TORONTO - A renowned Ottawa doctor who admitted to professional misconduct after three women were artificially inseminated with the wrong sperm has been suspended for errors that a disciplinary panel said left the women's children grappling with a lifetime of "social and psychological pain."
The College of Physicians and Surgeons of Ontario panel stripped Dr. Bernard Norman Barwin of the ability to practice medicine for two months.
"It's hard to imagine a more fundamental error in your former speciality than to impregnate the right women with the wrong sperm," disciplinary panel chair Dr. William King told Barwin at the Thursday hearing in Toronto.
Barwin agreed last year to stop the practice of artificial insemination after the college filed notice it would conduct a hearing after three of his patients alleged they were not impregnated with the sperm of their chosen donors. Two had intended to be inseminated with sperm from their husbands.
One of the children born as a result of the insemination errors said outside the hearing that Barwin should have had his licence revoked permanently — the maximum professional punishment available to the panel.
"I don't know my medical history. That's kind of scary," said the man, now in his 20s. He and the three women and their families cannot be identified under a publication ban.
"I know I look like my mother. But who do I look like on my other half? I'll never know."
The fertility specialist reached a plea agreement with the medical college in which he admitted he "failed to maintain the standard of practice of the profession."
In addition to the licence suspension, the ruling also reprimanded Barwin and ordered him to cover the $3,650 cost of the disciplinary proceedings.
Barwin, a celebrated gynecologist who received the Order of Canada in 1997, stood expressionless as the reprimand was read out.
He told the hearing he did not know how the mix-up occurred. He had been practicing artificial insemination since 1973.
"Dr. Barwin accepts that errors in his practice, which would fall below the standard of care, resulted in his failure to provide his patients with offspring from their intended biological fathers," the agreed statement of facts said.
In a victim impact statement read by a lawyer for the medical college, one of Barwin's patients referred to as "Patient D," said the wrong insemination "has impacted me a lot with mixed feelings."
"It's like there are two stories. No. 1: Having a wonderful son in our lives. No. 2: "I feel 'violated,'" the statement said.
"With our strong family values we are dealing with this. But it does not take away that it is always there."
The statement of facts says "Patient D" had gone to Barwin in the mid-1980s to be inseminated with sperm from her husband, which had been frozen before he began cancer treatment. It was only in 2011 that she discovered through DNA testing that the son she had raised for more than two decades was not her husband's child.
The document states that another woman who was inseminated by Barwin, referred to as "Patient B," had been acting as a surrogate for her sister, who could not have a child with her husband. The family discovered in 2008 that the sperm used in the procedure was not his.
The third patient became pregnant from an insemination by Barwin in 2004. She raised her child for three years before learning the sperm used in the procedure did not come from the donor she instructed Barwin to use, the statement says.
Barwin was invested in the Order of Canada for his "profound impact on both the biological and psycho-social aspects of women's reproductive health."
A profile on the Governor General's website says he has contributed greatly to the Planned Parenthood movement and the Infertility Awareness Association of Canada.
He founded the non-profit, pro-choice organization Canadians for Choice, which gives away an annual Dr. Norman Barwin Scholarship to a graduate student studying sexual health and reproductive rights.
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<strong>1. Your fertility is mostly determined by genetics, which influences how many eggs you are born with. </strong> Doctors believe that the number of eggs you have at birth determines the length of time you will remain fertile. At birth, women have about two million eggs in their ovaries. For every egg ovulated during your reproductive life, about 1,000 eggs undergo programmed cell death. Other things, such as smoking cigarettes and certain types of chemotherapy, can accelerate egg cell death and promote an earlier menopause.
<strong>2. Regular menstrual cycles are a sign of regular ovulation.</strong> Most women have regular cycles lasting between 24 and 35 days. This is usually a sign of regular, predictable ovulation. Women who do not ovulate regularly have irregular menstrual cycles. Those who do not ovulate at all may have a genetic condition called polycystic ovarian syndrome (PCOS).
<strong>3. Basal temperature charting does not predict ovulation.</strong> An older method of tracking ovulation involves taking your oral body temperature each morning before getting out of bed. This is called basal body temperature. This method is used to spot a rise in basal temperature, which is a sign that progesterone is being produced. The main problem with using this method is that your temperature rises after ovulation has already occurred. This makes it more difficult to time intercourse at an optimal time for conception. A better method is to use over-the-counter urine ovulation predictor test kits such as Clearblue Easy. These kits test for the hormone that prompts ovulation, which is called luteinizing hormone (LH).
<strong>4. Most women with blocked fallopian tubes are completely unaware they may have had a prior pelvic infection.</strong> About 10 percent of infertility cases are due to tubal disease, either complete blockage or pelvic scarring causing tubal malfunction. One major cause of tubal disease is a prior pelvic infection from a sexually transmitted disease such as chlamydia. These infections can cause so few symptoms that you may be completely unaware your tubes are affected. This is why fertility physicians will order a dye test of the tubes, called a hysterosalpingogram (HSG), if you have been trying and failing to conceive for 6 months or longer.
<strong>5. In most cases, stress does not cause infertility.</strong> Except in rare cases of extreme physical or emotional distress, women will keep ovulating regularly. Conceiving while on vacation is likely less about relaxation than about coincidence and good timing of sex.
<strong>6. By age 44, most women are infertile, even if they are still ovulating regularly.</strong> Even with significant fertility treatment, rates of conception are very low after age 43. Most women who conceive in their mid-40's with fertility treatment are using donated eggs from younger women.
<strong>7. Having fathered a pregnancy in the past does not guarantee fertility.</strong> Sperm counts can change quite a bit with time, so never assume that a prior pregnancy guarantees fertile sperm. Obtaining a semen analysis is the only way to be sure the sperm are still healthy!
<strong>8. For the most part, diet has little or nothing to do with fertility.</strong> Despite popular press, there is little scientific data showing that a particular diet or food promotes fertility. One limited study did suggest a Mediterranean diet with olive oil, fish and legumes may help promote fertility.
<strong>9. Vitamin D may improve results of fertility treatments.</strong> A recent study from the University of Southern California suggested that women who were undergoing fertility treatments, but had low vitamin D levels, might have lower rates of conception. This vitamin is also essential during pregnancy. At Pacific Fertility Center, we recommend our patients take 2,000-4,000 IU per day.
<strong>10. Being either underweight or overweight is clearly linked with lowered levels of fertility.</strong> The evidence in recent years is that obesity is clearly linked with a longer time to conception. Having a body mass index less than 18 or over 32 is associated with problems ovulating and conceiving, as well as problems during pregnancy.