In this episode of UBC CPD In Practice, reproductive endocrinologist Dr. Jason Hitkari, co-founder of Olive Fertility Centre in Vancouver and clinical professor at UBC, joins host Dr. Chris Morrow for a practical conversation on fertility and infertility for primary care providers. Dr. Hitkari addresses declining fertility rates in Canada and BC, pointing to delayed childbearing as the dominant driver. He demystifies egg freezing, explaining who it benefits most (those 35 and under), its exponential uptake, and its out-of-pocket costs. The episode walks through what a basic primary care fertility workup looks like, including the value of AMH testing, pelvic ultrasound, and semen analysis, and clarifies when referrals should be made based on age-dependent timelines. Dr. Hitkari also addresses male fertility, same-sex and trans patients, and the challenges of rural access. The conversation closes with an overview of BC's new MSP IVF funding, including eligibility criteria and the reality of a growing waitlist — a welcome but still-limited step toward reproductive equity. © UBC Faculty of Medicine All Rights Reserved
Guest: Dr. Jason Hitkari
Host: Dr. Chris Morrow
Producer: Craig Ferguson
Music: "Stand With Me" by Adrian Walther licensed via SoundStripe
Episode Timestamps
[00:00] – Introduction and episode overview
[00:29] – Guest introduction: Dr. Jason Hitkari
[01:05] – Declining fertility rates in Canada and BC
[03:54] – The rise of egg freezing and its exponential uptake
[05:20] – Elective vs. medical egg freezing (oncofertility)
[05:51] – Cost of egg freezing and lack of MSP coverage
[06:44] – CFAS guidelines on egg freezing: who and when
[07:32] – The primary care provider's role in egg freezing counselling
[08:05] – When to investigate infertility: age-dependent timelines
[09:46] – The basic infertility workup in primary care
[10:51] – AMH testing: what it is and how to interpret it
[11:53] – Pelvic ultrasound and tube assessment (HSG)
[13:44] – Who should be referred to a fertility specialist
[14:17] – Approaching the "fertility assessment" request in primary care
[15:44] – Overview of fertility treatments: IUI, IVF, and ICSI
[17:43] – Male fertility: lifestyle factors and semen analysis
[21:21] – BC's new MSP IVF funding: eligibility and coverage
[23:00] – The IVF waitlist and what patients can expect
[23:39] – How patients access the funded IVF program
[24:03] – Equity and access: financial, LGBTQ+, and legal barriers
[25:21] – Rural access to fertility care in BC
[27:05] – Key takeaways for primary care providers
[28:24] – Knowledge nugget: a brief history of fertility
[30:18] – Credits and CME information
Studies & Research Mentioned
Janecka M, Mill J, Basson MA, et al. Advanced paternal age effects in neurodevelopmental disorders—review of potential underlying mechanisms. Transl Psychiatry. 2017;7:e1019. doi:10.1038/tp.2016.294
Janecka M, Haworth CMA, Ronald A, et al. Paternal age alters social development in offspring. J Am Acad Child Adolesc Psychiatry. 2017;56(5):383–390. doi:10.1016/j.jaac.2017.02.006
Grossman DC, Curry SJ, Owens DK, et al. Screening for Ovarian Cancer: US Preventive Services Task Force Recommendation Statement. In: StatPearls. Rockville, MD: Agency for Healthcare Research and Quality; 2018. https://www.ncbi.nlm.nih.gov/books/NBK442158/
Practice Committee of the American Society for Reproductive Medicine. Fertility evaluation of infertile women: a committee opinion. Fertil Steril. 2021;116(5):1255–1265. https://www.asrm.org/practice-guidance/practice-committee-documents/fertility-evaluation-of-infertile-women-a-committee-opinion-2021/
© UBC Faculty of Medicine All Rights Reserved