learn about their fertility and not just make assumptions. Some women with Polycystic Ovarian Syndrome, for example, think that they can’t have kids, but this often isn’t the case. Even if someone isn’t planning to have a baby for ten years, they can have their fertility tested to get the full picture, so they can be reassured. There are other conditions when this applies, too—endometriosis, genetic conditions, etc. Don’t just google for ten years, worrying about what might happen. You can be proactive and get educated about your specific scenario, learn your options and know your potential timelines.
One of the more common myths about fertility treatment is that you have to try for a year before seeking help. This isn’t the case. Especially if you’re over 35. Don’t wait a year. The textbook answer is to come after six months at that age, but really, you can seek out help any time you’re stressed. And remember, just because you see a fertility specialist, doesn’t mean you’ll necessary need treatment.
PC: If you’ve been trying for a while, though, and you’re under the care of a family doctor, do you have to get a referral to see a fertility specialist?
KG: Yes and no. Not everyone has a family doctor, and many, if not most, clinics have a mission of access. With this in mind, many clinics have found ways to help patients obtain a referral. We’re subspecialists, so, in Ontario at least, you need a referral from a family doctor for it to be covered by OHIP. So, clinics like Pollin will partner with family doctors or employ a nurse practitioner to help facilitate that referral.
That said, I think family doctors are the foundation of health care in Canada, and you want someone to have a family doctor who is in charge of the patient’s whole care. They see us for fertility issues, but it’s also important for people to have family doctors to reach out to as another resource during the process. We will also let family doctors know when a patient does get pregnant, so they can be aware and a part of the team.
PC: It's one of the common myths about fertility treatment that fertility clinics are expensive—especially if you have to do something like in vitro fertilization (IVF). Is this always the case?
KG: This is one of the biggest misconceptions and, in my opinion, barriers. People don’t want to see me because they think it will be expensive. They jump to thinking about IVF and the costs associated. But for most people, this isn’t the case. At Pollin, we have two pathways—the IVF route is only about 25 to 30 percent of patients, while the balance of 70 to 75 percent is lower intervention. This is reassuring because, if you consider that a lower intervention patient usually tries for three to six months before going to IVF, this means the majority of patients get pregnant on that first pathway.
In terms of the costs, the majority of an initial fertility workup is likely to be covered by provincial health care (it is covered by OHIP in Ontario, where Pollin is based). Cycle monitoring, which is the observation of your cycle to pinpoint when you are going to ovulate, is also covered. Some provinces have government funding available for IVF treatment as well, but many people don’t need that level of intervention.
PC: There are some costs, though. So what could someone expect to pay for fertility treatment?
KG: It varies by patient, and how much intervention they need and want. There is such a range. For some people, everything is covered by provincial healthcare. For others, the costs would be more significant—for IVF with special genetic testing, for example—but there is everything in between. More and more companies are adding or expanding extended health care coverage to infertility, too. Some employers are now including coverage for treatments as well as medications in their employee plans, which can help to ease the stress. You can even reach out to your employer or benefits provider to see if better coverage for fertility treatments is available.
I’m hopeful that we’ll start to see more financing/payment options so that we can improve access. Time is actually a factor in the fertility world, so if it takes someone six months to save up for the treatment they need, that’s six months we’ve lost in terms of helping them to conceive. At Pollin, we’re trying to make treatment as accessible to people as possible, especially knowing that some people cannot grow their families without medical intervention.
PC: What can someone expect at their first appointment with a specialist like you?
KG: The first appointment is usually a get-to-know-you appointment. We talk about their medical history as an individual and/or couple. Then we start to talk about the initial tests we can do in a fertility workup. I try to break down what to expect, why we do them, what we could discover from them. In couples, we test both partners, too, to make sure we have the full picture.
Then in a follow-up appointment, we go through all of the results—this is a normal reading, this is your result, this is what we need to optimize, etc. At the end of this appointment, we discuss the options. We start with discussing low intervention options, then high intervention options. And with personalized medicine, which we do at Pollin, everyone is going to have a different path in terms of what they’re going to do. Fertility is overwhelming, and my job is to make it less so.
PC: As a fertility specialist, what do you want people to know?
KG: When people ask me why I’m so passionate about fertility awareness and education, it’s because the more we talk about it, the more we reduce the stigma around it. Many people don’t know that infertility is actually a disease. It is recognized as a disease by the World Health Organization. A lot of the reasons people have issues with fertility are medical conditions. The reasons people end up seeing me are medical conditions. Since this designation, it has been slow-going for insurance companies and government funding to catch up. If provinces provide universal health care, fertility issues should be included. Most fertility clinics and doctors are openly advocating for more funding for patients.
About Dr. Kim Garbedian
Dr. Garbedian is the medical director and founding doctor of Pollin Fertility. She is a Royal College of Physicians and Surgeons-certified gynecologist and reproductive endocrinology and infertility specialist. She manages complex problems related to infertility, recurrent pregnancy loss and fertility preservation.
About Pollin Fertility
Pollin Fertility is a modern fertility clinic that’s revolutionizing reproductive healthcare. Pollin’s mission is to develop the most advanced clinical, digital and IVF lab technology to improve the standard of care and optimize success rates for fertility patients. Pollin’s first flagship clinic spans 25,000 square feet on Yonge Street in Toronto, Ontario.
