Infertility Treatment: Getting Started and Knowing Where to Start

Infertility can feel overwhelming. If you've been trying to conceive without success, you are not alone. According to the World Health Organization (WHO), approximately 1 in 6 people worldwide experience infertility during their lifetime. For many individuals and couples in Ontario, understanding when to seek help and what treatment options are available is the first step toward building a family. Many people can experience this in their first experience trying to get pregnant and many experience secondary infertility. 

The good news is that advances in reproductive medicine have made fertility care more accessible than ever. In Ontario specifically there are more and more infertility clinics that have successful protocols and treatments. Additionally, in Ontario our governmen also offers publicly funded fertility programs that may help reduce some of the financial burden associated with treatment.  

What Is Infertility?

Infertility is generally defined as the inability to become pregnant after:

• 12 months of regular, unprotected intercourse if the woman is under 35 years old.

• 6 months if the woman is 35 years of age or older.

Infertility can affect anyone regardless of age, relationship status, gender identity, or sexual orientation. It may involve female factors, male factors, a combination of both, strong bacterial infections undiagnosed in the uterus, or unexplained infertility after testing.

Deciding on A Fertility Specialist and Clinic

Making the choice to seek out fertility clinics can be a daunting task. It requires a lot of research for couples to determine what is the best site for proper care and what protocols work best. Not every clinic will perform in the same way. In fact, Fertility Clinics are unregulated in Canada meaning, there is no one way or formally approved standardized treatment. Each and every fertility clinic is contributing to research, using their own methods in practice, their own approaches, and how they choose to work with a patient is different across each clinic. 

I highly recommend watching this quick video clip of what you should do before booking an appointment and doing your research. 

There have been so many instances where some clinics do not have proper policies and procedures increasing the risk of harm to the intended parents and increasing the risk of medical trauma and harm to the body. 

Asking Questions Helps You in the Long Run!

Some questions you should consider asking much like the video above are:

1. How do you handle the embryoes and care in the clinic?

This question is important because some clinics can be crowded, feel rushed, and may have accidents on site. If you get a sense that the environment is pressured and fast paced they may make more mistakes.

2. Who does the testing and where does that occur?

Some clinics will not do on-site testing and sometimes they house the embryoes off-site. Knowing where your biological embryoes and matter are matters. Where things are defrosted and thawed also is important to know for handling and care.

3. What are your views on retrievals and transfers and what is the process? 

This seems like an obvious question but its good to know all the steps. If it sounds logical and makes sense to you and feels good then its a good fit. But sometimes clinics will do things out of order or skip vital steps important to you and will dismiss your concerns. Please be sure you feel comfortable walking those steps and the team you are working with. You can always stop in the beginning before the retrievals and transfers if you feel uncertain or unsafe.

4. What medical investigations are needed prior to starting the process? 

This is a MUST ask question. Some clinics are skipping the basic bloodwork, hormonal evaluation testing, and basic reproductive care and jumping straight into retrieval and transfers. Many clinics are having an investigate after the first cycle and transfer. Which means a high rate of failure and a lot of prevention could be had prior to if properly managed and cared for. 

These are some of the questions that are going to help you make the most informed choices before spending your money. 

It can be helpful to write out your questions first to support you and prepare you. If you feel rushed or pressured take the time you need. This treatment and space is for you not for the doctor. Compassion matters when tending to your care and going through this challenging journey. Take the time you need. 

Your First Fertility Consultation: What to Expect

Your first appointment should be focused on understanding your medical history and developing a personalized fertility plan. Some clinics do not do this as a due diligience. It is your right as a patient to advocate and ensure the doctor and healthcare team you are working with understand the following information. 

• Medical and reproductive history
• Previous pregnancies, abortions, or miscarriages/losses
• Menstrual cycle history
• Lifestyle factors
• Current medications
• Family medical history
• Any chronic or illnesses in the past (PMDD, endometriosis, or polyendocrine metabolic ovarian syndrome PMOS) etc. 
• Physical and reproductive health status 

Both partners are usually evaluated, as male factors contribute to approximately 40–50% of infertility cases.

Common Fertility Tests

Your physician may recommend several diagnostic tests, including:

Blood Testing

Hormone testing helps evaluate ovarian reserve, ovulation, thyroid function, and reproductive hormones.

Ultrasound

A pelvic ultrasound assesses the uterus, ovaries, and antral follicle count.

Semen Analysis

A semen analysis evaluates sperm count, motility, morphology, and overall sperm health.

Tubal Assessment

Tests such as a hysterosalpingogram (HSG) determine whether the fallopian tubes are open and functioning normally.

These investigations allow your fertility team to identify the most appropriate treatment plan.

Fertility Treatment Options

Treatment depends on the underlying cause of infertility, age, reproductive goals, and personal preferences.

Lifestyle Modifications

For some patients, improving nutrition, maintaining a healthy weight, reducing alcohol consumption, quitting smoking, and managing stress may improve fertility outcomes.

Mental Health and Therapy 

Walking the infertility journey is emotionally, physically and mentally taxing. The clinics doing it right recommend you speak to a therapist specializing in infertility. Supporting your stress, anxiety, supporting in advocating for care, and decision-making skills are hard to do when you are grieving and wanting this to work. We can help here at Mindful Steps Therapy and specialize and focus in this area. Many women are finding success when they are able to heal both physically and emotionally no matter the treatment outcome. 

Ovulation Induction

Medications such as letrozole or clomiphene citrate can stimulate ovulation in individuals who do not ovulate regularly.

Intrauterine Insemination (IUI)

IUI involves placing specially prepared sperm directly into the uterus around the time of ovulation. It is commonly recommended for:

• Mild male factor infertility

• Unexplained infertility

• Single parents by choice

• Same-sex female couples using donor sperm

In Vitro Fertilization (IVF)

IVF is one of the most effective fertility treatments available.

The process generally includes:

1. Ovarian stimulation with fertility medications

2. Egg retrieval

3. Fertilization in the laboratory

4. Embryo development

5. Embryo transfer into the uterus

Additional services such as embryo freezing, preimplantation genetic testing (PGT), and donor eggs or sperm may also be considered depending on individual circumstances.

Ontario Fertility Program

Ontario offers publicly funded fertility treatment for eligible residents through participating fertility clinics.

Depending on eligibility, funding may include:

• One publicly funded IVF cycle (for eligible patients under age 43)

• Unlimited funded IUI and artificial insemination cycles when medically appropriate

• Fertility preservation for qualifying medical conditions

Patients must have a valid Ontario health card and meet eligibility requirements. Medication costs, embryo storage, and certain laboratory services are generally not covered and may require private payment or insurance coverage.

 

Emotional Well-Being Matters

Infertility affects far more than physical health. It can impact emotional well-being, relationships, careers, and finances.

Seeking support through counsellors, fertility support groups, family, and friends can help patients cope with the emotional challenges of treatment. Many fertility clinics include mental health professionals as part of their multidisciplinary care teams.

Remember that asking for support is a sign of strength—not weakness.

Looking Ahead

Beginning fertility treatment may feel intimidating, but you do not have to navigate the journey alone.

A consultation with a fertility specialist can provide answers, identify any underlying concerns, and help you understand the treatment options available. Whether your path includes lifestyle changes, IUI, IVF, or fertility preservation, early assessment allows you to make informed decisions about your reproductive health.

Every fertility journey is unique. With compassionate care, evidence-based treatment, and the resources available through Ontario's fertility programs, many individuals and families are able to take meaningful steps toward achieving their dream of parenthood.

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Research and Evidence

The information in this article is supported by current research and clinical guidelines, including:

1. Government of Ontario. Ontario Fertility Program — eligibility, funded IVF, IUI, fertility preservation, and participating clinics.

2. World Health Organization (WHO). Infertility Fact Sheet. Approximately one in six adults experience infertility worldwide.

3. American Society for Reproductive Medicine (ASRM). Practice Committee Guidelines on infertility evaluation and treatment.

4. European Society of Human Reproduction and Embryology (ESHRE). Guideline on the management of infertility.

5. Zwingerman R, et al. The Impact of Government Funded IVF on the Use of ICSI in Non-male Factor Infertility. Journal of Obstetrics and Gynaecology Canada (2026). The study found that increased use of ICSI in Ontario did not improve cumulative live birth rates for non-male factor infertility, supporting more evidence-based use of IVF laboratory techniques.