Division of Reproductive Endocrinology and Infertility
The Division is one of the four clinical cornerstones of the Department of Obstetrics and Gynaecology; as such, we strive for and achieve excellence in patient care, teaching and research as these relate to the subspecialty. Historically, it has been a leader nationally and internationally.
The Division’s Goals are:
- To provide patient care that is recognized as being of exemplary standards; this includes having clinical services in the In Vitro Fertilization Program and the Fertility-Endocrine Clinic that provide leading-edge results.
- To provide excellent educational programs that incorporate undergraduate, postgraduate, fellowship and community teaching. The Division’s Fellowship Program (RCPSC Residency) must continue to be a sought-after training position.
- To undertake research activities in the subspecialty which are innovative and collaborative.
- To have the Division recognized nationally as a leader in each of these activities.
The current Divisional programs are as follows:
- The Royal College – Accredited Residency Program in Reproductive Endocrinology and Infertility
- The UBC Fertility – Endocrine Clinic
- The UBC Ovulation Induction Program
- The UBC In Vitro Fertilization Program
- The UBC Andrology Laboratory
- The UBC Gyn-Endocrine Laboratory
The first two of these programs, the Residency (“Fellowship”) program and the Fertility-Endocrine Clinic, provide a needed service for the profession and for the public respectively. As such, they are publicly funded and generate research output.
The remaining programs are specialized provincial services, also potentially generating research output, but they are also capable of generating revenue for the Division. In times of Departmental budgetary constraint, the ability to generate revenue for Divisional activities (particularly education and research) is highly desirable.
The workload for the Ovulation Induction Program has continued to expand as the number of clinicians undertaking gonadotropin therapy has increased. Logistical problems can occur if the number of patients reaches a critical number, particularly on weekends when skeleton nursing and laboratory staff have sometimes found themselves hard-pressed to perform blood-taking, intrauterine inseminations, and find time to counsel patients with no back-up. The logistical position for these activities is being monitored, and alternative-staffing arrangements introduced if necessary.
The activities of the Division’s IVF Program have undergone internal and external review in the past year and the results of treatment in the calendar year 2000 have been of leading-edge quality. Nevertheless, there has been a significant decline in the numbers of treatment cycles over the past three years. The Division plans a number of strategies to try to promote patient recruitment to the IVF Program, both through direct-to-consumer awareness an through solicitation of referring physicians. Introduction of these strategies will require assistance from consultants and a more “business-like” approach to delivery of services; but the philosophy of care in the Division will continue to be based on patients determining their own management with advice from their care-givers. Broadening the options for treatment within the Program (including the intention to introduce a program for in vitro maturation of oocytes) will increase the Program’s overall appeal.
The UBC Andrology Laboratory was based for almost 20 years in the Department of Pathology at UBC Hospital; the agreement to house the laboratory was terminated abruptly in mid-2000, reportedly because of cost constraints affecting the Department of Pathology. The Andrology Laboratory has relocated its activities to the Willow Pavilion and its service activities have been integrated with the activities of the Gamete Laboratory of the IVF Program. The integration of the two service laboratories has streamlined the Division’s functions in the area and has laid the foundation for a male infertility service, to be established in conjunction with the Fertility-Endocrine Clinic and the In Vitro Fertilization Program. Coordinating the activities of these programs is in progress. Once established, a male infertility program has the potential to increase the activity overall of the In Vitro Fertilization Program.
The Gyn-Endocrine Laboratory has always been fundamentally important to the Division’s activities. The availability of in-house assays of reproductive hormones has allowed continued development of the ovulation induction program and, later, the In Vitro Fertilization Program. The Laboratory is, like the IVF Program and the Andrology Laboratory, one of the Division’s potential sources for revenue beyond operating grants.
The Recurrent Pregnancy Loss Program at BC Women’s Hospital operates in association with the Division, in that its Director is a full-time Division member. However, the funding of the program and its geographic location in the BC’s Women’s Hospital render it functional’y as a program of the BC’s Women’s Hospital’s Reproductive Medicine Program (which operates independently of the UBC Division).