General Fertility Questions

We have compiled a list of answers to commonly asked questions about infertility, infertility treatments and pregnancy.

When do I need to start taking precautions for pregnancy?

During fertility treatments, you need to start taking pregnancy-related precautions starting on the day of conception which is the day of a positive ovulation predictor test, insemination/IUI or embryo transfer procedure.

Is it safe to have local anaesthetic for dental procedures during fertility treatments and pregnancy? If dental procedures are needed local use of anaesthetics is safe in pregnancy?

It depends on the type of treatment required. Generally in the first trimester, it’s best to avoid any medications which could cause pregnancy harm. Consultation with your Dental professional is key.

Are antibiotics safe during fertility treatments or pregnancy?

A number of antibiotics are not safe during pregnancy, and should be avoided both pregnancy and following conception (after an insemination/IUI or embryo transfer procedure). Please check with your pharmacist or prescribing doctor regarding the antibiotics safety profile. Motherrisk.ca is an excellent resource.

What vaccinations are safe during pregnancy?

Live attenuated vaccinations like varicella and mumps/measles/rubella (MMR) are not advised during pregnancy despite limited evidence of toxicity. Pregnancy should be delayed for a period of one month after receiving the vaccination.

What can I use for constipation?

Any type of medication for constipation can be used prior to becoming pregnant. While pregnant, we recommend the use of bulk-forming laxatives like Colace or fibre-like products. Stimulating laxatives are not recommended during pregnancy as they can also cause uterine irritability.

What can I use for heartburn (acid reflux)?

Any type of antacid medication can be used prior to becoming pregnant. During pregnancy chewable TUMS –like medication and Zantac (ranitidine) is safe.

What if I have a genital herpes outbreak during treatment?

Genital herpes outbreaks are only a problem late in pregnancy when the baby is exposed to the birth canal. There are some options to reduce the chance of outbreak at term, if you have had outbreaks in the past. Active infection will not affect fertility treatment procedure or early pregnancy.

 

What if I’m between my fertility treatment procedure and the pregnancy test and bleeding?

Bleeding following fertility treatments is common (20-30% of patient), and when associated with a successful pregnancy, is likely related to instability in the lower uterine segment and cervical lining caused by the fluctuations in hormone levels created by treatment. If the treatment is unsuccessful you will eventually have your period, even if you are taking progesterone supplementation. The period following fertility treatments is commonly very heavy with more severe cramping than usual.

What if I am pregnant and bleeding/spotting?

Bleeding in early pregnancy is very common following fertility treatments (20-30% of patients), and as with above can be benign and related to the hormone treatments and supplements. However bleeding can also be related with failure of an intrauterine pregnancy and ectopic pregnancy. Differentiation between the above requires close monitoring with ultrasound and blood tests. If you are pregnant and bleeding you need to notify PCRM. If the bleeding is heavy and/or you are having severe pain you should proceed to the closest Emergency Room.

I am pregnant and having pain. Is this normal?

Pain in pregnancy should always be reported to PCRM. If severe you should proceed to the closest Emergency Room.

I just had a fertility treatment procedure and having pain. Is this normal?

It is common to have cramping after insemination/IUI for 1-2 days. Spotting is also quite common after this procedure. IVF egg retrieval can cause sharp and/or crampy lower abdominal pain for up to 5 days after, but symptoms should improve gradually over that time. If the discomfort is not going away please report this to PCRM.

How can I treat a headache/migraine during fertility treatment or pregnancy?

Certain migraine medication can be used during pregnancy. Please discuss with the physician managing your headaches and/or your pharmacist.

Is it safe to dye my hair during pregnancy?

Safety of these dyes has not been established, and generally should await the second trimester.

I’m doing IVF and my cervical mucous is thinning and heavier. Am I ovulating?

Estrogen causes your cervical mucous to thin and increase in volume. This is a natural mechanism to allow sperm to better penetrate the cervix around the time of ovulation when estrogen levels are at their peak. Ovarian stimulation during IVF produces the same effect by artificially raising estrogen levels from very early in the cycle. This is a normal response to the medication and the treatment protocols include drugs to block ovulation.

When should I be ejaculating/having intercourse during fertility treatment?

We generally recommend that an ejaculate occurs a minimum of 2-5 days prior to an insemination or the day of the egg retrieval. Nursing staff will instruct you on this during treatment.

When am I most fertile?

When you are in your late teens and early twenties. As women age, their eggs lose the ability to fertilize and develop normally. Unfortunately for the majority of women, their most fertile period is often one when they are emotionally and financially unprepared for child-rearing.

How do I know if I’m infertile?

You can’t know for sure without a comprehensive evaluation. However, there are a few indicators you can look for:

  • You are under 35 years old and have had regular, unprotected intercourse for 12 months and have not become pregnant
  • You are 35 years or older and have had regular, unprotected intercourse for 6 months and have not become pregnant

What is the success rate of fertility treatment?

80% of all women who seek care from fertility specialists become pregnant.

What are the most common causes of infertility?

  • Male factor infertility
  • Ovarian factor
  • Cervical factor
  • Tubal factor
  • Uterine factor
  • Unexplained causes
  • Female age-related
  • Failed fertilization
  • Recurrent miscarriage

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