If you undergo any of the assisted reproductive techniques here in Montreal, the clinic that you go to will provide you with this service. If you decide to go to T-CART in Toronto, you can have your ultrasounds done by
Dr. Samir Kalife
3550 Cote des Neiges, suite 700
Tel: 933-8877
Dr. Kalife is the best obstetrical ultrasound technician in the city.
If you require an ultrasound on the weekend, try
Procrea
1100 Beaumont
Tel: (514) 345-8535.
After you have completed your infertility workup and have been given your "recipe for success," you still run a 20% risk of having another miscarriage. This will most likely be due to genetics. If you should happen to experience an arrested pregnancy, you should make every attempt to have the fetus analyzed for genetic defect. As soon as you learn of your situation a D & C (dilatation and curettage) should be scheduled as quickly as possible as fetal tissue degrades rapidly.
Contact the Alan Beer Resource Center For Reproductive Immunology & Genetics for instructions. Dr. Kwak will tell you where to send the tissue. Local hospitals are not usually equipped to handle such testing, and even if they are, the testing usually involves attempting to grow live cells from degraded tissue which can lead to inconclusive results. The method used by the lab affiliated with the Alan Beer Resource Center For Reproductive Immunology & Genetics involves sophisticated techniques that are unparalleled in deciphering the riddle of recurrent miscarriage.
Have your doctor preserve the placental tissue in Formalin and the fetal tissue according to directions by the Alan Beer Resource Center For Reproductive Immunology & Genetics.
You can have your own chromosomes tested at the University of Montreal via Dr. Tulandi. It is a simple blood test. I’ve recently heard that the Alan Beer Resource Center For Reproductive Immunology & Genetics is now using another lab for this so it is best to contact them for further instructions. In Montreal you may have the genetic testing of the fetus and tissues done at
Procrea
1100 Beaumont
Tel: (514) 345-8535
Unfortunately, genetic tests for IVF patients to test their embryos for chromosomal defect prior to embryo transfer is not yet readily available locally. It has only been offered by
T-CART in Toronto
Tel: (416) 972-0110
and
Dr. Feinman in California
Tel: (805) 374-1737
Both centres remove a cell from the embryo(s) and send them to a special facility in the US where the testing is done. As of July, 2001 this procedure costs approximately US$3,000 and should only be considered for couples who run the serious risk of passing on a serious genetically related disease to their offspring such as Cystic Fibrosis or Downs Syndrome. There is another centre in the US where genetic testing can be done.
St. Barnabas Medical Center claims to have the highest fertility rates in the US.
Tel: (973) 322-8286
Amniocentesis is highly recommended for all pregnant females over the age of 35. This procedure is also highly recommended for all couples that have a known genetically related disease in their family histories. For best results, this procedure should be done by a Perinatalogist. This is an Ob/Gyn who specializes in high-risk pregnancies.
Both amniocentesis and CVS (chorionic villus sampling) are procedures to test the chromosomes of the developing baby. Chromosomes contain DNA, which is a genetic code that determines things like eye color, skin type and predisposition to certain inherited diseases. Not only is the information coded for by the DNA on the chromosomes important, but the absolute number of chromosomes is also important.
Normally, an individual has 46 chromosomes. You inherit 23 chromosomes from your mother and 23 from your father. Rarely, during the process of formation of eggs and sperm, a chromosome will either be lost (this is called "monosomy") or gained (this is called "trisomy"). One of the most common trisomies is trisomy 21, which means that the fetus has three copies of chromosome 21, instead of the usual two copies. This is commonly referred to as Down’s syndrome.
Amniocentesis and CVS can both test for the structure and number of chromosomes. Women who are 35 years of age or older are offered amniocentesis or CVS specifically to test for chromosomal number, because the risk of problems with chromosomal number are increased in this age group. Amniocentesis and CVS are also performed in patients of any age when they are known to be at risk of having a child with a genetic disorder, such as cystic fibrosis or sickle cell disease.
Amniocentesis is typically performed at 15 to 18 weeks gestation and is done by inserting a small needle through the mother’s abdomen and uterus into the amniotic fluid surrounding the baby. A small amount of amniotic fluid is removed for analysis. The needle is associated with minor discomfort, but most women do not find the procedure to be inordinately painful.
CVS is usually performed at 10 to 12 weeks gestation and can be done one of two ways:
What are the risks associated with these procedures? Any "invasive" diagnostic test during pregnancy carries a small risk of miscarriage. For amniocentesis and CVS, that risk is in the range of 0 to 1 percent. So, even though this risk is small, each woman must decide for herself if the information she will receive from the test is worth the small risk associated with it.
Another common question is, "Can these procedures damage the baby?" Both amniocentesis and CVS are done with the assistance of ultrasound to enable the person performing the procedure to accurately place the needle or catheter away from the baby. Using this approach, it is exceedingly unlikely that either of these procedures can cause damage to the developing baby.
This article is reproduced from the FamilyFun web site.
You can have your own chromosomes tested at the University of Montreal via Dr. Tulandi. It is a simple blood test. I’ve recently heard that the Beer Clinic is now using another lab for this so it is best to contact them for further instructions. In Montreal you may have the genetic testing of the fetus and tissues done at
Procrea
1100 Beaumont
Tel: (514) 345-8535
Unfortunately, genetic tests for IVF patients to test their embryos for chromosomal defect prior to embryo transfer is not yet readily available locally. It has only been offered by
T-CART in Toronto
Tel: (416) 972-0110
and
Dr. Feinman in California
Tel: (805) 374-1737
Both centres remove a cell from the embryo(s) and send them to a special facility in the US where the testing is done. As of July, 2001 this procedure costs approximately US$3,000 and should only be considered for couples who run the serious risk of passing on a serious genetically related disease to their offspring such as Cystic Fibrosis or Downs Syndrome. There is another centre in the US where genetic testing can be done.
St. Barnabas Medical Center claims to have the highest fertility rates in the US.
Tel: (973) 322-8286
www.endometriosisassn.org
The Endometriosis Association (EA) is a non-profit, self-help organization founded by women for women. The EA is dedicated to providing information and support to women and girls with endometriosis, educating the public as well as the medical community about the disease, and conducting and promoting research related to endometriosis.
www.endometriosis.org
Endometriosis Associations are listening to women everywhere, helping them to realise they are not alone. They have become a powerful, effective international force to keep researchers on course to achieve understanding and, one day, a cure for the disease.
www.ivf.com
Woman’s guide to overcoming endometriosis.
www.infertilitydocshop.com
FertilityDocShop is a resource that allows you to find information from doctors in your area that offer Assisted Hatching, Embryo, Sperm, Egg Ovarian Tissue Freezing, Gamete Intra Fallopian Transfer, Intra Cytoplasmic Sperm Injection, In Vitro Fertilization, Pre-Implantation Genetic Diagnosis, Sperm Aspiration, Tubal Ligation, Tubal Ligation Reversal, Vasectomy, Vasectomy Reversal, Zygote Intra Fallopian Transfer and other fertility procedures.
www.medicalandnursing-training.com
A guide to selected medical and bursing training and vocational schools provides the facts on Endometriosis
Local blood tests for
can be done at the hospital. However, often the results take some time and mistakes are often made when unusual testing is done as is the case with infertility. Mycoplasma cultures can take up to two months to be processed. I have found it to be more convenient to pay for blood testing which is usually a tax deductable expense (check with your accountant).
CDL Laboratories at
5990 Cote des Neiges
Tel: (514) 344-8022
is reliable and efficient. Most results are available the next day. They also provide same day service for those of you who what to know the results of your Beta HCG within a few hours. CDL has limited hours on the weekends.
If you are planning to have blood work done at the Beer Clinic in North Chicago, and cannot afford to travel there, I highly recommend that you drive to Plattsburgh to have your blood drawn and shipped. The initial blood work will involve approximately 15 tubes from the female and 17 from the male partner. The blood is perishable and has to be in North Chicago within 18 hours of having been drawn so timing is critical.
The Champlain Valley Physician’s Hospital (CVPH)
75 Beakman St.
Plattsburgh, NY
12901
(hwy 87, exit 37)
Tel: (518) 561-2000
has the proper blood vials and sometimes they have the packaging necessary to safely ship the blood (if they don't have packaging, see the instructions for packaging blood below). They charge a nominal fee, approximately US$7 for a vena puncture for each patient. Call ahead and ask for extention 7400. Speak to the supervisor and tell them that you are from Montreal and will be needing to have your blood drawn and shipped to the Beer Clinic in North Chicago (at the time of this writing the supervisor’s name is Dot Baker, the clerk is Tara, and the technician is Christine). They will probably ask you to fax her the number and types of tubes that you will need for each of you so that she can prepare for your arrival in advance.
The fax # is: (518) 562-7415.
You must bring a copy of your documents from The Beer Clinic indicating the tests that are to be done in Chicago, with the doctor’s signature on it, for CVPH’s files. Keep in mind that you can't have the blood drawn before 4:00 p.m. because it has to get to North Chicago within 18 hrs of having been drawn. The hospital will ship your blood if you provide a FedEx account number but if for any reason they can't ship it or you don't have a FedEx number, you should go to FedEx yourself, no later than 5 p.m., and send the blood by FedEx "Priority First" overnight delivery (available Mon-Thurs). They are located just down the street from the hospital at 768 Route 3. While you are at FedEx, ask them to give you a pile of specimen packs. These are large plastic biospecimen bags that you will need for future shipments.
After the border, take Hwy 87 to exit 37 After you exit, turn right onto route 3 Drive straight until you come to the fork in the road, stay left (you will see a blue hospital sign on the right side, ignore it because that is the route to the back of the hospital) After you stay to the left, go straight, following the blue hospital signs to Beakman. You will see the hospital. Go to "Patient Registration" on the first floor, tell them why you are there and pay for your vena puncture (approx. US$7 each). Proceed to the lab to have your blood drawn.
After your initial blood work has been sent, you may need additional tests. You can go to CDL to have your blood drawn for $25. You should send the blood via Federal Express from Montreal. Send the package "International Priority" overnight. You will need a Styrofoam container and a cardboard box to protect the blood from heat or cold. You can get these for 50 cents each at
Styropac
5319 Cleroux
Laval
Tel: 334-1365
Call ahead and ask "Bill" for the Northern Telecom Styrofoam pack and cardboard box.
There are numerous places to have bloodtesting done across the US and Canada. If you are unsure where to have this done, contact the Beer Clinic in North Chicago for information or where to go.
To package your blood properly:
1-800-463-3339 with your FedEx waybill number
and ask to trace the package to be sure it arrived.
Pharmacy Lynn Blouin is the best infertility pharmacy in Montreal. Lynn is wonderful at providing the necessary medications and information. Also, her prices are the best in town. She is located in the strip mall attached to
50 Cremazie
on the corner of Boul. St. Laurent and the Metropolitan East at exit St-Laurent
Tel: (514) 389-1318.
Dr. Samir Kalife is an excellent choice,
3550 Cote des Neiges, suite 700
Tel: (514) 933-8877
For recurrent miscarriage and very high-risk pregnancies, I recommend
Dr. Alice Benjamin
Royal Victoria Hospital
Tel: (514) 843-2894.
