Montreal Nurses Education Day
September 12, 2018
270 Saint-Antoine St W
Montreal, QC H2Y 0A3
Fertility Nurse Dilemmas and Controversies – Providing the Answers
The Nursing Special Interest Group of the CFAS presents a one-day interactive educational event focused on relevant dilemmas and controversies such as male sexual dysfunction, unexplained infertility, research, medications and protocols, setting patient expectations, the ethics of cultural diversity, and the role of fertility agencies.
We hope fertility nurses and all other interested disciplines will join us on September 12th, one day prior to the CFAS Annual Meeting in the beautiful city of Montreal. The day will start at 10am with enough time for morning flights, and we will finish the evening off with a sponsored cocktail hour and presentation of the Carole Rheaume Recognition Award intended to recognize and honour a nurse responsible for enhancing the patient experience, enhancing clinical practice and engaging the general public.
- Learn about patient expectations, personal boundary setting, and ethical management of our culturally diverse patient populations.
- Acquire new knowledge in male fertility evaluation, sexual dysfunction, acupuncture, nutrition and fertility lifestyle changes.
- Understand the roles of patient driven supports including fertility agencies and complementary medicine.
- Discuss research, fertility medications, protocols and the ‘unexplained infertility’ diagnosis to better counsel and support patients in their fertility journeys.
Mix & Mingle, Sign In
Registered Nurse in good standing with the Ontario College of Nurses since January 1999; and a mom of 3 grown children.
With over 15 years of experience with a primary focus on women’s reproductive health; I have worked in all roles of the reproductive nurse; from scrub, sedation, cycle monitoring, third party reproduction as well as nurse manager.
My focus has always been to support the patient as well as be a resource to my fellow colleagues by attending medical and nursing conferences offered by Canadian Fertility Andrology Society (CFAS) and the American Society of Reproductive Medicine (ASRM) and I have always encouraged nursing education through lunch and learns within the clinical setting. I also enjoy raising awareness for reproductive health within the community through volunteer opportunities such as Toronto Pride parade, and have represented previous fertility clinics as a speaker within the LGBTQ community. My goal is to provide compassionate, knowledgeable care to all patients and I am dedicated to providing a remarkable level of care.
Fertility Medications; Protocols & the Importance of the Fertility Nurse
This presentation will review the menstrual cycle and the various medications and protocols implemented when proceeding with Assisted Reproductive Technologies. Protocols discussed will be specific to the various diagnosis of poor responder/premature ovarian failure, advanced maternal age & PCOS.
The importance and clinical expectations of the Fertility Nurse will also be addressed with regards to supporting the patient (client) on their reproductive journey.
- At the end of this presentation attendees will be able to: discuss among fellow colleagues the benefit(s) of a specific protocol for a specific patient type.
- Demonstrate an understanding of the types of protocols used
- Understand the rationale of the various protocols used for specific patients
Dr. Peter Chan is Professor of Surgery and the Director of Male Reproductive Medicine at the McGill University Health Center. He received numerous national and international recognitions in his research. He has been serving as Principal and Co-Principal investigator for more than ten research grants funded by the Canadian Institutes of Health Research (CIHR). He is Past President of the Society of Reproductive Surgeon of the American Society of Reproductive Medicine. He is a four-time recipient of the Everett C. Reid Award of Excellence in Teaching in Urology at McGill University. Dr. Chan has published over 80 professional journal articles, book chapters and videos. He is the senior editor of a textbook entitled “Reproductive Medicine Secrets” and the second edition of “The Andrology Handbook” published by the American Society of Andrology. He is also featured in “Doctorology”, a television documentary produced by the Discovery Channel on the various medical subspecialties.
Male Sexual Dysfunction Among Couples Undergoing Fertility Treatment
While virtually all cultures and societies place fertility as a role of the female gender, various studies have clearly indicated the importance of male factor infertility in contributing to the etiologies of reproductive failure in a couple. Besides subnormal semen parameters, men with infertility may have additional symptoms of testicular dysfunction including hypogonadism and erectile dysfunction. Additionally, reproductive failure increases stress and anxiety to the couples and may further compromise their sexual relationship which in turn may affect their success in achieving pregnancy. With the introduction of various medical therapies for erectile dysfunction in men since the late 1990’s, sexual medicine has been considered one of the fastest growing field in urology. The latest development on the diagnosis, therapies and other management strategies of erectile dysfunction will be the focus of this presentation. Clinicians in reproductive medicine should be informed of these diagnostic and management options to provide their clients appropriate counseling to improve their sexual health and success in reproduction.
- Outline the prevalence and types of male sexual dysfunction experienced by couples undergoing fertility management.
- Identify the risk factors contributing to sexual dysfunction in men.
- Discuss the various management strategies to enhance male sexual function.
Liz is a cancer survivor, the Founder of Fertile Future, Co-Founder of Fertility Match and most importantly, the mother to beautiful daughter born through Egg Donation and Surrogacy.
After being diagnosed with cancer at 24 and realizing that young cancer patients needed fertility preservation education and funding, she founded Fertile Future. When she decided to pursue having a child via egg donation and surrogacy, the journey had many challenges: “Having a child was actually far more stressful than having cancer. I started to think about starting an agency in Canada known for making the journey of Egg Donation and/or Surrogacy a positive and exciting for clients, rather than stressful”.
Liz met Lisa during this time and the two became instant friends. Both had a strong vision of what a Canadian agency should deliver to all parties: Respect, Support, Trust and Integrity. Liz feels incredibly blessed to have the privilege to work with Intended Parents, Surrogates, Egg Donors and the industry professionals she has had the honour to learn from over the past 12 years.
From a young age, Lisa was taught how positivity and paying-it-forward was the way you should live life. She watched her aunt struggle with infertility and pregnancy loss. The pain she saw another experience impacted her greatly. When she learned about surrogacy as a teenager, Lisa knew instantly it was something she could do for a couple struggling to conceive.
A mom to 4 children of her own, Lisa loved being pregnant and realized that surrogacy was something she could do to help other families become a reality. She feels honoured to have helped complete two families, giving birth to twins in 2012 and 2015.
Lisa met Liz Ellwood during this time who was going through her own journey as an Intended Parent. They became friends and helped each other better understand the perspective of the Surrogates and Intended Parents. Lisa feels incredibly blessed to have the privilege to work with amazing Intended Parents, Surrogates, Egg Donors and of course the industry professionals as she helps to be the change in Third Party Reproduction.
Third Party Agencies – Navigating Egg Donation and Surrogacy in Canada
Our talk will give an overview of how an agency is able to work within current Canadian legal framework governing 3rd party reproduction and how partnering with an ethical and transparent agency can improve the Egg Donation and/or Surrogacy experience for clinicians as well as Intended Parent(s), Donors and Surrogates.
- Gain a better understanding of how an agency can operate within Canada’s legal framework in order to assist Intended Parent(s) who require Egg Donation and/or Surrogacy to build their family
- Acquire a clear picture the vital functions an Egg Donation and Surrogacy agency in Canada fulfills when working in partnership with Fertility Centres
- Improved knowledge about the potential benefits for all parties involved in 3rd party reproduction (Donors, Surrogates and Intended Parent
Dara Roth Edney works with people experiencing infertility or seeking treatment due to sexual orientation, gender identity or relationship status. As a Reproductive Counsellor, she supports those dealing with infertility and loss, provides decision-making guidance and effective coping strategies, as well as conducts assessments and counselling for gamete donors, surrogates and Intended Parents. She holds a Master’s degree in Social Work (MSW) from the University of Toronto and Bachelors’ Degrees from York (BSW) and McGill (BA) Universities. She is a Registered Social Worker with the Ontario College of Social Workers (RSW), a member of the Canadian Fertility and Andrology Society and the Canadian Counselling Special Interest Group, as well as the American Society for Reproductive Medicine. Dara works closely with professional and community organizations, is a regularly invited speaker at conferences and workshops, provides ongoing government consultations and is involved in industry research. Based in Toronto, Dara works closely with clinics from across Canada and with patients from around the world. She is dedicated to a practice that is inclusive, empathetic, personalized and helpful.
Setting Expectations and Building Boundaries
In this interactive workshop presentation by Reproductive Counsellor, Dara Roth Edney, MSW, RSW, participants will gain a better understanding of their own workplace expectations and how these, along with the expectations of others impact their daily work life. Working individually and in small groups, current clinic practices around defining expectations and setting boundaries will be explored. Together with colleagues from across Canada, participants will have the opportunity to better understand their own responses to situations and develop concrete practices for establishing boundaries, with the support of colleagues. And in doing so, broaden perspective on ways in which they can have greater success in managing patient expectations and behaviours.
- Identify personal, workplace and patient expectations
- Develop effective strategies for (re)defining reasonable expectations
- Apply concrete practices for establishing and maintaining boundaries
Mary Wong is the founder of ALIVE Holistic Health Clinic, author of the book Pathways To Pregnancy, a Certified High Performance coach, and a Traditional Chinese Medicine practitioner with over 25 years of experience. She has helped countless women and couples overcome infertility. As a patient who struggled with fertility challenges, Mary’s personal experience has fostered compassion and a deep respect for the women who come to her for help. Through her expertise, guidance, and mission, Mary strives to improve patients’ fertility and overall health while bridging the gap between Eastern and Western medicine.
She is a member of Canadian Fertility and Andrology Society and sat on the Ontario government’s appointed expert panel for Infertility and Adoption. The report of this panel laid the groundwork for IVF funding in Ontario.
Mary is a sought out speaker on Fertility for Health Care Professionals and has appeared on radio, television and magazines including CTV, The Toronto Star, and Talks at Google where “the world’s most influential thinkers, creators, makers and doers” speak.
Patient Centred Care- Offering Hope and Support
Most fertility clinics across Canada espouses the importance in a patient centred approach to care.
This means providing care that is respectful of and responsive to individual patient needs and where all clinical decisions are guided by patient values.
The aim of this presentation is to allow you to gain a better understanding in two aspects of patient centred care:
- Why and how Complementary and integrative medicine (CIM) services are patient driven. The controversies and dilemmas in support of CIM, specifically acupuncture, will be discussed.
- Advanced interpersonal communication skills and the impact of the “nocebo effect” will be identified.
- Understand and recognize the demand in Complementary and Integrative Medicine in fertility
- Acquire new knowledge in fertility acupuncture, lifestyle and dietary changes for patients
- Discuss advanced interpersonal skills to improve patient experience, overall satisfaction, and retention rates
Kelly began her nursing career in Labour and Delivery 20 years ago before moving into the field of fertility in 2004 with the former UBC Centre for Reproductive Care in Vancouver. She went on to work with the teams at Genesis and Olive for the next 10 years before moving back to Ontario and joining the team at ONE Fertility. Kelly is also a part time faculty member in the School of Nursing at Western University and a PhD Candidate at the University of BC where she is looking to better understand the ways the digital age impacts women’s experience of infertility and their decision making regarding fertility treatments. Kelly is also the proud mom of 4.
Research for Fertility Nurses – It is possible
Overview of steps in clinical research will be reviewed beginning formulation of research questions through to identifying venues for dissemination.
We will discuss how to rally support for nursing research and
how to carve out time for research in your clinical role.
- Participants will be be able to identify research questions in their clinical setting.
- Participants will be able to describe the steps in the research process including how to access support.
- Participants will be able to identify strategies for develop research projects in their clinical setting.
Angel Petropanagos is the Quality Improvement Ethicist at William Osler Health System in Ontario. She the Co-Chair for the Canadian Fertility and Andrology Society’s Ethics and Law Special Interest Group, a board member of the Canadian Bioethics Society, and also the Co-Managing Editor of Impact Ethics (www.impactethics.ca). In 2013, Angel received her Ph.D. in philosophy from Western University, with specializations in bioethics and feminist theory. She then completed a postdoctoral fellowship in bioethics at Novel Tech Ethics, in the Faculty of Medicine at Dalhousie University and a clinical ethics residency at William Osler Health System. As a clinical and organizational ethicist, Angel adopts an Ethics Quality Improvement approach, which seeks to address common, systemic ethical issues in a systematic and measurable way. As a researcher, Angel is most interested in the ethics of fertility preservation, third party reproduction, and emerging technologies. She regularly contributes to the review and development of policy and guideline documents and provides freelance ethics consultation and research support. @APetropanagos
The Ethics of Fertility Patient Cultural Diversity
The demographics of patients in Canadian fertility clinics is changing. Increasingly, patients seeking fertility treatments are diverse with retrospect to race, ethnicity, religion, gender, sexual identity and orientation, (dis)ability, and socioeconomic status. Understanding and managing diversity, while seeking an equitable and inclusive healthcare/ work environment can be difficult. In this presentation, I outline the key ethical components of diversity, equity, and inclusion in healthcare and summarize common challenges and opportunities for improvement. I offer several practical, evidence-based strategies for building and sustaining positive and inclusive patient/ staff experiences within the clinic.
- Describe the differences between diversity, equity, and inclusion
- Identify the key ethical components of health diversity, equity, and inclusion within the fertility clinic setting
- Understand and apply strategies for supporting the ethical provision of fertility services to diverse patients within your clinic setting
Dr. Neal Mahutte is the Medical Director of the Montreal Fertility Centre. Dr. Mahutte did his undergraduate at Stanford University, medical school plus OB/GYN residency at McGill University and REI fellowship at Yale University. From 2003 to 2007 he was on the faculty at Dartmouth. Dr. Mahutte is board certified in both the United States and Canada, and served as the President of the Canadian Fertility and Andrology Society from 2014-2015. He is currently Chair of the Clinical Practice Guideline Committee for the CFAS, and serves on the REI Practice Committee for the Quebec College of Physicians. In his free time Dr. Mahutte enjoys playing tennis, spending time with his wife and 5 children and kidding around with friends and colleagues.
Unexplained infertility is most commonly defined as the presence of normal ovulatory function, a normal semen analysis and at least one patent fallopian tube. Based only on these 3 simple criteria it is estimated that 30-50% of infertile couples have “unexplained infertility.”
In clinical practice, however, we recognize the limitations of this diagnostic evaluation. Age, ovarian reserve, oocyte quality, endometriosis, uterine factors, cervical mucous factors, tubal dysfunction, immunological factors, genetic factors, coital difficulties, other male factors and failed fertilization all may contribute to infertility. Unfortunately, these factors are not necessarily excluded in the majority of published studies of unexplained infertility.
Natural per cycle conception rates decline as the number of failed attempts at conception increase. In young couples the monthly conception rate is 30% in the first 2 months, but declines to 8% after 6 months and 4% after 9-12 months. Nevertheless, cumulative pregnancy rates even with low monthly conception rates can be encouraging.
The management of unexplained infertility is typically empiric with consideration of the efficacy, safety, cost, and risks of each treatment option. Historically, a step-wise progression in treatment has been initiated with the least invasive, least expensive option followed by a gradual progression to assisted reproductive therapies if the initial treatments fail.
The aim of this talk is to provide evidence-based recommendations on the management of unexplained infertility including expectant management, surgical intervention (laparoscopy), intrauterine insemination (IUI), controlled ovarian stimulation with oral agents or gonadotropins, and in-vitro fertilization with and without ICSI.
- To understand the definition of “unexplained infertility”
- To understand the impact of age and duration of infertility on monthly conception rates
- To be able to apply evidence based strategies in the management of couples with unexplained infertility
Join us for a cocktail reception where we will award the winner of this year’s Carole Rheaume Award,
About the award:
Carole Rhéaume RN was an exemplary fertility nurse who worked at Ovo Clinic based in Montreal. Carole was a tireless patient advocate, a caring nurse and a true leader. She was also an active member of CFAS including both its Nursing and Admin Special Interest Groups. Carole spearheaded numerous initiatives to improve patient care and access to care. In that role she actively collaborated with the Association of Infertile Couples of Quebec and helped organize activities to promote infertility awareness. Unfortunately, Carole was tragically killed in the winter of 2015 when she stopped her car on the side of the road to help another motorist who had veered off track.
This award seeks to acknowledge and commemorate Carole’s passion for, and contribution to patients with infertility.
Description of the Award
The Carole Rhéaume Award comprises of a sponsorship of up to $2,500 CAD for a registered nurse to attend an international conference in reproductive medicine in the 18 months following receipt of the award.
Supported by a restricted fund provided by EMD Serono Canada