FAQ
This area has been developed to answer frequently asked questions. If you are unable to answer your questions from other areas of the Heartland website, you may find it here. If you have a question you'd like to see included in this section, please submit it to the email address and it may be posted at a later date. No questions will be answered via email. Please seek direct advice from your health care providers.
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Appointments
Do I need to have a referral to book an appointment?
Yes, in Manitoba, you need to have a referral from a family physician, specialist or allied healthcare professional, prior to booking an appointment with any specialist. If you require more information please call the clinic.Do I have to pay for the first consultation with an infertility specialist?
Generally no, the initial assessment for infertility is covered by your provincial health plan. If you are a resident outside of the country a consultation fee will be charged.Do you treat same sex couples at Heartland?
Yes.What is the age cut off for infertility treatment?
At Heartland, we recommend treatment commence before age 44 for IVF and prior to age 48 for Oocyte donation.I am in my 20's but unable to get pregnant. Is it too soon to see an infertility specialist?
No. If you have been trying for 6 - 12 months without success it is time to begin some investigations.How long does it take to get an appointment once a referral has been made?
Depending on the time of year, lab shut downs, whether you want to see a specific physician or first available specialist and if you have up to date lab results from your referring doctor affects when an appointment can be booked. Our goal is to book your appointment as soon as possible, once your referral has been received.Is there anything I can do to speed up the process of starting infertility treatments?
Speak to your family physician about obtaining the recommended investigations, as outlined on our website referral forms. Bringing these test results to your first consultation can be very beneficial if they have been done in the last 3 months.Do you treat out of province and out of country patients?
Yes. Out of province patients can seek care through their provincial health plans. We are able to treat out of country residents for IVF only.
Surgical Gynecology
Do you perform laparoscopic hysterectomies?
Yes, on suitable candidates. We perform both supracervical and total laparoscopic hysterectomies.What can I eat or drink prior to my surgery?
Your physician & doctor's assistant will provide all necessary information at your pre-operative assessment.What medications can I take the morning of my surgery?
The Pre-anaesthesia clinic nurse, at the hospital your surgery is booked at, will review your medications and advise you on which can be taken prior to your surgery. Please go to the pre-anaesthesia clinic with a complete list of all your current medications and questions.When can I return to work after surgery?
It depends on the procedure and variable recovery rates. Generally you can return to work 1 week from diagnostic laparoscopy/hysteroscopy, 1 -2 weeks after operative laparoscopy/hysteroscopy, between 2 - 4 weeks for laparoscopic hysterectomy/myomectomy and 6 - 8 weeks after traditional abdominal surgery.When can I travel after laparoscopic surgery?
On average, within 1 - 2 weeks.When can I drive after surgery?
It all depends on the type of surgery but generally within 1 - 4 weeks.When can I resume sexual activity?
Each procedure will vary. Minor surgical procedures are usually 1 - 2 weeks, major surgeries between 4 - 6 weeks. Consult your surgeon for their recommendations.When can I go to the gym after surgery?
Each procedure and individual varies; however, a general guideline is within 2 weeks for minor surgery and 4 - 6 weeks following major surgery. Consult with your physician prior to beginning strenuous activities.When can I take a bath?
Following a surgical procedure you can shower within 48 hours and bathe after 7 days.How soon can I use my hot tub or go swimming after my surgery?
If there is no outward sign of infection at your incision sites, then the average time is 2 - 3 weeks.When do I remove the bandages or steri-strips?
Surface bandages can be removed, under clean conditions, within 48 - 72 hours. Steri-strips can be removed within 7 - 10 days. If rash or blistering occurs, you may be allergic to the adhesive. Notify your physician as they may have to be removed sooner.When do stitches/staples come out?
Usually within 7 - 10 days.When do I start Lupron after endometriosis surgery?
Within 1 week.Women's Health
What is considered day 1 of my cycle?
Cycle day 1 is the first day of flow, not necessarily the heaviest flow. Spotting doesn't count.Who should be vaccinated with Gardasil (HPV vaccine)?
The target group recommended for vaccination is women between the ages of 12 - 26 years. In Manitoba, Gardasil is paid for by the provincial government for girls age 12 (grade 6 or 7). Contact your family physician, pediatrician or gynecologist to arrange for vaccination. 3 Vaccines are required within a 6 month time frame.How often do I need a PAP smear?
It is recommended that routine pap screening should occur every 12 - 18 months for women above 18 years of age, or sooner if sexually active.How do I manage break through bleeding on the birth control pill?
Initially it is recommended you stop the pill at the start of bleeding, for 7 days, to allow a proper withdrawal bleed. If bleeding continues, despite resumption of the pill, see your physician to discuss options.When should I have a mammogram and how often?
In Manitoba, regular screening is offered to women, beginning at 50 years of age. If you have a family history of breast cancer, a mammogram may be done earlier. All women should perform regular self breast exams and report any changes to their physician.Fertility Facts
When am I most fertile during my cycle?
Women, with a regular menstrual cycle, are most fertile between cycle days 10 - 20.At what age are women most fertile?
Women are most fertile when they are in their late teens and early 20's.How do I know if I'm infertile?
Infertility is the inability to conceive after 6-12 months of trying, if you have regular menstrual periods and are under 35 years of age. If you are 35 or older, have been trying to conceive for 3 - 6 months unsuccessfully, you should request a referral to an infertility specialist for further investigations.What are the most common causes of infertility?
Should I be taking folic acid?
Folic acid should be taken by women attempting pregnancy in either a regular multiple vitamin or as a supplement by itself at a minimum dose of 0.4mg - 1.0mg daily.Fertility Treatments
How quickly can we begin an IVF cycle?
The average time is 4 - 6 months, once confirmation or a diagnosis of infertility has been made. This time frame may vary slightly due to patient volumes and scheduled lab closures for quality assurance.Will drug plans cover the costs for the medications?
Some extended health plans do cover fertility medications. Check with your insurance companies about the DIN (drug identification number).Can we make any lifestyle changes prior to infertility treatment?
It is strongly recommended that both partners quit smoking as smoking is known to affect both sperm and egg quality and therefore ability to fertilize. It is also recommended that you maintain a healthy weight and body mass index. Reducing stress will improve your sense of well being and help you to cope with your difficulties in conceiving. Avoid excess caffeine, or other stimulants and abstain from alcohol consumption.Can I take herbs during an infertility treatment?
There are no studies to assess how herbal supplements may influence outcomes of infertility treatments; therefore it is recommended you stop all herbal supplements. Vitamins are OK to take. Persons attempting pregnancy should take a folic acid supplement.Can I exercise during treatment?
Regular, moderate exercise is beneficial to your overall health and to reduce stress. Strenuous physical activity, especially any new activity is not advised during treatment.Can we have sex during treatment?
If you are having a test where pregnancy could be negatively affected, such as an HSG, your physician may recommend not having sex or using condoms to prevent pregnancy if you do. During IVF treatment, once stimulation injections start, women may find intercourse uncomfortable as their ovaries can get quite enlarged. If you are pregnant, it is OK to resume sex unless you have any cramping or spotting. Often times, patients feel more comfortable with resuming sex after they have had their first early obstetrical ultrasound, around 6 - 8 weeks gestation.Is miscarriage more common after IVF than normal conception?
There are no significant differences in miscarriage rates between pregnancy achieved through IVF and conceiving naturally. The risk of miscarriage increases significantly with advancing maternal age, whether conceived naturally or through IVF.What side effects can be expected on the IVF medication?
As the ovaries are stimulated, they become enlarged and there may be some pelvic and abdominal bloating. Some women also experience minor mood changes, headaches or nausea, although these are uncommon.What do I do if my cycle is unsuccessful?
If your cycle is unsuccessful a return appointment with your Primary Care Physician will be arranged through the nurses to review your cycle, make any changes and discuss other options.Is there a difference in the success rates between fresh or frozen embryos?
Yes. Women are twice as likely to conceive following fresh embryo transfer. Not all embryos are suitable for freezing, or survive the thawing process; however, success of pregnancy from frozen embryos has been steadily improving over the years.How long can embryos be frozen?
As long as they are maintained in liquid nitrogen they can be frozen indefinitely.How long do I have to rest after an embryo transfer?
After your embryo transfer you will be able to leave the clinic in less than an hour. In the first 24 hours you should rest and limit strenuous activity, but do not require strict bed rest. Implantation of the embryo occurs within the first 3 - 4 days of transfer. Maintaining light activities for the first week is recommended.How common are multiple pregnancies with IVF?
Multiple pregnancies occur in about 20% of IVF cycles. In women under 37 years of age only 2 embryos are recommended for transfer, in women who are older, up to 3 embryos could be transferred. These guidelines limit the risk of high order multiple pregnancy.Is artificial insemination painful?
Occasionally cramping can be felt during this procedure, but generally it is not painful.Is donor sperm safe?
Yes. The donor sperm has to meet rigorous screening criteria as set forth by Health Canada.