A Halifax fertility clinic has become the first on the East Coast to offer frozen eggs through an American donor bank, meaning Atlantic Canadians who need help conceiving can start the process closer to home.
Atlantic Assisted Reproductive Therapies has always offered services involving fresh eggs retrieved from known donors, but the clinic's chief operating officer said that option doesn't work for every hopeful parent, compelling some to leave Canada in search of donor eggs.
"It's hard to find somebody that you know that's willing to donate their eggs," said Julie Keizer. "It's a big challenge."
One in six Canadian couples face infertility, according to the Public Health Agency of Canada. That number has doubled since the 1980s.
Keizer estimates there are dozens of Atlantic Canadians looking for donor eggs every year. The non-profit clinic's wait list has hundreds of people on it, with an average wait of eight to 12 months for various services, including frozen egg storage, in vitro fertilization and gestational carriers.
A 'big game changer'
Anonymous donor egg services have long been offered in other parts of Canada, particularly in Toronto.
Offering the service in the Atlantic region is welcome news to Sara Cohen, a fertility lawyer who is also the president of Fertility Matters Canada, an organization that provides support to families trying to conceive. She calls the move a "big game changer" for people on the East Coast.
"This really opens up possibilities for people in Atlantic Canada to build their families at home and to have access to using their doctor and their facilities, instead of travelling halfway across the country for weeks, if not months at a time in order to build their family," Cohen said.
Some people who've been unable to find a willing egg donor have opted to travel to another country in search of an anonymously donated egg. Those patients must stay for the duration of their treatment, which could last several weeks.
"The thing that concerns us about that is the consistency and quality of treatment. In Canada, we have pretty consistent results across clinics," said Keizer.
She added that Canadian clinics also comply with best practices of the Canadian Fertility and Andrology Society, a national non-profit organization whose members include physicians, nurses, psychologists and ethicists working in reproductive medicine and science.
Single embryo transfers
One of those best practices is its single embryo transfer policy, meaning the patient will only get one embryo through the embryo transfer cycle — possibly two depending on the patient's age and past results.
When getting the procedure overseas, patients are often motivated to get three or four embryos transferred at a time to increase the chances of getting pregnant, said Dr. Megan Dufton, laboratory director at Atlantic Assisted Reproductive Therapies.
While it does increase the chance of pregnancy, it also increases the chance of conceiving multiples.
"With more than one fetus, that puts the pregnancy and the babies at higher risk of many complications that can occur during that pregnancy," she said.
How it works
Using an American donor egg bank, patients at the Halifax clinic can go through profiles to choose the donor's characteristics, like physical attributes or family history.
The frozen eggs, in a lot of six to eight, are then shipped from the U.S. and stored at the clinic until needed.
The eggs are then thawed, fertilized and cultured into embryos. After five to six days, an embryo is transferred to the patient's uterus and any remaining embryos of good quality, usually about 80 per cent, are frozen for potential future use.
Dufton said their success rate of clinical pregnancy is about 50 per cent, which is higher than the national average of about 38 per cent. A clinical pregnancy is one confirmed by the presence of hCG, known as the pregnancy hormone, and the confirmation of a gestational sac on ultrasound.
The procedure comes with a hefty price tag. The clinic's embryo transfer cycle costs $7,000 with an additional $4,000 to $10,000 for drugs, depending on the patient's age and their drug coverage plan. Those prices are at cost for the clinic.
The eggs cost another $14,500 US — about $18,000 Canadian — to be paid to Donor Egg Bank USA.
"It's a big investment," Keizer said, noting the U.S. company that supplies the eggs has a guarantee to send another batch if the first one doesn't generate a usable embryo.
Eggs are far less plentiful and more complicated to access than sperm, which Keizer said adds to the cost. One cycle of egg donation usually yields eight to 10 eggs, whereas one sperm donation usually yields millions of sperm.
The clinic now also offers known donor sperm services, meaning a patient looking for sperm can have someone they know donate sperm instead of getting it from an anonymous donor.
Assisted Human Reproduction Act
Cohen said the procedure will always be costly when egg banks are involved.
Under Canada's Assisted Human Reproduction Act, you are not allowed to compensate egg donors. Doing so can result in up to 10 years in jail or a $500,000 penalty.
"We are compensating those egg donors outside of Canada. It's just that we're not paying them directly; we're paying the egg bank, which already owns those eggs," she said, adding it's "almost a loophole" in the law.
Cohen said no parents have ever been charged under the act, which was implemented in 2004, but the potential penalties are severe enough to act as a deterrent.
"I think it would be much better if we were able to just do this here in Canada and could have known donor gametes here or could make a donor registry," she said, noting 90 to 95 per cent of the country's donor sperm is imported from the United States, and a large percentage of the country's donor eggs will be now, too.
"I really don't believe that was the intention … but that's the reality that this legislation has actually imposed on patients here in Canada," she said.
Fertility treatments not covered in N.S.
Atlantic Assisted Reproductive Therapies is the only fertility clinic in Nova Scotia. Although based in Halifax, it also helps patients from Prince Edward Island, New Brunswick, and Newfoundland and Labrador where there is more limited access to various fertility treatments and services.
Since it began offering anonymous donor eggs in January, Keizer said the clinic has done several consults a week with potential patients.
Fertility treatments are not covered in Nova Scotia. No one from the provincial government was available for comment on the matter.
Late last year, P.E.I. introduced financial support of up to $10,000 for people who leave the Island for fertility treatments.
New Brunswick, meantime, offers a special grant of up to $5,000 for those diagnosed with fertility issues who end up using in vitro fertilization or insemination procedures.
"It is a trend that provinces are adding coverage for fertility treatments … we're very hopeful that in the next few years there'll be some coverage in Nova Scotia," Keizer said.
ABOUT THE AUTHOR
Brooklyn Currie is a reporter and producer with CBC Nova Scotia. Get in touch with her on Twitter @brooklyncbc or by email at firstname.lastname@example.org
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