Dr. Geneviève Genest is an immunologist and allergologist at the Montreal General Hospital. She is the founder of the first and only Reproductive Immunology Clinic in Canada. She also offers the only Canadian training in reproductive immunology available through her fellowship program.
As an authority in her field, she sees patients from all over Canada and, although she currently works alone, she is on a mission to share her expertise by training other physicians. Her recent teaching session as a visiting expert at Harvard’s Grand Rounds presented her latest work in understanding the relationship between the immune system and recurrent miscarriages.
Dr. Geneviève Genest acquired this confidence and knowledge under the leadership of her mentor, Dr. Phil Gold, former Chair of the Department of Medicine at McGill and former Physician-in-Chief at the Montreal General Hospital. Thanks in part to the guidance and wisdom of this highly regarded doctor, Dr. Genest specializes in a medical area that is still relatively unexplored and yet so vital.
A Unique Clinic to Address Immune System Dysfunction
Recurrent miscarriages, failed attempts at in vitro fertilization (IVF) and infertility, all unexplained. For one out of six couples suffering from reproductive difficulties, this painful reality is sometimes the end of their journey towards starting a family. As she points out, “Infertility or repeated miscarriages is a marathon, not a sprint. Unfortunately, there are ups and downs, grieving, and emotions that come up. By the time patients arrive at my clinic, they are at a very high point of vulnerability.”
However, there is one significant avenue that Dr. Genest believes has not been fully investigated: the imbalance of the uterine system. Her hypothesis is that this immune system problem affects both conception and maintenance of pregnancy. To this end, Dr. Genest has treated many patients with unexplained recurrent Miscarriages with a blood product called intravenous immunoglobulin (IVIG), a molecule used to treat several autoimmune diseases. Used in fertility, this molecule aims to restore the immune system’s ability to recognize the embryo, help it implant and avoid rejecting it.
The results of these trials are astounding, in the first 6 years of the program, the pregnancy rate was over 60% for these hundreds of women who had previously failed all other treatments. “From the moment I was able to see what this molecule could do for these women who were unable to develop or maintain a pregnancy, I became completely fascinated and invested in this project,” Dr. Genest stated.
Reshaping the Standards: A Blessing in Disguise
“During the pandemic, we never stopped our activities. We adapted, like everyone else. However, on our side, the big problem we faced was the shortage of blood donors,” Dr. Genest said. As blood products became limited, they were reserved for those who absolutely needed them. The molecule used, intravenous immunoglobulin, was therefore no longer available for reproductive immunology treatments. For two years, this situation led Dr. Genest to explore other approaches to treat her patients. Driven to help them become parents, Dr. Genest turned this obstacle into an opportunity by finding several new treatment options. Even without access to intravenous immunoglobulin, Dr. Genest’s clinic has seen more than one in two women with infertility problems achieve pregnancy with the use of newly discovered molecules in this area.
As part of her research, Dr. Genest is also trying to develop a diagnostic test to run her clinic, “identifying that the infertility problem is related to the immune system is critical to offering personalized and adapted treatments,” she stated. ”Currently, we use a diagnostic method by exclusion, which means that we treat women whose previous tests appear normal, but who still cannot develop or maintain a pregnancy,” she adds. By developing diagnostic tests, such as blood tests, Dr. Genest hopes to improve the accuracy of treatment for her patients. Ultimately, she aspires to help the many women who suffer from not having any explanations, whether it be by bringing them to her clinic or by giving them a sense of what is going on.
Without Dr. Genest’s outstanding work, hundreds of patients would remain trapped in this “black box” of uncertainty and misunderstanding. Her support is essential and vital. To continue to develop the only immuno-fertility clinic in Canada, she needs help and resources, which is why she is looking to hire a dedicated nurse to help her coordinate the clinic she is currently running alone. Please help her provide a happy ending for all these families!