If you are having trouble conceiving baby number two or three, you are not alone. Many women are shocked to find that they can’t get pregnant with a subsequent baby when they had no problem conceiving their first child.

Secondary infertility is defined as the inability to get pregnant following any prior pregnancy or the birth of one or more children. This condition is much more common than most people think. At Olive Fertility, 30 percent of the patients we see are experiencing secondary infertility and according to the Center for Disease Control, it affects approximately 12 percent of women trying to conceive a second child.

Along with the rollercoaster of trying to conceive, the social isolation can be particularly painful for women with secondary infertility. Couples or single parents shouldn’t give up hope. There are several different treatment options, and the good news is: if you’ve had one child, your chances of success with fertility treatments are higher than if you have never had a child.

When should you talk to a doctor?

The most important message is to get your fertility checked sooner rather than later, as age is the number one reason for fertility issues. Talk to a family doctor and get referral to a fertility specialist if:

• You have been trying for four to six months.

• You have a history of Polycystic Ovary Syndrome (PCOS), pelvic inflammatory disease, painful periods, miscarriage, endometriosis, ectopic pregnancy, difficult caesarian section and/or irregular cycles.

• Your partner has a low sperm count

Causes of secondary infertility

Many things can change after the first pregnancy, including the age of the parents, weight and even scarring that can be the result of an ectopic pregnancy, infection or a caesarian section.

Factors that can contribute to secondary infertility in women and men include:

• Advanced maternal age (age 35 and older)

• Impaired sperm production or low sperm count

• Damaged fallopian tubes

• Endometriosis

• Uterine conditions

• PCOS

• Weight gain in both men and women

• Lifestyle factors including smoking, marijuana use and heavy alcohol use

• Certain medications

Finally, secondary infertility—just like primary infertility—can be diagnosed as unexplained. As many as 50 percent of cases of secondary infertility are identified as unexplained.

Treatment options

The first step is to have a complete fertility workup to try and identify the underlying cause. Your fertility specialist will go over the results of your tests with you and discuss an appropriate treatment plan.

Treatments for secondary infertility are like those offered for primary infertility which include:

• Superovulation, where you take oral or injectable fertility medications, to stimulate your ovaries to produce multiple eggs increasing the chance of fertilization.

• Intrauterine insemination (IUI), during which sperm is placed inside the uterus to promote fertilization. IUI can increase the number of sperm that reach the fallopian tubes, which increases the likelihood of successful fertilization.

• In vitro fertilization (IVF), which involves combining egg and sperm outside the body and then transferring an embryo back into the uterus.

Advances in technology increase IVF success

The chances of having chromosomally abnormal eggs increases significantly in women over 35 and is one of primary reasons for IVF failure. But advances in Assisted Reproductive Technology are increasing the success rates of IVF.

A test called Preimplantation Genetic Testing for Aneuploid (PGT-A), allows us to screen the IVF embryos for chromosome imbalances and determine which ones are the most likely to result in a successful pregnancy.

Studies have shown that IVF with PGT-A can achieve:

• Implantation rates of 70 percent

• Miscarriage rates as low as 10 percent

• A low risk of chromosomal problems such as Down syndrome (diagnostic accuracy is about 98 percent)

In British Columbia, consultation with a fertility specialist and most fertility testing and surgery is fully covered by MSP with a referral from your family doctor or a doctor at a walk-in clinic. IVF funding may also be available depending on family income.

Each year, thousands of Island families must leave home for health care. In Nanaimo, the nearest hotel is over two kilometers from the hospital. Mothers in early labour from Ucluelet face a 2.5-hour drive, while families from Port Hardy travel 388 kilometres.

Jesse’s House in Nanaimo will bring families closer to care, removing a major barrier to vital health services.

Children’s Health Foundation of Vancouver Island recently announced a $10-million fundraising campaign to build a home away from home for Island families travelling to Nanaimo for their child’s health care. The announcement was made at a special groundbreaking ceremony held at the future site of the home on the Nanaimo Regional General Hospital campus on October 8.

The 16-bedroom facility, named Jesse’s House, will welcome families from across Vancouver Island and the surrounding islands who need a place to stay while accessing Nanaimo Regional General Hospital and nearby health care services. Construction is estimated to be complete by spring 2027.

Jesse’s House is named after Nanaimo resident Sheri Shanahan’s daughter, the late Jesse Shanahan. Sheri has been an important partner and champion for a home away from home in Nanaimo ever since she stayed at Jeneece Place while Jesse was admitted to the neonatal intensive care unit at Victoria General Hospital.

“When my family stayed at Jeneece Place, it gave us comfort during one of the hardest times of our lives,” said Shanahan.

“I am so excited to have worked alongside Children’s Health Foundation of Vancouver Island to bring the vision of Jesse’s House to life. This home away from home will have a huge impact on the lives of Island families, providing a safe, warm place where they can receive the same support that meant so much to us, and be just steps away from their child.”

Jesse’s House will be the third home in the Foundation’s Homes Away From Home program, with others in Victoria and Campbell River. Jeneece Place was established in 2012, after Jeneece Edroff (now known as Frankie) asked the community to rally behind the development of a home for families to stay while their children received health care in Victoria. In 2021, together with families, health care providers and community groups from northern Vancouver Island, the Foundation expanded the model to open a second home in Campbell River called Q’walayu House.

“It’s wonderful to see the Foundation expand into Nanaimo to support families north of the Malahat who need to travel to access care for their kids,” says Paul Murray, board chair of Children’s Health Foundation of Vancouver Island.

“Jesse’s House will have such a large impact for generations to come, and we are excited to work alongside the community to bring it to life.”

To date, the Foundation has generated $7 million for the project through assurances from the community, including Coastal Community Credit Union, Budget, the Rogers Foundation and an anonymous donor who stepped forward with an astounding $2 million core funding gift.

“The Nanaimo community has stepped up in such a big way to meet the growing demand for a mid-Island home away from home,” said Veronica Carroll, CEO of Children’s Health Foundation of Vancouver Island.

“With no government funding for this project, every bedroom, shared space and moment of support this home provides to families will be thanks to the generosity and foresight of people in this community. It is truly inspiring.”

Through a collaborative agreement with Vancouver Island Health Authority (VIHA), the Foundation has been granted a 40-year lease for a parcel of land on the Nanaimo Regional General Hospital campus.

“Jesse’s House will provide much-needed comforts of home and familiarity during very difficult times for families,” said Leah Hollins, Island Health board chair.

“We are so thankful to Children’s Health Foundation of Vancouver Island for their support of families, and to Jesse’s mom, Sheri, for creating such a powerful legacy from her own personal hardship. Jesse’s House will take the worry of accommodations away so families can focus their energy on their loved ones receiving care.”

The project’s lead architect is Alan Lowe, who also designed the Foundation’s two other homes, Jeneece Place and Q’walayu House. Tectonica Management Inc. of Nanaimo is the project’s construction manager.

Children’s Health Foundation of Vancouver Island is working with a dedicated committee and dozens of community partners to help make this dream a reality.

Learn more and donate at islandkidsfirst.com.

The Province of British Columbia launched a publicly funded in-vitro fertilization (IVF) program in July.

As of July 2, eligible BC residents have access to one-time funding of up to $19,000 toward the cost of a single standard IVF cycle, including treatment and medications.

“Knowing that the government is stepping in to help with funding makes a world of difference,” says Rachelle Pastilha, an IVF patient in BC who was diagnosed in 2008 with endometriosis.

“It brings real hope—not just for us, but for so many others out there who are going through the same thing. So, thank you, from the bottom of my heart. This means more than words can say—for my family, and for countless others.”

Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. According to a recent report from the World Health Organization, one in six people globally are affected by infertility over the duration of their reproductive lives. IVF is a fertility treatment that includes a complex set of procedures that can lead to a pregnancy. IVF costs an average of $20,000 per round and many people need two to three rounds to be successful.

“For people needing to access IVF care to start a family, the costs can make it simply out of reach,” says Josie Osborne, BC Minister of Health.

“Being able to have a child shouldn’t depend on how much money you make. That’s why today we are launching BC’s first-ever, publicly funded IVF program that will ensure more people can access this life-changing treatment and bring hope to thousands of British Columbians on their path to parenthood.”

Fertility clinics that are participating in the publicly funded fertility program will submit applications on behalf of their patients to the Ministry of Health. Applications will be reviewed in the order they are received, with provincial funding provided directly to a patient’s fertility clinics to limit up-front costs. BC will deliver the program through Olive Fertility Centre, Pacific Centre for Reproductive Medicine and Grace Fertility and Reproductive Medicine.

“This is a monumental moment for individuals and couples struggling with infertility, who dream of starting or growing their families but rely on advanced fertility services,” says Niamh Tallon, clinical medical director at Olive Fertility Clinic.

“The BC government’s new funding initiative acknowledges the significant financial barriers many face. By addressing these challenges, this program is a critical step toward ensuring more equitable access to fertility care, aligning BC with other provinces that have already embraced similar measures.”

Funding amounts will be based on household income. Households with a pre-tax income of $100,000 or less will be eligible for the full $19,000, with benefits phasing out for households earning more than $250,000. The Province estimates that the program will fund between 1,100 and 4,500 IVF cycles, with the funding available this fiscal year.

Laura Spencer, certified fertility coach, says she was elated to hear that public IVF coverage was finally coming to BC, but was disappointed to learn that coverage is tied to income and not medical need.

“I feel equal parts joy for the people who are fully covered with the $19,000, and heartache for those who are ineligible due to income, age or the long wait times,” she adds.

“IVF isn’t a luxury; it should be considered the same as any other medical treatment.”

To be eligible for the program, individuals must be at least 18 years of age, 41 years of age or younger at the time of application and enrolled in the Medical Services Plan.

Learn more about the IVF program at gov.bc.ca/gov/content/health/ accessing-health-care/publicly- funded-ivf-program.

Island Health Youth Clinics offer free confidential, youth-focused care including mental health support, STI testing, birth control, harm reduction services and more by on-site nurses and a variety of other health professionals (no MSP or appointment required). These clinics are open to teens and young adults across Vancouver Island. islandhealth.ca

Did you send your kids back to school? That’s the question we asked four Island Parent writers. Here are their answers and how they reached their decision on whether or not to send their kids back to school.

Throughout the summer, every time I chatted with one of my girlfriends, the same question kept popping up: Are you sending your kids back to school?

We couldn’t escape the discussion—it was all over social media and the news. Yet despite all the exposure, no clear answer emerged. It seemed like you were “damned if you do, damned if you don’t.”

No matter what your decision, I commend your parenting and your choice. I chose to send my children back to school and here’s why.

1. Much of the research says this pandemic is not going away any time soon. If we are waiting for a vaccine, it may be a very long wait. So instead of wishing for the way things were, we need to learn how to function with the way things are.

Truthfully, there are so many reasons to keep our children home from school: they could be hurt, they could be bullied, they could be accosted by a stranger while walking to school, there could be an earthquake, there could be lice, measles, runny noses… The list goes on and on.

As parents, our natural instincts tell us to protect our babies at all cost. Despite this, we cannot live fully, being afraid. And I don’t want to make decisions based in fear.

Yes, I am scared that my children may become ill. I am also afraid of all the other items on my list, yet I choose to push through my anxiety so that my children can see what it looks like to be brave, refusing to let fear hold us back from experiencing a full life.

2. I was a teacher for 15 years and I know that school staff is doing everything to keep our children safe. Teachers love our children and will protect them to the best of their ability. They will diligently remind them to wash their hands, keep their distance, and wear their face masks. I trust our teachers. I also know that they, too, are afraid. They feel pressure. Some feel unsupported. Some feel criticized for decisions over which they have had no control. They, truly, are in this with our children, for better or for worse.

3. I trust my children. Granted, at 11 and 14 years old, they are able to understand the expectations and the reasons behind all of the precautions. I have taught them how to wash their hands properly and supplied them with hand sanitizer and face masks. I need to let go of control and allow my children the space to take care of themselves. They will make mistakes, of this I am sure. I make mistakes! There have been moments when I have left my facemask at home or forgotten to wash my hands. No one is perfect.

My children may succumb to peer pressure, noticing that not all their friends are taking precautions. I choose to view this as a test run, an exercise in doing the right thing and making responsible choices. Very soon, they will be faced with more difficult decisions regarding sex, drugs and drinking. Considering this, I am grateful they have an opportunity to develop their sense of self and integrity before the big stuff hits.

I acknowledge that being able to choose whether or not to send my children back to school is a privilege. I can consider this because we are all healthy and strong. No one in my family is ill. No one is immuno-compromised. We are blessed and I am not oblivious to the fact that, for some, this situation is exponentially more difficult. Even so, it was not an easy choice for me to make.

After sharing my decision with my parents who are in their mid-60s, they wondered if they should continue to see my family once we return to school. Our safety bubbles are about to explode. With one child in elementary school and one in high school, their learning cohorts will, collectively, reach over 100 students and staff.

We are also a blended family, which includes a step-son on my side and two step-sisters on my ex-husband’s side. With all of our children returning to school, our safety bubbles are now over 400. I don’t think we can consider it a safety bubble any longer.

While I understand and support my parents’ hesitation, it still breaks my heart. This will be difficult for all of us, but we need to move forward in our lives. Whatever choice you make, there will be a cost to pay.

No matter what you decide to do with your own children, I know that you have given it copious thought and you are doing what you believe is right. I don’t judge you. I hope you don’t judge me. This is a difficult situation and we need each other’s respect and support.

Did you send your kids back to school? That’s the question we asked four Island Parent writers. Here are their answers and how they reached their decision on whether or not to send their kids back to school.

I decided in March not to send my son, Angus, back to school this fall. I beat the rush for the Distributed Learning programs and applied to a number of them. In May he was accepted into EBUS, out of SD91.

It took a lot of time for me to accept that I’d made the right decision. It was lucky I didn’t venture out of the house much in May, because everyone I ran into heard about how anxious I felt. Would this be detrimental to Angus—socially, emotionally, academically? And what about me and my own mental health? What had I done?!

Angus went to school at South Park, which changed last year from a choice school to a catchment school. We are not in the catchment, so even if we decide we’d like him to return in Grade 5 next year, the chances are there will be no space for him. And he made friends there. He loved his Education Assistant (EA). His classes were small and he’d received support.

But our bubble contains Angus’s grandparents. Mike has asthma. Angus has a hard time social-distancing. He can tolerate a mask for about 10 minutes. He puts things in his mouth when he’s overwhelmed—his hands, objects he finds around him. He needs physical touch—either for comfort, or (at school) to ensure he is paying attention. Unexpected routines and changes are a huge source of anxiety for him. Bricks and mortar school simply didn’t feel like an option.

Also, I wanted Angus to have support if schools closed again. I picked EBUS as an alternative to traditional school because it’s one of 16 Distance Learning (DL) options in BC that will allow students with a designation, like Angus with Autism Spectrum Disorder (ASD), the ability to earmark some of their special needs funding. EBUS lets us allocate $10,000 to services we feel Angus needs—an EA who will work with him two afternoons each week at home, occupational therapy, curriculum resources.

From March to June, Angus had two 20-minutes Zooms and one backyard visit with his EA. This year, if schools close again, I know he’ll receive more support than that.

Before the pandemic, I had talked to the school about homeschooling Angus in the afternoons, but they convinced me it wasn’t the right choice for him. When we had to learn from home I realized it was probably what I should have been doing all along. Angus was diagnosed with generalized anxiety disorder and had been prescribed anti-anxiety medication which we planned to start during spring break. While he was anxious at home, at school his anxiety was intense. He had daily meltdowns. We didn’t start the medication, but Angus’s anxiety has decreased considerably these last six months—and we’re in a pandemic!

I like teaching Angus, and he learns well at home. We continued all through the summer. I’m able to focus on the things he needs most assistance with, filling gaps to bring him up to grade level in subjects he finds difficult.

We started a multisensory phonics-based spelling program that has brought him from struggling to spell three-letter words to spelling multi-syllable words with confidence. He’s learned his multiplication tables. Because we can take our time, I rarely scribe for him and the legibility of his printing—which is hampered by his fine motor challenges—has improved considerably.

That said, he’s also learning how to type. I’m proud of his efforts and so is he. He experiences success, can take breaks when he needs to, and the only distraction is Charlie Brown the dog.

I know the option of homeschooling is not open to everyone. We’re lucky. I work from home, and my work is flexible—I am the festival director for the Victoria Festival of Authors, I write, and I edit freelance. I can take on less of the latter if I need to (which I definitely do) and since life during a pandemic doesn’t seem to correspond with flashes of creative brilliance, it’s really only festival work I need to balance with homeschooling.

Before Angus was born, I was an educational assistant. Therefore, I can convince myself—and more importantly my kid—that I know what I’m doing. And though Mike has returned to his job at Camosun College, our bubble is still relatively small—which is exactly how we want it.

Learning from home is definitely not the right choice for everyone, but it’s the best decision we could have made for our family.

Doesn’t have to be “Papa’s,” of course. Please replace that with whichever guardianship title suits you. I just like alliteration.

Also, I’m not a lawyer. I don’t even play one on the radio. So this ain’t legal advice (I threw in the “ain’t” there to solidify my point); it’s a balance of Googling and Papa paranoia.

There are many points of privacy we don’t have much control over without encasing our littles in bubble wrap or traveling with an entourage of tall, sunglasses-wearing security to fend off the paparazzi.

For instance, in Canada, it is legal for anyone to take a photo of you, or your kids, without your permission, if you’re out in public, or otherwise viewable from a public vantage point (if they’re not on private property), where you have no reasonable expectation of privacy.

It gets detail-y and law-y when it comes to commercial use, so I’m not venturing into that swamp.

What I am here to talk about is the protection of our kids’ personal privacy which we, as parents, have control over.

Everybody loves a baby photo or 20. It’s great to see children grow up through Facebook albums or Instagram accounts created to document their upbringing, but at some point, it’ll be time to think about the kid’s own autonomy, and what they might want when it comes to their image online.

The fact is, we all cultivate our online personas, whether a little or a lot. For digital natives growing into their own, having a backlog of images and milestones documented on a parent’s social media account and associated with their name might not be the coolest thing, dude.

I don’t know if the kids still say “dude.”

So, here are some ideas from Paranoid Papa Bud to balance showing your pride and joy off to the world…against them docking your coolness points later in life because of that photo of their naked butt in the bathtub when they were six.

Put yourself in their shoes. Many of us should be considered very lucky that our younger-days antics weren’t captured frame-by-frame for the entire world to see. Curate what you post, both for your audience (cull that series of face-in-birthday-cake shots down to one, rather than posting four similar ones) and your kids’ future rep.

I also don’t know if the kids are still concerned with their “rep.” I’m sure they are, but perhaps it’s called something different in 2020, like “Klout.”

Consider a nickname, or just use their initials. Especially if your real first and last name is on your social media accounts, maybe you address your little by the first initial of their first name. Many folks go by their first and middle names. Or, perhaps, a (hopefully non-embarrassing) nickname. Heck, I gave my daughter both a nickname (Kit Kat) and a hashtag (#PapaKidlet). Anything to slow down the search engines.

Ask. As they become aware of the internet and its direct connection to them—have them Google themselves or, better yet, have them Google you—check with them before posting photos or video of them. As their parent/guardian, you’re the one most allowed to post their likeness online, but like many other aspects of your relationship, this is a matter of respect. Show them that courtesy by asking, respect their decisions, and keep the conversation open and normalized.

Keep track of your media. There’s lots of internet out there, and it can be easy to lose track of where photos or video of your child have been uploaded. But, if you’re careful to keep it to, say, a couple or three main places, it’ll be easier to go back and pull any down which they may later find mortifying and request you remove. You do have a password manager to keep track of all those different passwords, right?

Watch identifiers. Scrutinize content pre-posting for anything which may make it easier to figure out your child’s city/school/home address. I’ve seen plenty of albums which include both a photo of the kid in a school wear, and another in front of their home with a visible street number. Doesn’t take much Google-Fu from there to find that house.

Engage in disinformation. That nickname you may be using? Ask them to consider using one of their own. Those cutsey screen names we used to use may be cringe-worthy today (ROOTBEERPOUNDER69420@ICQ.COM), but they also made it tougher to find us online.

Of course, as parents/guardians, we should be a part of any forms your child fills out asking for their name, address, phone number, date of birth, etc. But, unless it’s vital that the information be accurate (e.g., something for a health agency, government, etc.), consider keeping it to just their initials, using your work address, using your mobile or 000-000-0000 as a phone number, shifting their date of birth by a month or six, etc. Just keep it consistent in case some recall of the information is needed as a security challenge later.

It’s all about small deterrents to make OSINT (Open Source INTelligence, or using publicly-available records to gather information) on your family that much more difficult. While these ideas may not stop the most determined goofball from Googling you and yours, it should add enough noise to the signal to discourage the majority of ’em.

The National Ballet of Canada’s Ballet Fun for Kids gives access to fun projects and resources designed to bring the beauty of dance and live theatre right to your home. Learn more about ballet, watch clips of your favourite performances, practice your dance moves or get creative with arts and crafts. Just use your imagination and have fun!

national.ballet.ca

UBC is bringing a guided Play & Learn program to your living room with free live-streamed activity sessions on a variety of topics: art, science, nutrition, drama, wellness, enrichment and more. Sessions are accessible through a smartphone, tablet or laptop, and are designed for children to be able to participate without hands-on involvement from parents/guardians.

recreation.ubc.ca/get-moving/play-learn/

The YMCA’s YPlay aims to help build strong kids and a strong family at home. Activities are designed for a variety of ages and levels of ability and can be done from your family room for free. Choose from activities including: songs, arts & crafts, healthy play, physical literacy, physical activity and—coming soon—safety and story time.

www.ymcahome.ca/yplay

Sport for Life presents “Physical Literacy at Home” to help support parents and guardians and kids to develop physical literacy at home during the COVID-19 pandemic. These activities are selected from the PLAYBuilder resource. Sport for Life provides a new video on Tuesdays and Thursdays at

sportforlife.ca